Healt Financing TWG UPDATE July, 2016

Last HFTWG met June13th

Health Financing Strategy up-dates:

  • The cabinet paper in request for the establishment of a Single National Health Insurance has been submitted to the Cabinet Secretariat with the Health Financing Strategy in Annex. The Ministry is currently awaiting feedback from Cabinet.
  • Before submission to Parliament (still planned for September 2016) the Social Security Regulatory Agency made it a requirement to conduct an actuarial analysis. This analysis will be carried out by a certified actuarial firm supported by USAID (July/August). A national consultant may be chosen to flank the assessment, for which GIZ expressed interest of support.

CHF

  • At the last HF TWG NHIF presented its further plans in moving ahead with a harmonized database for CHF related membership management for which they have hired a consultant.
  • The presentation of the consultant focused on how to expand and improve on the existing NHIF database to enable a common interface for CHF data integration (adapt feature to integrate CHF data needs).
  • The members of the TWG received the presentation with strong criticism, pointing out that for the past 10 months a task force composed of different CHF implementers met on sharing experiences and to discuss which components of best practice made already in TZ to combine into the creation of a harmonized database. The presentation by the consultant demonstrated little recognition of what had been discussed during the last months.
  • Further there was the feeling that the “new” proposal is now looking only at expanding the existing database instead of creating a needed Health Insurance Management System for the country in recognition of the HFS plans to create a single insurer.
  • It was also emphasized that NHIF, to be transparent, should have shared the TORs of the database consultancy with the TWG in advance to allow for comments. Since this has not happened the meeting concluded that NHIF share the TORs with the TWG.

NHA and PER:

No up-dates

Results Based Financing:

  • The RBF process assessment kicked-off as planned during the week of the 6th June and the assessment inception report was presented at the June TWG
  • TWG members largely consented with the proposed study methodology and focus and gave some relevant further suggestions on looking specifically also into MSD and the alternative supplier system, the separation of functions and how/whether facilities are capacitated to prioritize and allocate funds better under RBF; how does the current PFM system fit the RBF design; look also into issues of technical and financial sustainability and the capacity of the RBF unit currently managing the roll out (at MOHCDGEC and PORALG).
  • As for the progress on the impact assessment activities by the research consortium consisting of IHI, London School of Hygiene and Michelsen Institute Norway no updates had been provided at the past TWGs, but concerns now arose seeing a report on their side on potential overlaps with the now kicked off process assessment in Kishapu.

Better Budgeting Practices Tool: Aligning PFM with HF – Why important and what can be done

  • PFM and HF systems aim to make use of public funds effectively. In health this means that funds are spent efficiently and equitably, and used to purchase quality interventions
  • Alignment between Budget Cycle/ PFM system and health financing policy is critical here
  • The tool presented at the TWG is a tool developed initially by OECD and then adapted to LMIC through assistance of WHO/WB through Results for Development (R4D) Consulting firm. It consists of a framework and diagnostic guide which helps to do 3 things:
  • Gain better understanding of the health financing environment and its bottlenecks
  • Create a collaborative roadmap for actionthat will allow countries to strengthen alignment and
  • Have lasting and constructive impact on dialogue between health and finance officials
  • The tool was presented by PS3 who if consented to by the Government partners (MOHCDGEC, PORALG and MOF) will assist apply the tool in TZ
  • Application will be through conducting joint workshops(potentially in August) between the 3 Ministries to have them go through the tool, discuss jointly and thus be part of the analysis as well as the formulation of an action plan to overcome bottlenecks. This process will be generally supported by WHO in TZ with some support also from P4H.
  • The presentation of the tool will also have to take place in the PFM TWG as well as to the MOF/PFM reform program

Next envisaged HF TWG Wednesday 13thJuly 2016

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