Bernard Konga, the director general, told a press conference to announce the new packages in Dar es Salaam yesterday that NHIF said the fund has made improvements to the benefits package for various purposes.
These include the need to widen services to the public and strengthening control measures to prevent fraud, while the move is also intended to enhance the provision of health services to NHIF members.
The roll out seeks to ensure NHIF sustainability and increase access to affordable healthcare for more people, he said, noting that the purpose of the improvement is to align the benefits package with the national essential medicines list and the standard treatment guidelines, he said.
He explained that the new package for surgical services takes into account input costs and actual market prices, expanding the scope of ‘super-specialist’ surgical services, underlining that the current package has not been updated since 2016.
Changes that the NHIF sees as improvements relate to its enabling act, Article No. 39 of the NHIF Act, implying that reduced charges that private hospitals are demanded to accept are intended to ensure a positive outlook of the fund’s lifespan and sustainability.
Key services revised in the new packages include medical doctors’ consultation fees, drug access services, surgical services and routine clinical and super specialized clinical services, he said, elaborating that rolled out ‘improvements’ were set out at different stages where at various points stakeholders were being consulted.
At the start of the year when the move was being put into motion and private health care providers rejected the packages, Health minister Ummy Mwalimu sought to address the concerns and prevent service disruptions, holding a consultative meeting with auxiliary stakeholders, namely civil society bodies of community health care providers.
Those asked to attend the meeting were representatives from the Christian Social Services Commission (CSSC), the Medical Association of Tanzania (MAT) and the BAKWATA Medical Association affiliated with the nationwide Muslim Supreme Council, as well as the Association of Private Health Facilities in Tanzania (APHFTA) being in attendance.
Health sector officials say the meeting's outcome brought about a significant shift as the minister promised to prioritise transparency and collaboration, holding back the start of application of the new packages.
She instructed a thorough review pending further discussions with stakeholders, which observers say is being made difficult by the need to start applying the law on universal health coverage already signed by President Samia Suluhu Hassan with NHIF as the principal channel of implementation
Officials said that an independent committee was formed to objectively assess the revised benefits, but APHFTA reacted in a statement yesterday saying the new packages will push private hospitals to severe losses, making them close their businesses.
Most private hospitals will die a natural death as the new packages will increase operational costs while service charges are sharply decreased to be aligned with public health centres and hospitals.
A number of well-known private health care have reportedly expressed their reluctance to receive NHIF clients on the basis of the new charges, including Kairuki, TMJ, CCBRT, Masana, Regency, Rabinisia, Aga Khan and Bochi, all located within the city of Dar es Salaam.
Dr Egina Makwabe, the APHFTA chairperson, said that despite the formation of a committee by the minister responsible for health, there are no changes made to the packages as expected.
“The revision of the changes were made in 2016 and since then they have not made any changes despite the rise in the cost of living,” she said, making the new rollout fall into the same situation as when NHIF suspended the rollout of the revised indicative prices.
They were originally slated for January 1, 2024 but received tremendous stakeholder criticism when an outline was made or circulated to stakeholders with potential boycott of NHIF clients at private hospitals.
The same situation is back in place as the packages are in tune with the precepts of the universal health coverage legislation, where apparently private hospitals are asked to obtain on similar cost levels as public hospitals.
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