Exploring perceptions of clients with regards to National Health Insurance services in a selected public hospital in Dar es Salaam, Tanzania
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Date
2015
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
University of KwaZulu-Natal
Abstract
Background: The National Health Insurance (NHI) of Tanzania is commonly known as
the National Health Insurance Fund (NHIF). The scheme operates under the supervision
of the Ministry of Health and Social Welfare (MOHSW) together with an independent
board of the NHIF. It is a mandatory form of healthcare financing primarily for public
servants and other categories of employees in the formal sector which covers hospital
costs for the principal member and six beneficiaries of any age.
Purpose: The purpose of this study was to explore the perceptions of clients with regards
to National Health Insurance Services in a selected public hospital in Dar es Salaam,
Tanzania.
Methodology: Guided by objectivism, this study adopted a positivist paradigm and a
quantitative approach. A non-experimental, exploratory-descriptive and cross sectional
research design was used and a self-administered structured questionnaire was used for
data collection. Ethical clearance was obtained from the University of KwaZulu-Natal
Research Ethics Committee and the Humanities and Social Sciences Research Ethics
Committee (HSSREC) in South Africa, and from the Kinondoni District Hospital Research
Ethics Committee in Tanzania.
Results: The results of this study indicated that 64.8% of participants were the principle
members of the NHIF and the majority (63.1%) were female. While joining the fund would
have been compulsory for the 54.9% of the participants who were civil servants and
15.6% who were traders or business people, the majority (90.1%) of all the participants
indicated that they had joined the scheme because it offered financial protection against
illness. The majority of participants acknowledged the benefits of being a member of NHI,
with 93.5% agreeing that joining the scheme benefited them and their beneficiaries,
93.4% agreeing that it gave them reassurance that their family would receive care, 89.3%
agreeing that it provided easy access to health care, 83.6% agreeing that it would save
money from paying hospital bills and 82.8% agreeing that belonging to NHI was better
than having to make out-of-pocket payments.
Recommendations:
Despite their positive attitude towards the NHI services, participants admitted that NHI
does not permit health care access to all citizens and that, even with the cover of the
NHIF, they still needed to save money to pay for hospital care. Therefore, the study
recommends the expansion of the NHIF benefits packages up to the Primary Health Care
level to avoid user fee for the insured. Similarly, the NHIF management must find another
mechanism of funding the Community Health Fund to provide coverage for the poor rural
communities who depend only on out-of-pocket payments. Further research is also
recommended to explore the perceptions of the majority of Tanzanians who are not
covered by the NHIF schemes.
Keywords: Community Health Insurance, Health Insurance, National Health Insurance,
National Health Insurance benefits, Tanzania health care system, universal health
coverage
Description
A dissertation submitted in partial fulfilment of the requirements for the award of
Coursework Master’s Degree in Nursing (Community Health).
Keywords
Community health insurance, Health Insurance, Tanzania
Citation
Omari, Minael N. (2015) Exploring perceptions of clients with regards to National Health Insurance services in a selected public hospital in Dar es Salaam, Tanzania. Unipublished paper, University of KwaZulu-Natal