A Dissertation submitted to the School of Public Administration and Management
in Partial Fulfillment of the Requirement for the Award of Degree in Master of
Science in Health Monitoring and Evaluation( MSc-HME) of Mzumbe University
The National Health Insurance Fund (NHIF) was established under the National Health
Insurance Act No. 8 of 1999 as contributory Social Health Insurance Scheme.
Social Health Insurance Scheme is a health scheme insurance which is provided by the
governments to its employee. Tanzania presented social health insurance by creation of
the National Health Insurance Fund (NHIF) in 1999 with the objective of improving the
quality and accessibility of health services to Government employees. NHIF facilitates
admission of health care services to its beneficiaries through a network of accredited
health facilities nationwide. This study evaluated implementation of NHIF benefit
package in selected accredited health facilities, challenges encountered and
improvement measures.
The study was conducted in Dar es salaam, Ilala Municipal whereby a facility based
Case studies of both quantitative and qualitative nature was carried. A total of 300
beneficiaries, 10 NHIF staff from Ilala office and respondents from 10 selected
accredited health facilities participated in the study. The study population comprised of
both male and female respondents aged 21 to 60 years with the education level from
secondary to university and above, (80%) had a working experience of more than five
years. Quantitative data were processed and analyzed by using Microsoft excel and
Statistical Package for Social Sciences (SPSS) software while Atlas ti. Software was
used to analyze Qualitative data. Over half of the respondents (over 50%) agreed that
NHIF objectives were achieved and there are several items within the benefit package
that can be accessed by the beneficiaries from accredited health facilities. Besides, a
number of challenges were reported to have been encountered by the accredited health
facilities in the process of implementing the NHIF service provision as per benefit
package. For example, 60 % mentioned lack of modern diagnostic equipment‘s, 80%
mentioned Medicine out of stock, 90% mentioned delayed reimbursement of funds from
NHIF, 17% Unrealistic prices for some items within the package, 15%.Services not in
the package, 90% shortage of staff and lack of space.
From these findings, the following recommendation can be drawn; more effort is still
needed to address the challenges encountered by accredited health facilities and increase
awareness on benefit Package. Government set a policy to establish regulatory authority
to govern price of services in Health sector, timely claims reimbursement. However,
measures are needed to be taken to strengthen and improve services within the facilities;
take measure to address the issues of unrealistic prices on some of the services and
include the services that are not in the current package but much needed by beneficiaries
and final recommendation is to increase budget in Health Sector