We can achieve universal health coverage

THE government envisions a country where mandatory health insurance for all is the key driver of healthcare delivery.

Nonetheless, making the scheme workable will require making tough decisions and working out a strategy, which would help all Tanzanians appreciate the value of being insured.

As heath advocacy organisations convened in Dar es Salaam recently to ponder on how to guarantee healthcare access to the poor and marginalised, the big question to all health stakeholders.

We were told that a bill would be tabled in the National Assembly as part of the country's plan to introduce the mandatory health cover. However, it has not been tabled yet.

In other countries, reports show that two low income countries in sub-Saharan Africa have achieved high health insurance coverage. They are Rwanda and Ghana.

By 2012, in Rwanda the coverage was over 80 per cent while in Ghana it was over 60 per cent, according to a study, "Equity in financing and use of health care in Ghana, South Africa, and Tanzania: implications for paths to universal coverage," in Lancet Journal.

In Tanzania, only about 30 per cent of the people can access health insurance, according to current government data.

The rest, over 35 million people are forced to dig deep into their pockets when they want to access services at health facilities.

The government is now striving to expand health insurance coverage to 50 per cent of all Tanzanians by 2020.

In view of this, the government's vision of ensuring that every Tanzanian gets mandatory health cover is seen as a game-changer. But, there are challenges to overcome if the plan is to be successful.

The government must only focus on streamlining policy issues and mobilising the health stakeholders as it paves the way for implementing the plan.

There has been a clamour from various stakeholders, asking the government to review the strategy. Private health sector investors have specifically cautioned about the monopoly of Universal Health Coverage (UNC) strategies, whereby the government relies on the NHIF for implementation, side-lining the private sector.

Tanzania for many years, insists that it was risky to surrender this huge healthcare plan to the government.

He says government structures have been known for not having stable administrative strategies.

Currently, the government shoulders a burden of over 70 per cent of people who receive healthcare by exemption.

Health insurance is what will save the poor and marginalised people from the challenges of accessing healthcare.

In 2015, the World Bank (WB) released a report, which showed that the rate of impoverishment for people who pay out of pocket for healthcare stood at 2 per cent.

In its first ever report tracking down the worldwide coverage for health, the WB revealed that the poverty situation was worse among the people who could not access the prepaid health services, especially in countries that have invested a small share of their national budget for health.

The World Health Organisation had once cautioned that a split between formal and informal populations can delay more fundamental reforms to reach citizens at scale. We must not relent on our efforts to bring about mandatory health insurance for all the people.