Acting Director General (National Health Insurance)

H.E Jakaya Kikwete has had two wonderful terms that has put Tanzania on the right Track to attain its Vision 2025 – to make Tanzania a Middle-Income Country. Regarding the health sector, what in your opinions are the President’s main achievements?

Honourable President Jakaya Kikwete during his ten years in leadership of our country has achieved a lot of things including health care maintenance and growth in Tanzania; he has participated in various global initiatives on health and other endeavours which has earned him and our country international recognitions. Here in Tanzania health insurance is now available, accessible, affordable and open to the majority of population both in urban and rural areas where they have better access to a wide network of private, faith based and public health care facilities. There is a remarkable improvement in the country’s health infrastructures, increased stakeholders participation through dialogue and increased community participation in decision making through governing committees and health boards. Furthermore anti-poverty strategies are in place to ensure the poor has access to health care services. During his tenure he was heavily involved in advocating the concept of social health insurance as a result, the scope of coverage of National Health Insurance Fund (NHIF) and Community Health Insurance (CHF) was exponentially increased from 3% in 2004/2005 to 23% by June 2015. We consider ourselves as most privileged to enjoy his political will and now we are ready for the Universal health coverage in few years to come.  

The health sector has become of real importance in Tanzania leadership– What are the factors that explain such a growth in the market? Detail for us the Challenges and opportunities

It is true that health sector has become of real importance in Tanzania leadership, there are various factors that explain such a growth in the market; the introduction of several health Insurance schemes in the country such as National Health Insurance Fund (NHIF) which has played a great role in health care maintenance and enhanced the public private partnership in the country whereby for example the Fund is dedicated to providing support to the beneficiaries to access health services through a wide network of accredited quality health facilities throughout Tanzania. The challenges which we face at the National Health Insurance Fund include; medicines stock-outs to some facilities where our members access services especially in rural areas, shortage of some diagnostic equipments in some health facilities and the use of manual system by providers to lodge their claims to us. We have introduced a soft loan arrangement for medicines, diagnostic equipments and information systems to address those challenges. Fortunately the challenges have turned out to be opportunities as most of the health facilities are now applying for loans geared to address a particular challenge and depending on the need. By and large the situation has improved, there are gaps here and there and those are our focus in the meantime.

The National Health Insurance Fund is a Public institution established by the Act No.8 of 1999 (CAP 395 R.E 2002) with the main objective of ensuring health care services to; employees in the public, private, other groups are available, accessible and affordable to contributing members and their respective legal dependents – How do you think NIHF will be supporting his Excellency’s effort to attain Tanzania’ Vision 2025 – Make Tanzania, a middle-income country

First and foremost we are obliged to ensure that the objectives of establishing NHIF are realized and maintained at all times. We have learned this from his Excellency President Jakaya Kikwete on the imperative need of having dialogue with our members and stakeholders, we shall continue cherishing healthy dialogue in order to improve services and customer satisfactions.  NHIF will continually be supporting his Excellency’s effort via various ways such as; Provision of loans geared to improve internal capacity for the provision and delivery of health services in the country, construction of government sponsored undertakings such as modern health facilities like Twin towers at MOI and  the Benjamin Mkapa Utra modern Hospital  at the University of Dodoma (UDOM),  secondly is the provision of health services to contributing members of the Fund who have retired from gainful employment, this is  designed to serve a husband and wife. Towards 2025 we shall actively participate in the BRN program by reimbursing promptly all services providers according to their star level rating and shall continue to participate in health care development projects through government sponsorship, we will give more emphasis on health education and promotions especially in rural areas, in so doing we believe the aims of achieving high quality livelihood for our people will be realized because they will be healthier and will definitely  participate in social development endeavours without fears of catastrophic health expenditures once they fall sick because they will have proper health insurance coverage.

What are the different benefits of being part of the National Health Insurance Fund? What are the benefits for Tanzanians?

The National Health Insurance Fund has entered into contractual agreements with various service providers throughout the country. At these facilities our beneficiaries are entitled to access eleven benefits which include the following: Registration, member of NHIF will benefit especially to covers costs related to Registration and Consultations in hospitals and in the health centres and even at dispensaries, secondly Outpatient Care Services, The Fund covers for the costs relating to medicines prescribed in Generic names and medical consumables as per the National Essential Medicines List (NEMLIT) and additional medicine list recommended (to NHIF) by experts, not only that but also Retirees Health Benefits, Comprehensive Medical Services are offered to the Retired principle members and their spouses, in their post retirement life , The Fund covers for the costs of Investigations and Diagnostic tests as per the Investigation List in the benefits package. There are 143 Investigations including Ultrasound, Echocardiography, CT-Scan and MRI. There are other benefits package offered by NHIF which include Surgical Services, Inpatient Care Services, Physiotherapy and Medical/Orthopaedic Appliances and lastly surgical services. The Fund do also covers for minor, major and specialized surgical services done by super specialist at specialized hospitals. We have a wide and comprehensive benefits package south of Sahara.

What are the different awards the NHIF have received over the past years? Explain what were the reasons behind those awards?

The National Health Insurance Fund (NHIF) of the United Republic of Tanzania has received the International Social Security Association (ISSA) Good Practice Award for Africa 2011 for improvements in its health insurance scheme. The International Social Security Association (ISSA) Good Practice Award, which was presented at a ceremony in Arusha on 5 December, was given to the NHIF for its strategic approach to improving its medical benefits package and health-care facilities, which has resulted in greater availability of medical services and an increase in the population which has access to health insurance in Tanzania. The ISSA Good Practice Award programme is organized on a regional basis over a three-year cycle, with the competition for Africa 2011 attracting 42 entries from 19 countries representing 21 organizations.

What is your national coverage network in term of services?

The NHIF has established Offices in all regions in the Mainland and an Office in Unguja to serve members who are under the Union Government, we are now closer to our members that before. .NHIF beneficiaries are accessing health services through a wide network of accredited health facilities of more than 6,000 health facilities which  include government and non-government owned health facilities, these are geographically scattered all over the united republic of Tanzania. Type and levels of accredited health care facilities under the Fund include:-National Hospital, National equivalent hospitals, Zonal and Regional referrals, District/Designated/Council Designated Hospitals, Accredited Drugs Dispensing Outlets (ADDOs) and Diagnostics Centres (Imaging and Laboratories) and specialized clinics With regards to Community Health Fund we have a network of more than 144 CHF Coordinators whom we are working with in 167 Local Government Authorities.

What is your investment portfolio?

The Fund has investment portifolio that caters for short term and long term avenues. For short term the Fund invests on short term government securities and deposits in banks. As for long term investments the fund invests in, Treasury bonds, corporate bonds, shares and in governments sponsored project such as development of health sector infrastructure.  

From a more personal perspective now, when you look back over the past year, what do you feel most proud of?

I have been developed from within, I started as a Principal Actuary in 2001 and now I have been promoted to act as the Director General of National Health Insurance Fund (NHIF). The beginning was so challenging because the concept of health insurance was relatively new to majority of Tanzanian. I am proud to be in the team that participated to turn around that situation and almost everybody now is happy with what we are doing here. There are several areas achieved by NHIF that make me feel most proud of, such as; the introduction of medical and equipment facility portfolio in 2007,, for example the construction of hospitals and the loans to buy the equipment, secondly Provision of health services to retirees which is not common in traditional health insurance schemes. We have an improved benefits package that is very comprehensive as compared to other schemes south of Sahara. We are also proud on the way His Excellency has been pushing development of the health sector, he is so close to the health sector, we are more proud of him, the Ministry of health and social welfare and the entire government for uplifting this Fund to this unprecedented height.