BACKUP Health Zanzibar - Technical Support to Delivering a “Comprehensive and sustainable Universal Health Insurance (UHI) in Zanzibar”

Revolutionary Government of Zanzibar (RGoZ) is in the process of introducing UHI that over time can cover the entire population, as the main social health protection and financing scheme in country and thereby strengthen the healthcare system of Zanzibar. The focus of this assignment is to support the government in this endevour by providing technical assistance in the following areas:

1. Facilitate an actuarial valuation exercise to ensure the development of a financially viable and sustainable UHI that provides adequate healthcare to everyone (including the poor and vulnerable people) primarily through domestic resource mobilisation.

2. Undertake a Household Socio Economic Study for the informal sector in order to guide the UHI design, especially the contribution setting and exemption/ subsidy arrangements for poor and vulnerable.

3. Support the design of the social health protection scheme through these key activities:
    a) Development of robust institutional arrangements for enrolment, contribution collection, service delivery and establishment of appropriate information systems to support effective administration of public healthcare services;
    b) Establishment of mechanism to facilitate strategic purchasing through purchaser and buyer split; and
    c) Strengthening of service delivery, financial management in the health care providers and selection of Reimbursement mechanisms.

4.    Reinforce the development of a Health Insurance Management System (HIMS).

Operationalizing such a UHI programme is a longer process which needs is to be facilitated through engagement in the political economy of the country, facilitated through local institutions or floors which can enable dialogue, consensus building and facilitating decision making and policy reforms. This project supports this broader picture of engagement in Zanzibar to establish and operationalise a UHI. The project is closely coordinated with the UHI Technical Committee (MoHSCGC, MoFP and President Office) in Zanzibar and the GIZ BACKUP Health team at GIZ HQ.

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