Tanzania
Health Insurance Fund proposal
In December 2006 a scoping study was carried out in Tanzania as a first step to determine whether this country is suitable for implementation of a Health Insurance Fund program. The scoping study demonstrated that Tanzania offers promising opportunities for a Health Insurance Fund program.
Local insurer
Following this scoping study, PharmAccess developed a proposal for a program in Tanzania and identified a local insurer, Strategis Insurance Limited, as the most favourable executing partner for the program. Strategis was selected based on criteria such as financial organization, coverage and medical quality and capacity. The selection process included a financial due diligence, which was carried out by a reputable, internationally recognized accountancy firm.
Target groups
Potential target groups matching the Health Insurance Fund’s criteria were identified. These groups include workers at the Dar es Salaam fish market (fishermen, auction workers, cooks); people with a micro credit in Dar es Salaam; and coffee farmers involved in organic coffee farming in Arusha/Moshi in Northern Tanzania.
Benefit package
PharmAccess and the local insurance partner developed the insurance benefit package, set the premiums, and developed operational processes for enrollment of members and premium collection.
The design of a benefit package for the Health Insurance Fund Tanzania program is based on several factors. Firstly, the wishes of the target groups are incorporated as much as possible. Secondly, the main diseases will be covered by the Health Insurance Fund insurance package. Thirdly, the package is benchmarked against other insurance policies currently available in Tanzania. The result is a basic package with primary care and limited essential secondary care including some hospitalization days and medication.
The implementation of the program is expected to start in the second quarter of 2009.