Title:
Equity of Access to Health Services in Tanzania: Challenges to Achieve Universal Health Coverage
Authors:
James, Ligwa Emmanuel
Year:
2015
PAGE:
x, 73
Language:
En
Subject:
mHealth in Low-Resource Settings
Keywords:
User Fee and OOP, Health Services in Tanzania, Catastrophic Health Expenditure, impoverishment, Exemptions and Waiver, Universal Health Coverage
Abstract:
Background: User fees and out of pocket payments are forms of health care financing in Tanzania which are considered inequitable as the poorest and vulnerable groups are not able to access the health services at the point they need or even they are able to access the health services they must pay at the expense of other basic needs and suffer financial catastrophic and impoverishments. Therefore financial risk protection, as well as access to care is a cornerstone of the universal health coverage. Objective: The general objective of this thesis is to review the challenges in reaching equity of access to health services in Tanzania and to achieve universal health coverage. Methodology: Literature review. Findings: User fees and OOP payments have an impact on the utilization of the health services at the households and at the health facilities. Some families have experienced catastrophic health expenditures and impoverishment. Findings also show that Tanzania has an exemption and waiver policy which is ineffective due to: (i) Poor targeting (ii) Lack of reimbursements (iii) Shortage of resources and (iv) Lack of monitoring and evaluation. Other options have been analyzed to finance the health services which are CHF which have several challenges which are: (i) Low enrollments (ii) CHF design (iii) Community health services and (iv) Highly regressive. The NHIF challenges are: (i) unspent funds (ii) Lack of drugs (iii) Under spending of funds. The donor funds challenges are: (i) Delays in releases (ii) Unpredictable flows (iii) Not released 100 % (iv) Released with conditions. Conclusion: (i) User fees and OOP payments are major barrier to access health services (ii)They can be the cause of catastrophic health expenditures and impoverishment (iii) Exemptions and waivers policies in Tanzania do not function as stipulated (iv) CHF have low coverage (v)NHIF have huge reserve of funds (vi) Donor funds are unpredictable. Recommendations: The government of Tanzania should (i) Strengthen the prepayment schemes. (ii) Cross subsidize between NHIF and CHF (iii) Review the capacity of NHIF (iv) Harmonize with donors (v) Strengthen the exemption and waiver (Vi) Earmark tax to pay for the poor.
Organization:
KIT - Royal Tropical Institute
,
VU - Vrije Universiteit Amsterdam
Institute:
KIT (Royal Tropical Institute)
Department:
Development, Policy and Practice
Country:
Tanzania
Region:
Eastern Africa
Training:
Master of Public Health / International Course in Health Development (MPH/ICHD)
Category:
Research
Right:
© 2015 James
Document type:
Thesis/dissertation
File:
FX0Z7LqMuq_20161025105503898.pdf