Mwanga District council opts for an alternative health insurance


Mwanga District Councillors and senior officers from the district have made an important decision on health care.

They have resolved that people deserved better health services and the insurance system dubbed improved Community Health Fund (iCHF) was the best option for them.

In the new strategy, the Ministry for Health , Community Development, Gender, Elderly and Children teams up with the National Health Insurance Fund (NHIF), district councils and a Dutch NGO – PharmAccess to offer services to the local people.

Mwanga councillors unanimously endorsed inauguration of the newly introduced iCHF that started as a pilot in some districts of Kilimanjaro and Manyara regions.

The approval came after a sensitization seminar from senior officials from NHIF, PharmAccess and from the district, such as the District Commissioner (DC), Mr Aaron Mbogo and Mwanga District Council Chairperson, Ms Theresia Msuya.

The councillors acknowledge that when they first received a word from iCHF stakeholders it was difficult to cross to their minds that it could be a good plan for health of their electorates and others in the district. It was not judicious to think that way by then, as a PharmAccess Senior Official, Mr Prosper Msuya puch holes on the Community Health Fund (CHF) and introduced the iCHF.

Mr Msuya says it was challenging to convince people that moving from CHF to iCHF would be anything better, as there are a lot of shortcomings in CHF, although have been fully addressed.

He says CHF that caters for middle and low-income people was introduced as a pilot in Igunga District, Tabora region in 1996. That by an Act of Parliament was rolled out countrywide in 2001 while in 2009 it was put under guardianship of NHIF.

He says the stakeholders have decided to move from CHF to iCHF because CHF was overburdened by responsibilities as it had few officials.

There were no checks and balances as district council collected funds but did not deliver needed medical services as nobody questioned it, made a follow-up or sought to get feedback in regards to services delivered.

Now under iCHF, it is the guardian – NHIF that will be collecting funds while district council administers service delivery as PharmAccess provides technical support as well as financial. The new premium introduced is 30,000/- for every group of six people per annum.

The Government will, for every some, add 30,000/- to ensure quality health services delivery on time and in a conducive environment. The manager says the premium of 10,000/- that was charged for a year from a family or a group of six persons did not match costs of the services.

Furthermore, the system was not scientifically calculated basing on insurance policy, as people enrolled and paid the same when were already ill, while insurance system calls for prepayment of premium.

That is the way, like in vehicle insurance system, one cannot enroll and get services for a damaged vehicle, but pays in advance, insuring the vehicle regardless it gets accident or not.

If it does not, the premium covers other vehicles that are damaged and the same way it works for people’s health. Under iCHF, notes Mr Msuya, there are special people dealing with registration and would be going to people’s homes and that has proved successful in Siha, Hai, Moshi and Rombo districts as well as Manyara region.

Currently Rombo leads in enrollment under iCHF. iCHF provides more services than CHF. A family of four dependents and two parents/ guardians or six people (such as students) choose two health facilities – primary and referral ones where they would get medical services, including emergency surgeries.

They can change the centres they want to be treated at every three months. CHF was offering medical services from public-owned health facilities only, but now patients will get services from the public ones as well as religious and privately owned centres.

Mr Msuya says under CHF services were poor as there were no enough resources and health providers were not motivated. He says under iCHF more resources would be committed for quality services of the people and assures the public that drugs will be available. Identification of CHF members was done by using only one card but under iCHF every member will have their own card.

The new plan is set to be sustainable as it is systembased and does not depend on a particular person at a certain place. He quotes Albert Einstein who once said insanity is doing the same thing over and over again and expecting different results. Stakeholders in iCHF have proved the different way of doing things is productive.

It is true because now Manyara and Kilimanjaro have been singled out as models for other regions when the iCHF is set to go countrywide sometime to come. Under iCHF, says Mr Msuya, inpatients and outpatients get quality services, including emergency surgeries such as delivery, after accidents and others that are not longtime plan.

There are limited services, such as five days for inpatients and not applicable for long-time planned surgeries because the premium cannot bear. If many people enrol it may be possible in future. Higher costs medical services are covered under NHIF bigger programme.

Mr Msuya notes that there is capitation plan, where service providers will be funded beforehand depending on enrolments. Funds that remain after every duration might be used to improve the centres.

Chairperson of Mwanga District Council, Ms Theresia Msuya calls upon fellow councillors to sensitise people of the importance of getting enrolled with iCHF. They can do so in public rallies as well as in meeting the people from house to house. She says that would serve well the people, as the premium is affordable as opposed to burden of medical costs.

She asks for councillors to volunteer paying for some disadvantaged families, saying she knew some could pay even for up to three families. Councillors called for medical staff to play their part by offering better services and use of good language to patients.

NHIF Kilimanjaro Regional Manager, Mr Fidelis Shauritanga hails Mwanga councillors for the move and the people for coming first in the region as far as enrolment with CHF is concerned.

He says people have been coming to Kilimanjaro from as far as Ethiopia, to learn of how iCHF operates and that is a huge credit.

Mwanga District Commissioner (DC), Mr Aaron Mbogo is happy with what transpires, saying the insurance concept creates peace of mind, one relaxes because they are sure of getting quality medical services whenever they fall ill.

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