Universal Health Coverage (UHC) Tanzania


Tanzania is investing heavily in reforming sustainable health financing and leveraging integrated digital solutions to advance Universal Health Coverage and ensure that all Tanzanians have access to any quality health services they need, when and where they need, without financial hardship. Together with other development partners, Switzerland uses this momentum to support the government in establishing a Universal Health Insurance and the Center for Digital Health.

Country/region Topic Period Budget
Tanzania
Health
Governance
Employment & economic development
nothemedefined
Health systems strengthening
Information and communication technology (ICT)
Primary health care
Social protection
01.02.2023 - 28.02.2028
CHF  5’220’000
Background Tanzania has made substantial efforts in improving primary healthcare services by increasing the number of health facilities, healthcare workers and medical equipment. This has led to improved healthcare service utilization and better health outcomes. However, health system inefficiencies and health financing remain major bottlenecks to ensure universal health coverage to all Tanzanians while ensuring financial protection against sickness. Currently, only 15% of the population in Tanzania mainland is covered by any health insurance, while almost non-existent in Zanzibar.
Through Switzerland's funded 'Health Promotion and System Strengthening' HPSS project, the government has reformed and rolled out nationwide a community-based insurance for the rural population and informal sector, called Community Health Fund with its Insurance Management Information System. By the end of the project in October 2023, 5% of the Tanzanian population was enrolled in the Community Health Fund.
In 2023, both governments, Tanzania mainland and Zanzibar, have fast-tracked their commitment to establish a mandatory health insurance, by enacting a specific law. The two health ministries are at different stages of operationalization, but similarly struggle with structural, systemic and legislative limitations.
In parallel, both ministries recognize the transformative power of digital health technologies and its immense potential to optimize healthcare delivery, enhance responsiveness, and foster the attainment of universal health coverage. Respective digital health strategies are implemented with more or less success, mainly due to weak governance and coordination of digital innovations and slow integration in the health system.
Objectives Support efforts of the government of the United Republic of Tanzania to progress towards Universal Health Coverage for its population, especially the youth and women.
Target groups

Primary target groups are the central government ministries, departments and agencies (regulatory authorities and health insurance fund), both in Tanzania mainland and Zanzibar.

Secondary target groups are healthcare providers at the decentralized level, and healthcare users, namely the population of Tanzania at large but predominately vulnerable groups like mothers, children and youth.

Medium-term outcomes
  1. Key state institutions are strengthened to expand health insurance coverage for the Tanzanian population, especially women and youth.
  2. Foundations for the operationalization and sustainability of the Center for Digital Health are built to serve as catalyst for Tanzania's digital health transformation.
Results

Expected results:  

  • Capacity of the respective ministries, departments and agencies with respect to their universal health insurance and digital health mandates is strengthened
  • Respective regulations, standard operating procedures, systems' tools and governance structures are improved
  • Sound and transparent financial sustainability strategies and further development plans are elaborated
  • Aligned and coordinated policy dialogue between partners and Tanzanian government is ensured


Results from previous phases:  

  • Political Economy Analysis of the universal health insurance context in Tanzania informed about the complex political dynamics that led to the long delays in the endorsement of the Bill by Parliament
  • Consultants supported the Ministry of Health Mainland to elaborate on operationalization and sustainability plan for the Center for Digital Health.
  • Former HPSS project manager is supporting the Ministry of Health in incorporating experiences and lessons learnt from the community health fund into the new regulations.


Directorate/federal office responsible SDC
Credit area Development cooperation
Project partners Contract partner
International or foreign NGO
Private sector
Foreign state institution
  • Foreign private sector South/East
  • Sub-National State SouthEast
  • Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ); Implementing partner for the Center of Digital Health to be identified


Coordination with other projects and actors
  • GIZ Improving Health Care in Tanzania project and Embassy supported Good Financial Governance project
  • Embassy supported Health Basket Fund (HBF), Tanzania Social Action Fund (TASAF) and Ifakara Innovation Hub (IIH)
  • SDC head office funded Geneva Digital Health Hub and Providing for Health network (P4H)
  • Key stakeholders: Germany, United Kingdom, USAID, World Bank, UNICEF, WHO, Fondation Botnar, PATH, PharmAccess
Budget Current phase Swiss budget CHF    5’220’000 Swiss disbursement to date CHF    1’077’267 Total project since first phase Swiss budget CHF   76’239
Project phases Phase 1 01.02.2023 - 28.02.2028   (Current phase)