ArticleHealth economics2022
Toward mandatory health insurance in low-income countries? An analysis of claims data in Tanzania.
Article in Health economics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed.
- Healthcare facility accreditation status and associated factors in Somalia: evidence from the 2022-2023 harmonized health facility assessment.BMC health services research · 2026Article
- Quality of care and health insurance uptake in Namibia.Journal of public health in Africa · 2026Article
- Institutional design features of health insurance subsidy programmes in Africa: a narrative review.International journal for equity in health · 2025Review
- Landscape analysis of pregnancy exposure registries in low- and middle-income countries: a scoping review.BMJ open · 2025Article
- Health insurance in rural Tanzania promotes self-care for among patients with non-communicable diseases via their disease management behaviours.International health · 2025Article
- Nowcasting reported covid-19 hospitalizations using de-identified, aggregated medical insurance claims data.PLoS computational biology · 2025Article
- Patient's willingness to pay for improved community health insurance in Tanzania.Health policy OPEN · 2024Article
- Oral health approach in universal health coverage.BMC public health · 2024Review
- Claims data from health insurance programmes in sub-Saharan Africa: an untapped resource to promote Universal Health Coverage.BMJ global health · 2024Article
- Prescribing patterns of antimicrobials according to the WHO AWaRe classification at a tertiary referral hospital in the southern highlands of Tanzania.Infection prevention in practice · 2024Article
- DSEception: a noval neural networks architecture for enhancing pneumonia and tuberculosis diagnosis.Frontiers in bioengineering and biotechnology · 2024Article
- Comparing the roles of community health workers for malaria control and elimination in Cambodia and Tanzania.BMJ global health · 2023Review
- Investigating sustainability challenges for the National Health Insurance Fund in Tanzania: a modelling approach.BMJ open · 2023Article
- Impact of Coronavirus Disease COVID-19 on the Relationship between Healthcare Expenditures and Sustainable Economic Growth.International journal of environmental research and public health · 2023Article
- The Effect of Mobile Payment on Payment Waiting Time for Outpatients With Medical Insurance: Historically Controlled Study.JMIR formative research · 2023Article
- Usage and parental knowledge of antibiotics in children undergoing (adeno) tonsillectomy in northern Tanzania.The Pan African medical journal · 2023Article
- Mandatory health insurance for the informal sector in Tanzania-has it worked anywhere!Frontiers in health services · 2023Article
- Toward mandatory health insurance in low-income countries? An analysis of claims data in Tanzania.Health economics · 2022Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Many low-income countries are in the process of scaling up health insurance with the goal of achieving universal coverage. However, little is known about the usage and financial sustainability of mandatory health insurance. This study analyzes 26 million claims submitted to the Tanzanian National Health Insurance Fund (NHIF), which covers two million public servants for whom public insurance is mandatory, to understand insurance usage patterns, cost drivers, and financial sustainability. We find that in 2016, half of policyholders used a health service within a single year, with an average annual cost of 33 US$ per policyholder. About 10% of the population was responsible for 80% of the health costs, and women, middle-age and middle-income groups had the highest costs. Out of 7390 health centers, only five health centers are responsible for 30% of total costs. Estimating the expected health expenditures for the entire population based on the NHIF cost structure, we find that for a sustainable national scale-up, policy makers will have to decide between reducing the health benefit package or increasing revenues. We also show that the cost structure of a mandatory insurance scheme in a low-income country differs substantially from high-income settings. Replication studies for other countries are warranted.
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