ArticleHealth policy and planning2015
The administrative costs of community-based health insurance: a case study of the community health fund in Tanzania.
Article in Health policy and planning, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Mapping healthcare service utilisation for diabetes and hypertension in Tanzania mainland: bayesian spatial modeling.Frontiers in health services · 2026Article
- Investigating membership attrition dynamics in community-based health insurance: a survival analysis of socioeconomic and program-specific determinants in the Amhara Region, Northwest Ethiopia.BMC public health · 2025Article
- Developing the improved Community Health Fund in Tanzania: was it a fair process?Health policy and planning · 2023Article
- Implementation barriers and remedial strategies for community-based health insurance in Bangladesh: insights from national stakeholders.BMC health services research · 2022Article
- Factors Associated with the Implementation of an Improved Community Health Fund in the Ubungo Municipality Area, Dar es Salaam Region, Tanzania.International journal of environmental research and public health · 2022Article
- Universal health insurance in Africa: a narrative review of the literature on institutional models.BMJ global health · 2022Review
- The failure of community-based health insurance schemes in Tanzania: opening the black box of the implementation process.BMC health services research · 2021Article
- Looking at the bigger picture: how the wider health financing context affects the implementation of the Tanzanian Community Health Funds.Health policy and planning · 2019Article
- The shaded side of the UHC cube: a systematic review of human resources for health management and administration in social health protection schemes.Health economics review · 2018Review
- Determinants of community health fund membership in Tanzania: a mixed methods analysis.BMC health services research · 2014Article
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Authors and funding
3 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Community-based health insurance expansion has been proposed as a financing solution for the sizable informal sector in low-income settings. However, there is limited evidence of the administrative costs of such schemes. We assessed annual facility and district-level costs of running the Community Health Fund (CHF), a voluntary health insurance scheme for the informal sector in a rural and an urban district from the same region in Tanzania. Information on resource use, CHF membership and revenue was obtained from district managers and health workers from two facilities in each district. The administrative cost per CHF member household and the cost to revenue ratio were estimated. Revenue collection was the most costly activity at facility level (78% of total costs), followed by stewardship and management (13%) and pooling of funds (10%). Stewardship and management was the main activity at district level. The administration cost per CHF member household ranged from USD 3.33 to USD 12.12 per year. The cost to revenue ratio ranged from 50% to 364%. The cost of administering the CHF was high relative to revenue generated. Similar studies from other settings should be encouraged.
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