Introduction and implementation of the Universal Health Insurance (UHI) in Zanzibar
Project Abstract
The Revolutionary Government of Zanzibar (RGoZ) is in the process of introducing Universal Health Insurance (UHI) after having been offering universal (non-contributory) access to public health care since gaining independence in 1964. UHI will complement Government financing for the health sector and reverse the poor quality of care at public health facilities and improve health outcomes. The vision is that, over time, UHI will cover the entire population as the main social health protection and financing scheme of the sector, thereby strengthening the healthcare system for Zanzibar. The Zanzibar Health Services Fund (ZHSF) has been established under the Ministry of Health to oversee the implementation of UHI.
In this context, GIZ BACKUP Health through its Health Financing Component has provided extensive technical support in preparing the ground for Zanzibar’s UHI via a consultancy delivered by Swiss Tropical & Public Health Institute in 2022. The consultancy provided recommendations to the RGoZ in the areas of actuarial analysis, socio-economic pre-conditions of the population to be covered, and operational set up of the UHI and data management tools needed for effective management of the scheme. This additional technical support should follow-on from the recommendations of the 1st assignment with a focus on the UHI implementation phase.
Swiss TPH will perform this mandate with the aim to contribute to ensuring efficacy of the health sector to provide adequate and quality services in the seven main components as described:
A. Capacity building to ZHSF staff
B. Study visits to other countries (Peer Exchange)
C. Medical Coding (for effective benefit package delivery)
D. Development of a ZHSF Strategic Plan
E. Development of a ZHSF Risk Management Plan
F. Development of a ZHSF Business Plan
G. ZHSF Monitoring and Evaluation Plan
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Swiss TPH offers to support the introduction and implementation of UHI in 2022-2023 based on the logic of building capacities of the ZHSF and stakeholders (mainly MoFP and MoH) especially to further refining the design, planning, and implementation of a scheme that can provide UHI most effectively to the people of Zanzibar. We will perform this mandate with the aim of contributing to ensure effectiveness of the health sector to provide adequate and quality services in the seven main activity clusters as described above.
Launching workshop and inception mission were organised in January 2023 and medical coding as well as various plans to be developed are in progress since then.
Swiss TPH accompanied two delegations under the leadership of the Zanzibar Health Service Fund (ZHSF) for study visits, to Ghana and Rwanda gain hands-on experience on how to run UHI schemes. These visits were successfully organised thanks to the professionalism of the National Health Insurance Authority (NHIA - www.nhis.gov.gh/nhia and to the Rwanda Social Security Board (RSBB - www.rssb.rw
Key lessons learned were shared on overcoming challenges linked to setting up governmental health insurance schemes in Sub-Saharan Africa, such as ensuring effective resource mobilization, guarantee quality of services purchased and questions of equity in access to these services.
Main Applicant(s)
Geography
Involved Regions:
Africa
Involved Countries:
Tanzania, United Republic of