ArticleBMC health services research2021
The failure of community-based health insurance schemes in Tanzania: opening the black box of the implementation process.
Article in BMC health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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Who cites it
25 citing papers in PubMed.
- Informing policy through evidence: A scoping review of factors that influence enrolment in community-based health insurance in East Africa.Global health research and policy · 2026Article
- What affects the performance of hospital financing interventions in low and lower-middle income countries from the program design and implementation perspective? A scoping review.Health policy and planning · 2025Article
- Digital pulse: Social media reaction to South Africa's National Health Insurance implementation.African journal of primary health care & family medicine · 2025Article
- Article
- Service delivery factors associated with enrollment to the improved community health fund among household members: a cross-sectional study in the Manyara region, Tanzania.BMC health services research · 2025Article
- Health insurance in rural Tanzania promotes self-care for among patients with non-communicable diseases via their disease management behaviours.International health · 2025Article
- Challenges and Opportunities of Universal Health Coverage in Africa: A Scoping Review.International journal of environmental research and public health · 2025Article
- Acceptability of innovative department community-based health insurance in central Mali: A mixed methods study.The International journal of health planning and management · 2025Article
- Caregiver dynamics and factors affecting health-seeking behaviors for childhood diarrhea in Mukuru informal settlements in Nairobi, Kenya.Frontiers in public health · 2025Article
- Exploring machine learning classification for community based health insurance enrollment in Ethiopia.Frontiers in public health · 2025Article
- Universal health coverage for women of reproductive ages: a survey-based comprehensive assessment of service utilisation and health expenditure in Tanzania.BMJ public health · 2025Article
- Patient's willingness to pay for improved community health insurance in Tanzania.Health policy OPEN · 2024Article
- Controversies in implementing the exemption policy for the elderly healthcare services in Tanzania: experiences from the priority setting process in two selected districts.Cost effectiveness and resource allocation : C/E · 2024Article
- ' … You become a prisoner of your life': A qualitative study exploring the experience of joint pain and accessing care in Hai, Tanzania.SSM. Qualitative research in health · 2024Article
- The socio-cultural contexts shaping health-seeking behaviours among community members regarding childhood cancer in Tanzania: A qualitative study.Pediatric blood & cancer · 2024Article
- Assessment of the Effect of Community-Based Health Insurance Scheme on Health-Related Outcomes in Ethiopia: A Systematic Review.Iranian journal of public health · 2024Review
- Article
- Comparing the roles of community health workers for malaria control and elimination in Cambodia and Tanzania.BMJ global health · 2023Review
- Developing the improved Community Health Fund in Tanzania: was it a fair process?Health policy and planning · 2023Article
- Development of the sickle Pan-African research consortium registry in Tanzania: opportunity to harness data science for sickle cell disease.Frontiers in hematology · 2023Article
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2 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundGlobally, there is increased advocacy for community-based health insurance (CBHI) schemes. Like other low and middle-income countries (LMICs), Tanzania officially established the Community Health Fund (CHF) in 2001 for rural areas; and Tiba Kwa Kadi (TIKA) for urban population since 2009. This study investigated the implementation of TIKA scheme in urban districts of Tanzania.
methodsA descriptive qualitative case study was conducted in four urban districts in Tanzania in 2019. Data were collected using semi-structured interviews, focus group discussions and review of documents. A thematic approach was used to analyse the data.
resultsWhile TIKA scheme was important in increasing access to health services for the poor and other disadvantaged groups, it faced many challenges which hindered its performance. The challenges included frequent stock-out of drugs and medical supplies, which frustrated TIKA members and hence contributed to non-renewal of membership. In addition, the scheme was affected by poor collections and management of the revenue collected from TIKA members, limited benefit packages and low awareness of the community.
conclusionsSimilar to rural-based Community Health Fund, the TIKA scheme faced structural and operational challenges which subsequently resulted into low uptake of the schemes. In order to achieve universal health coverage, the government should consider integrating or merging Community-Based Health Insurance schemes into a single national pool with decentralised arms to win national support while also maintaining local accountability.
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