81314485 - Strengthening Management and Implementation of Public Health Insurance in Tanzania

The government of Tanzania both in mainland and Zanzibar has made significant progress toward achieving Universal Health Coverage (UHC) by passing a bill to establish Universal Health Insurance (UHI) as part of the efforts to ensure that all citizens are accessing quality health services without financial hardship. To support this, the Government of Germany, through its Federal Ministry for Economic Cooperation and Development (BMZ), has commissioned GIZ with 2 million EUR to support the governments in Tanzania mainland and Zanzibar with implementation of UHI. This funding supplements the 10 million EUR already allocated to the Improving Health Care Programme (IHCP) for initiatives such as maternal and neonatal health, reproductive health, and evidence-based planning. Furthermore, the Swiss Development Cooperation (SDC) has committed additional to 2.1 million EUR to co-finance the project. Objectives and Indicators: The main objective of the UHI output is to strengthen the capacity of the health insurance system to expand coverage to the Tanzanian population, including mothers and newborns. To achieve this, three intermediate outcomes are targeted: 1. UHI policy and regulatory framework are developed and implemented - this framework is necessary to ensure alignment of actors towards a goal and achieving coordinated action. 2. The capacity of targeted UHI institutions to manage financial sustainability is improved - only financially stable institutions can grow and serve their members in the long-term. 3. The acceptability of UHI in the informal sector has increased - in the absence of strong enforcement mechanisms, the 85% of workers in the informal economy have to accept the value proposition of health insurance and enrol voluntarily. The output will be monitored through indicators such as the integration of international best practices into UHI regulations, improved cost control in health insurance operations, and increased acceptability of UHI among informal sector groups. Partners and Methodological Approach: The partners include Ministries of Health in mainland and Zanzibar, Ministry of Finance and Planning both in mainland and Zanzibar, National Health Insurance Fund (mainland), Zanzibar Health Service Fund (Zanzibar) and the Tanzania Insurance Regulatory Authority (TIRA). The implementation will focus on capacity development through expert support, technical advice, and training for staff at key institutions. Main activities per output Output 1 - Advise on developing reform roadmaps and related M&E frameworks (overall and institution specific), policies, regulations and guidelines. - Advise on organizational development to establish effective organizational structures and core processes. - Equip newly established units for UHI. - Train individuals on health financing and social health protection policy, and health insurance regulation. - Support Tanzanian participation in the Leadership for UHC (L4UHC) to enable senior decision-makers develop leadership skills and collective actions needed for effective UHI implementation. Output 2 - Advise Ministries of Health on modelling sectoral resource needs, - Build capacity among regulators and insurance providers for projecting sustainability and solvency of insurance schemes, - Build capacity of regulators and insurance providers for regulating and negotiating service prices, - Strengthen claims management system of insurance providers incl. fraud prevention. - In Zanzibar: Support setting up of the Health Equity Account and the unit that will run it. Output 3 - Develop communication strategies and core messages on the strategic orientation of UHI for Ministries of Health. - Develop and pilot marketing strategies and materials and expand distribution channels expanded for health insurance providers. - Advise the health insurance regulator on structures and processes for grievance mediation and resolution.