Abstract
BackgroundGlobally, there is increased advocacy for community-based health insurance (CBHI) schemes. Like other low and middle-income countries (LMICs), Tanzania officially established the Community Health Fund (CHF) in 2001 for rural areas; and Tiba Kwa Kadi (TIKA) for urban population since 2009. This study investigated the implementation of TIKA scheme in urban districts of Tanzania.MethodsA descriptive qualitative case study was conducted in four urban districts in Tanzania in 2019. Data were collected using semi-structured interviews, focus group discussions and review of documents. A thematic approach was used to analyse the data.ResultsWhile TIKA scheme was important in increasing access to health services for the poor and other disadvantaged groups, it faced many challenges which hindered its performance. The challenges included frequent stock-out of drugs and medical supplies, which frustrated TIKA members and hence contributed to non-renewal of membership. In addition, the scheme was affected by poor collections and management of the revenue collected from TIKA members, limited benefit packages and low awareness of the community.ConclusionsSimilar to rural-based Community Health Fund, the TIKA scheme faced structural and operational challenges which subsequently resulted into low uptake of the schemes. In order to achieve universal health coverage, the government should consider integrating or merging Community-Based Health Insurance schemes into a single national pool with decentralised arms to win national support while also maintaining local accountability.
Highlights
Over the past few decades, the global community has been advocating for Community-Based Health Insurance (CBHI) schemes in order to increase access to healthcare services and achieve Universal Health Coverage (UHC)
Most recently, many Low and Middle Income countries (LMICs) have included community-based health insurance (CBHI) in their strategies towards UHC which advocates for countries to guarantee all people access to healthcare services without facing financial deprivation [2]
This study investigated the implementation of Tiba Kwa Kadi (TIKA) scheme in urban districts of Tanzania
Summary
Over the past few decades, the global community has been advocating for Community-Based Health Insurance (CBHI) schemes in order to increase access to healthcare services and achieve Universal Health Coverage (UHC). CBHI follows the principles of insurance including resource pooling, prepayment and risk-sharing and negotiation with other partners in the health system to improve access and quality of healthcare services. Most recently, many Low and Middle Income countries (LMICs) have included CBHI in their strategies towards UHC which advocates for countries to guarantee all people access to healthcare services without facing financial deprivation [2]. Like other low and middle-income countries (LMICs), Tanzania officially established the Community Health Fund (CHF) in 2001 for rural areas; and Tiba Kwa Kadi (TIKA) for urban population since 2009. This study investigated the implementation of TIKA scheme in urban districts of Tanzania
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