Social health protection and health financing

Project description

Title: Tanzanian-German Programme to Support Health – thematic area: Social health protection and health financing
Commissioned by: German Federal Ministry for Economic Cooperation and Development (BMZ)
Country: Tanzania
Lead executing agency: Ministry of Health and Social Welfare
Overall term: 2003 to 2016


More than 50 years after Tanzania gained independence, many of its people remain without access to high quality health services. Reasons for this include insufficient per capita health expenditure, unequal distribution of financial resources, ineffective exemption mechanisms for the poor and insufficient incentives for the efficient provision of health services. There is therefore a need to reform the financing of the healthcare system and create effective social health protection mechanisms. This is necessary in order to ensure that all citizens of Tanzania can benefit from their fundamental right to good healthcare and that the country moves closer to the ultimate goal of universal health coverage.


The social health protection system offers the population comprehensive, quality health services at the point of care. The community health funds have improved their management and are reaching more members. Thus, the health of the Tanzanian population – particularly the health of the poor – is improving.


The programme combines regional and district-level implementation measures with policy advice at national level. At the policy level, the programme supports the Tanzanian Ministry of Health and Social Welfare in drafting a comprehensive national health financing strategy, designing a more extensive form of community health funds (CHFs) and developing ways of identifying particularly poor and vulnerable people. The financing strategy aims to create a framework for financing health services that satisfy the criteria of effectiveness, efficiency, equity and solidarity and reach all citizens of Tanzania (universal health coverage).

The programme supports the community health funds, which are intended to prevent their members, particularly poor families in the informal sector, from falling into greater poverty or experiencing financial ruin in case of illness. Selected health facilities and authorities in the programme’s regions of Tanga, Mbeya, Mtwara and Lindi are supported in implementing an improved CHF management system. The main focus is on developing human resources, streamlining administrative processes and creating more transparency in financial management. In addition, the health service providers are to obtain greater access to financial resources. The programme aims to improve the range of services available to members and the acceptance of CHF member cards in selected health facilities.

Results achieved so far

An evidence-based draft for the Health Financing Strategy is now in place, which aims to achieve universal health coverage by 2025.

Local councils are increasingly responding to efforts aimed at facilitating access to CHFs for the poor by making pro-poor allocations in their budgets. Enrolment has increased among poor population groups, although not to the expected degree.

Healthcare facilities have received access to CHF funds through the creation of bank accounts, which has significantly increased their readiness to support the CHF system.
Advisory services in districts and regions have also contributed to considerable improvements in the management of public finances and to an improved understanding of CHF processes at all levels.

Additional information