Transcript group premiums in microhealth insurance. experiences from tanzania.

CHF WORKSHOP-USE
AND MANAGEMENT OF
COST SHARING FUNDS
AT THE DISTRICT LEVEL
Presenter: A.D.Kiwara
MUHIMBILI UNIVERSITY
COLLEGE OF HEALTH SCIENCES
COST SHARING FUNDS
Origin
Legality
FIELD EXPERIENCES
Definition ambiguities on the ground.
 District level
 Health Centre and Dispensary Levels.
 Community levels
MANAGEMENT OF THE FUNDS
IS AN ISSUE.
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What constitutes these funds
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Where are the funds deposited.
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Who makes decisions on use of the funds
collected.
USE OF FUNDS
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THIS IS A CRITICAL ASPECT OF COST
SHARING FUNDS.
It needs a clear definition and follow-up to
ensure that desired results are obtained.
Use NEEDS streamlining
Proper use will facilitate improved
collections.
USE of FUNDS ctd
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EXPERIENCES ON THE GROUND.
The lower levels have problems accessing
the collected funds and in their use.
They do not know how to access the
funds and so they remain passive.
In some areas funds are accumulated for
a long time despite needs.
USE of FUNDS ctd
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The health facility managing committees
are least informed and involved in funds
collected and their use.
SUGESTIONS FOR THE FUTURE
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DEPOSIT ALL FUNDS FROM COST
SHARING SOURCES REACHING THE
DISTRICT LEVEL IN ONE SINGLE
ACCOUNT.
RENAME THIS ACCOUNT THE THE COST
SHARING ACCOUNT.
NHIF TO ESTABLISH THEIR CHEQUES IN
THIS NAME
SUGESTIONS ctd

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OPEN A VIRTUAL BOOK KEEPING
ACCOUNT FOR EACH PUBLIC HEALTH
FACILITY INDICATING INDIVIDUALLY ALL
DEBIT AND CREDIT TRANSACTIONS.
ASSIST THE ACCOUNTANT BY
INTRODUCING A SIMPLE BOOK-KEEPING
SOFTWARE ENABLING EASY
DOCUMENTATION OF THE
TRANSACTIONS PER PROVIDER.
SUGESTIONS ctd
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INVOLVE ACTIVELY THE HEALTH FACILITY
GOVERNING COMMITTEES IN
MONITORING OF THE COST SHARING
FUNDS. QUARTERLY FEEDBACK
STATEMENTS TO BE SENT TO
INDIVIDUAL HEALTH FACILITY
COMMITTEES.
ELABORATE GUIDELINES FOR MONTHLY
USE OF THE COST SHARING FUNDS.
CRITERIA TO CONSIDER IN THE
GUIDELINES
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Upfront payment to each provider
Incentive payment to provider staff
Remuneration to key actors in NHIF and
CHF funds.
Drug funding.
Reimbursement to District hospital for
attending CHF patients.
Reserve building etc
MWISHO
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AHSANTE SANA KWA KUNISIKILIZA.
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SASA TUJADILI
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THANKYOU FOR YOUR ATTENTION.
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NOW IT IS TIME FOR DISCUSSIONS