UHI in Tanzania: Ensuring Fair and Affordable Healthcare Access for Every Citizen

Dodoma — THE government has affirmed that the Universal Health Insurance (UHI) will guarantee every Tanzanian fair and affordable access to healthcare, marking a major transformation in the country's health system as the national launch approaches. Speaking at a strategic meeting with executives of institutions under the Ministry of Health and frontline healthcare staff at Benjamin Mkapa Hospital (BMH) in Dodoma recently, Minister for Health, Mohamed Mchengerwa, said the launch of UHI set to take place within President Samia Suluhu Hassan's first 100 days, will redefine healthcare provisions in the country and establish a new foundation for national health security. He stressed that UHI is not a policy announcement or a political event, but a large-scale national system that begins operating from day one of its launch, "leaving no room for half measures." "This is not just a policy milestone; it is a defining moment for healthcare rights in Tanzania. Each of us has a role and a direct responsibility to ensure that UHI begins with stability, is managed with discipline and protects the dignity of the Tanzanian patient," he said. Follow us on WhatsApp | LinkedIn for the latest headlines Mr Mchengerwa said the introduction of UHI will significantly increase the demand for healthcare services, as many citizens who previously avoided hospitals due to costs will now be able to access health services. He emphasised the urgent need for health facilities to prepare for this increased demand by ensuring adequate beds, specialists, medicines and essential supplies while maintaining quality. ALSO READ: Samia mourns MP Halima Nassor, hails her dedicated service Once launched, he added, the National Health Insurance Fund (NHIF) will become the heart of Tanzania's entire health system, linking citizens to their right to healthcare, providers to accountability, and medicines to effective cost control and quality assurance. "With its future mandate, NHIF will no longer function as a typical insurance institution, it will become a national health system operator, responsible for managing systemic risks, reducing political shocks and ensuring long-term financial, operational and technological stability," he said. He added: "NHIF is not just a payer; it is the stabiliser and guarantor of the health system." The minister further noted that while Tanzania is not the first country to adopt UHI, it has the advantage of learning from global successes and failures. Some countries, he said, rolled out UHI without strong governance, digital systems or cost-management frameworks, and are now struggling with uncontrollable costs and inefficient systems. He said some countries launched too quickly without solid governance, digital controls, or cost management, and are now struggling with uncontrolled systems, rising costs, and resource waste. "Being late can sometimes be a privilege, because it gives us foresight. We are not the first, but we want to be the last to make avoidable mistakes," he said. He said launching UHI establishes a new social contract between the government and citizens, one that must stand on solid systems, the right technology and high accountability. "It must be a digital-first system to control utilisation, claims and service delivery," he said. The minister directed all institutions to ensure that medicines and medical supplies which form a major portion of healthcare costs are controlled through e-prescription and electronic medicine management systems. "You cannot insure everyone sustainably if you cannot see where the money goes," he said. He stressed that UHI is not a short-term political project, nor a programme to be launched with excitement and later abandoned. "It is a generational system, affecting children born today, youth entering the labour market tomorrow and the elderly who will need protection in future." He said UHI cannot be judged through a single leadership term but through its ability to endure economic cycles, demographic shifts and disease burdens over decades. As a result, he said, institutions overseeing medicines and medical devices particularly the Medical Stores Department (MSD) and Tanzania Medicines and Medical Devices Authority (TMDA) carry a heavier responsibility than ever before, as UHI will channel more funds towards medicines than infrastructure. "Without strong systems across the entire supply chain from registration, procurement and distribution to final dispensing, UHI becomes a leaking system," he cautioned. The Minister directed the Permanent Secretary in the Ministry of Health, Dr Seif Shekalaghe, to coordinate a national Readiness and Preparedness Exercise involving the Ministry, NHIF, TMDA, MSD and all other institutions key to UHI sustainability. "This must not be a paperwork exercise. It is a real assessment of each institution's capacity identifying weaknesses early, correcting them before national rollout and establishing clear accountability," he said. He emphasised that UHI cannot rely on the readiness of one or two institutions but on the preparedness of the entire health system. He stressed: "We cannot afford guesswork in reforms of this magnitude."