Health Financing
Background:
The TGPSH supports the poverty reduction strategy in Tanzania and the German Action Programme 2015 for poverty reduction in particular in regard to basic social services. Since the introduction of cost-sharing within the Health Sector Reform in Tanzania, TGPSH has been working actively with the Ministry of Health to see how to best manage the system. Since the development of Community Health Funds by the Ministry of Health and Social Welfare (MoHSW) and World Bank, TGPSH has sought to actively support the rolling out of the fund at district level. The programme is supporting the School of Public Health in offering annually a course in Health Financing at District level.
Component Area:
The component focuses on collaboration with different stakeholders at all levels, stressing interagency collaboration. At the national level, the component supports the Ministry of Health, Department of Planning, CHF Unit in the area of advocacy, implementation, monitoring and evaluation. Technical advice and support are provided to various partners (Regional and District institutions and NGOs) in the regions Lindi, Tanga, Mtwara and Mbeya. In addition, at national level TGPSH advocates the rise in funding allocated to the national health budget.
Approach:
Realising the importance of partnership, ownership and learning from best practices, the component is advising the (MoHSW) how best to support the implementation of the CHF. This includes the development of IEC materials and supporting the development of a training module in financial management at Zonal Training Centre level. In addition the component has supported the development of the Tanzanian Network of Community Health Funds (TNCHF), now a registered NGO bringing faith-based, public and even private health insurance schemes into dialogue and serving as a centre of expertise to support schemes in the country in strengthening their management and organisation. There is a strong overlap with the TGPSH Public Private Partnership Component as concerns collaboration among stakeholders at district level. The health financing component aims to contribute primarily by advisory services and training, and secondarily by local subsidies/financial contributions;
- to the funds available to the health sector in the four regions Tanga, Lindi, Mtwara and Mbeya via bilateral budget allocations and by mobilisation of local resources increasing and being managed efficiently, transparently and correctly;
- to the decentralised district health services in the regions efficiently managing available resources
The health financing component makes its experiences gained in the country and from other countries available for the development process in the four regions. At the same time the component gains in significance by working with different executing organisations and at national and several levels in the various regions, and contributes the insights and experience thus acquired into the sector-policy dialogue in consultation with the other donors. This should lead to improving the use of the basket funds.
The component is aiming to mobilize and allocate health resources to an optimum. This will have an immediate effect in the four assisted regions of the programme but also beyond by implementing innovative financing mechanisms with model character replicable to other areas of the country.
As part of health financing the system of community based health insurance schemes in the country is worked on. Efforts by individual schemes are brought together in a networking system for which the Tanzania Network of Community Health Funds has been created. From this network further establishment of Community Health Funds in the districts is supported via a social franchise system.
At provider level assistance is offered to improve financial management of the health services. As a working forum on hospital management a Hospital Management Working Group consisting of donor representatives and the MOH is chaired by the component.
The health financing component is also the competence unit of the programme for public funding in the health sector. One of the activities is focusing on participation at the Public Expenditure Review within the donor community.