Assessment of the Community Health Fund in Hanang District, Tanzania

摘要

The Tanzanian Community Health Fund (CHF) was established by the Ministry of Health on a pilot basis in December 1995. Its purpose was to ensure the availability of quality health services at affordable prices and to mobilize additional resources for the provision of health care. The CHF is essentially a district-level prepayment scheme for primary care services targeted at the rural population and the informal sector. A household joins the CHF by paying an annual membership fee, which provides unlimited access to outpatient services at CHF-participating facilities. User fees at health centers and dispensaries are implemented as part of the introduction of the CHF, as is an exemption policy to ensure that families who cannot afford to pay the membership fees obtain a free CHF card. CHF providers are mainly public sector facilities, although the intention of the scheme is to include private sector and mission providers. The CHF is currently operating in 23 districts, with the goal of implementation in all districts by 2003. In 2001, the CHF Act established the CHF as a key component of the health financing strategy. This assessment was conducted in Hanang District to provide CHF administrators with data and recommendations to improve the management and utilization of the CHF throughout Tanzania.