A Dissertation Submitted to Mzumbe University in partial fulfillment of the Requirements for Award of the Degree of Masters of Health System Management (MHSM) of Mzumbe University
Community Health Fund (CHF) is the scheme which was established by the CHF Act of 2001,so as to identify possible mechanisms for accessing basic health care services particularly among the population in rural areas. In Tanzania, the scheme was first introduced in Igunga as a pilot district in 1996.
The general objective of the study was to determine the challenges encountered by community health fund in provision of health care services in Dodoma Municipal. Specific objectives of the study were to assess the availability of the essential drugs through CHF in the health facilities, to assess the time spent by CHF members to access health services in health facilities, to identify the availability of the health personnel in the health facilities to provide health services under CHF scheme and to asses CHF awareness among the community members.
This study was conducted in Dodoma municipal council which has a population of 410,956 people according to national census of 2012. During the study the researcher applied a case study design where both probability and non- probability sampling methods were used. The sample size consisted of 105 respondents of which 1 was ward executive officer, 3 health care providers, 1CHF coordinator and 100 heads of households. Data collected was analyzed and edited so as to ensure accuracy by using statistical package for social science programme (SPSS).
During the study the researcher got the following findings encountered by community health fund in provision of health care services in Dodoma Municipal: 72% of the respondents said could argue that waiting time when accessing health services through CHF scheme is a challenge, 47% of the respondents said that they were able to pay for the services. However, they could not join the scheme due to lack of awareness. 90% of the respondents argued to have a little knowledge on the CHF package while 72% pointed out unreliable health services as one of challenges encountered by CHF in provision of health services. 86% of the respondents stated that lack of sensitization is one of the challenges encountered by the CHF scheme in provision of health services.
In order to address the Challenges encountered by CHF in provision of health services; The government should make a detailed review on the amount of contributions among CHF members and that CHF membership should be mandatory for all the people in the country and not voluntary. Drug audit should be a common practice in health facilities and that uniform mechanism of accessing health services should be practiced among both NHIF and CHF members. The government should also employ enough health staff in health facilities in order to improve to quality of health services provi