A Dissertation Submitted in Partial Fulfillment of the Requirement for Award of Degree of Master of Business Administration (MBA) of Mzumbe University
The study aimed at assessing the functionality of the health insurance system in Tanzania using the National Health Insurance Fund (NHIF) as a case study. Specifically, the study aimed at examining the health package provided to various categories of clients, assessing the user perception concerning the services delivered at various health facilities and examining the challenges facing NHIF in delivering service to its members and beneficiaries.
The study used a total of 140 respondents comprised of NHIF members and beneficiaries, providers of health services and officials from NHIF. Stratified sampling was used whereby the targeted population was divided into groups based on the services that they provide. A purposive random sampling was used to select elements from each stratum to form the sample. The interview and questionnaire data collection methods were used to collect primary data while secondary data were collected from various documents.
The study finds that delivery of health services in government hospitals face serious problems of shortage of qualify staff, shortage of medicines, and poor quality of health services. The private hospitals are performing better in terms of health service provision, quality of staff and availability of medicines and quick responses to the customers’ demands. Insufficient health benefits packages to satisfy in curative services from NHIF, long waiting for laboratory tests and in seeing medical doctors, discrimination of card holders in some health facilities, and abuse language were mentioned as some of the challenges facing NHIF clients. Other challenges include increasing number of retirees who are not contributing anymore but continue to use the services, and fraud whereby some clients misuse the membership cards. The study concluded and recommended to improve and strength the human resources capacity of health sector, put in place motivation and attractive atmosphere for both public and private sector in order to improve the services delivered to NHIF clients and the population at large.