Faith Actors’ Advice on Achieving Equitable Health Services for the Poor in Tanzania

The Government of the United Republic of Tanzania needs only TZS 150 billion for 5 years to cover the cost of 28 percent of health insurance for low-income Tanzanians, the country’s religious leaders have said at a recent Breakfast Debate organised by Policy Forum in collaboration with the Interfaith Standing Committee on Economic Justice and Integrity of Creation (ISCEJIC) on September 27, 2019.

Speaking at the debate, Bishop Stephen Munga of ISCEJIC said the Committee conducted a survey on access to health care in Tanzania in 2017/18 using national statistical information with the aim of acquiring accurate information on health issues in the country.

The report shows, the average contribution of the government to the health sector to be 35 percent, development partners 37 percent, and private providers 28 percent. This shows a strong dependence on external sources of funding; All government sources come from the main budget. There are no specific (fenced) sources for the purpose of paying for the health budget; Only 32% of Tanzanians have access to health care through health insurance, meaning that 68% of Tanzanians are not sure of health care; From these 32 percent have health insurance, 23 percent are from CHF-enhanced health insurance, 8 percent are from National health insurance, and 1 percent are from private health insurance; 28% of the 68% who are unsure of health care are low income people who are quite poor and are not able to contribute anything like buying a health insurance card; and the remaining 40 percent are people who can afford health insurance but need to be mobilized to join.

Furthermore, Bishop Munga elaborated further on the universal health coverage (UHC) so that all communities can access the preventive, curative and rehabilitative services they need while also ensuring that the use of these services does not expose the user to financial hardship.

Generally, Tanzania could do more to increase investments in the health sector. For approximately a decade, the average Annual Health Budget has been only 10 percent of the Government's total expenditure, 15 percent less than the agreed resolution in the Abuja Convention. The budget for the health sector has been shrinking from 75 percent (2014/15) to 57 percent (2016/17) and the average National Budget spending is $31 less than the average approved by the World Health Organization (WHO) which is $60.

Sheikh Nuhu Jabir Mruma also emphasised the reason why religious leaders are stressing on equitable health by stating that health is an investment and people need to be in good health for sustainable development to be achieved.

As a recap, for the Government of the United Republic of Tanzania to achieve its goals of ensuring that every citizen has confidence in the country's services, the religious leaders recommend the following:

• The government should cover the cost of 28 percent of health insurance for low-income Tanzanians (2.7 million households, which is 14.5 million people);
• The government needs only TZS 150 billion for 5 years from the various tax fenced sources proposed to cover health insurance for low-income households in Tanzania at an average of TZS 10,000 per household by the government and
• The government needs 127 billion euros in 5 years from various tax-funded sources proposed to cover health care costs for 40 percent of Tanzanians who have not yet joined the average contribution of TZS 30,000 to 30,000 households and governments.
• The government should increase the effectiveness of health care delivery by 20 to 40 percent by eliminating various challenges;
• The government should lead the success of the provision of a health budget based on the approved budget;
• The government should protect and improve cooperation with the private sector in health especially access to health services in all areas;
• The government should improve the service sector to pay for the elimination of challenges in service delivery

The Interfaith Standing Committee on Economic Justice and Integrity of Creation (ISCEJIC) has the role of promoting equity , human rights and ensure affordable health for the poor in Tanzania and focuses on issues of tax justice for reducing inequality, works on issues of industrialization, employment and the environment, and peace and protection of creative integrity.