VOLUNTARY community-based health insurance in low-income settings can prove challenging such that millions of families in Tanzania still consider health care an expensive endeavour
However, villagers in Handeni district in Tanga Region have a reason to wear a smile on learning that a chicken could be dear enough to guarantee a six-member family medical care for a year.
Gone were the days when the Handeni villagers had to brave the hard-earned Sh10,000 to cover family health insurance for the annual duration. Payment in financial terms for the residents of a community where financial circulation is nearly stagnant proved too hard to afford, according to Handeni District Commissioner, Godwin Gondwe.
“It is the perception that unfortunately hampered most of the people from joining the nationwide health scheme,” he said, adding; “Handeni district is inhabited by more than 430,000 people whose families own an average of 20 fowls each, but they were not aware that a simple chicken could provide them with health security for twelve months.”
But thanks to house-to-house community awareness campaign are the amazingly positive results in such a way that between July and December 2016 a total of 35,286 people were registered for the community health insurance scheme as opposed to the past that had seen only 5,881 villagers having their health insured, he said.
Describing the approach adopted, the DC said he did not invent the wheel but rather looked around and discovered the unexplored resources was just in abundance. They included the dormant fowl industry that either produced chickens for sale or for domestic consumption.
“The people had been traditionally resistant to pay Sh10,000 for health insurance, until when they were told they could give a chicken for sale at the village administrative office and immediately get the cash.
Many have turned up for registration and the district can now boast of making headway to have family members linked to community health fund,” he said in an overtone of pride.
Citing an example of Mwinjuma Seleman, a resident of Mkata ward who had expressed regrets over delay in joining the scheme owing to high expenses, the DC said Mwinjuma’s was a reflection of the public sentiments.
“When villagers discovered that fees for doctor’s consultation, medicines at designated pharmaceutical stores, among others was covered by a mere chicken for six family members for 12-strong months, they were overwhelmed with enthusiasm,” Gondwe said.
It was made clear that the intention was to have all family members registered to community health fund at their own convenience.
However, having all residents in the area connected to the health scheme was not the end of a far-sighted health services improvement plan in Handeni as availability of medicine was an equal priority.
“We (district authority) have formed a departmental coordination network to make sure that every sector delivered accordingly. For example, the District Medical Officer has the responsibility to make sure that drugs from medical stores department (msd) are available and accessible to the people,” he said.
“Team-work spirit continues to yield positive results. For example, care of patients is highly encouraged among doctors and nurses such that when any prescribed antibiotics is not in stock, an alternative is immediately administered instead of callously sending away the sick in despair. Mother and child mortality must come under control,” said Gondwe in a boastful gesture.
To confirm that collective decision always remained the right leadership avenue, Gondwe said councillors had jointly agreed that due to rising operation costs, effective this year the villagers would contribute Sh20,000 worth of two roosters for community health fund. The consensus was endorsed and embraced by the villagers.
In 2009 the National Health Insurance Fund (NHIF) took over the management of the Community Health Fund (CHF) to increase insurance coverage, efficiency, supervision and access to services.
The NHIF is a compulsory insurance scheme for the formal sector offering extensive benefits to members.
The Community Health Fund (CHF) is a voluntary scheme established by the Ministry of Health and Social Welfare (MoHSW) for the informal sector with premiums fixed at between Sh5,000 to Sh30,000 for care in public primary facilities. Both schemes have been in operation since 2001.
Key achievements include successful integration of CHF within the NHIF organisational structure, improved reporting systems and growing awareness of the reform since 2011.
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