National Health Insurance Fund

The National Health Insurance Fund (NHIF) is a health insurance institution established under the Health Insurance Act, Chapter 395, with the primary aim of ensuring access to health services for individuals. It is a government institution operating under the Ministry of Health. The Fund is managed by a Board of Directors, while its day-to-day operations are overseen by the Director General.

Membership Expansion

Initially focused on registering public servants, the Fund has expanded its scope to include other groups such as council members, private companies, educational institutions, individuals, children under 21 years, farmers in cooperative societies, and organized groups like street vendors and motorcycle taxi operators. Additionally, NHIF manages the Parliamentary Health Insurance Scheme and serves members of the Zanzibar House of Representatives.

ISO 9001:2015 Certification

The NHIF has been ISO 9001:2015 certified since 2018, demonstrating compliance with quality management systems that enhance efficiency, reduce losses, and increase customer satisfaction.

Core Functions

The primary functions of the Fund include:

• Registering members and issuing identification cards.
• Collecting contributions.
• Registering healthcare providers for service delivery to members.
• Settling claims from healthcare providers.
• Investing surplus funds to generate income.
• Assessing the Fund’s sustainability.
• Providing public education on health insurance.

Contributions

Under the Health Insurance Act, public sector employees must register and contribute 6% of their monthly basic salaries, shared equally between the employer and the employee. The Fund has developed alternative contribution arrangements for voluntary member groups.

Beneficiaries

NHIF beneficiaries within a family plan include the contributing member, their spouse, and up to four legally recognized dependents. As of June 2024, NHIF had 5,026,069 members, representing 8% of the Tanzanian population.