Capacity building on national health insurance
Project properties
- Partners: Germany
- Status: In progress
- This project is part of the Global Flagship Programme on Building Social Protection Floors for All
Description
In 2023, the Government of the United Republic of Tanzania and the Revolutionary Government of Zanzibar took a major step towards expanding health insurance coverage by enacting the Universal Health Insurance (UHI) laws in Zanzibar (March 2023) and mainland Tanzania (December 2023). These reforms aimed to improve access to quality health care and offer financial protection to citizens, particularly in response to the rising out-of-pocket health expenditures, which increased from 22% in 2015/16 to 32% in 2019/20, as reported in the National Health Accounts 2022. The Universal Health Insurance Act of 2023 for mainland Tanzania introduced wide-ranging health system reforms. These included mandatory health insurance, the establishment of a public health insurance fund, development of a standard benefit package, and the regulation of the scheme through the Tanzania Insurance Regulatory Authority. The Act also supported complementary private health insurance and mechanisms for identifying and financing the poor. Both mainland Tanzania and Zanzibar incorporated the creation of an “Equity Fund” to subsidize health coverage for disadvantaged populations, with financing sourced from levies on items such as carbonated drinks, liquor, cosmetic products, gaming, motor vehicle insurance fees, and electronic transactions. The Tanzania Insurance Regulatory Authority was designated as the regulatory body for the scheme, tasked with implementing structural and institutional adjustments, including the establishment of a dedicated directorate for universal health insurance, regional expansion of regulatory services, and implementation of public awareness campaigns. Health insurance has demonstrated its effectiveness in enhancing equitable access to health services and reducing financial risk in various countries including Tanzania, Rwanda, Ghana, and Ethiopia. Improved service utilization, lower out-of-pocket expenditures, and reduced catastrophic health spending have been noted outcomes. For Tanzania, reaching the informal sector—which employs 85% of the workforce—is critical to achieving broad population coverage. Emphasis was therefore placed on strengthening systems and institutions that target informal sector inclusion and ensuring that poor households, women, children, and youth are not left behind. The introduction of new managing and oversight institutions has created a significant demand for capacity building in core social health insurance functions, particularly in financial governance, enrolment, claims management, and monitoring and evaluation. The project seeks to respond to this need through a partnership with relevant stakeholders, leveraging the International Labour Organization’s expertise in social health protection to design and implement a tailored capacity building programme. This initiative is aligned with the International Labour Organization’s Programme and Budget 2024–2025 under Outcome 7: Universal Social Protection. It contributes directly to global and country programme outputs on strengthening social protection systems, with particular focus on gender-sensitive coverage and the inclusion of vulnerable and informal sector groups. The project also supports the realization of Sustainable Development Goals 1.3 and 3.8 and reinforces the ILO’s commitment to coordinated action within the United Nations system at both global and national levels.SDG
Goals
- End poverty in all its forms everywhere
- Ensure healthy lives and promote well-being for all at all ages
Time
11.03.2025 - 31.01.2026
Budget
0 / 170,706
Development Cooperation