MSI Tanzania advocate for the inclusion of family planning in the National Health Insurance Fund

MSI Tanzania have been actively advocating for sustainable domestic financing for family planning services.

​Although Tanzania has a policy for the free provision of family planning services, implementation of this has faced persistent challenges due to inadequate, inconsistent, and unpredictable financing. This is one of the reasons for low contraceptive uptake in Tanzania (36%). In early March, MSI Tanzania participated in the Parliamentary Committees Public Hearings on the National Health Insurance Fund (Amendments) Bill. The team were able to submit formal recommendations advocating for the inclusion of family planning services in the National Health Insurance Fund.

Among the key arguments presented in support of including family planning in the insurance fund were its proven impacts on public health and economic outcomes:

• Family planning significantly reduces maternal mortality by at least 44%, child mortality by 35%, and unsafe abortions by 85%. It is also an effective preventive measure, reducing early and unintended pregnancies by 29% and teenage pregnancies by 22% – Henshaw, Singh, and Haas (2003).
• For every TZS 2,200 (equivalent to 1 USD in 2018) invested in family planning, there is a return of TZS 9,008 (approximately 4.1 USD) in savings – Health Policy Plus (2018)
• Including family planning in the fund is a step toward achieving Universal Health Coverage by 2030 and ensuring equitable access to healthcare. It will also strengthen domestic resource mobilisation, promote sustainable financing for reproductive health services, improve the well-being of women, girls, and children, and reduce the financial burden on the government and dependence on donor funding.

Key outcomes from the meeting included positive engagement with private insurance companies already offering family planning who shared their best practices. There was also strong support from Members of Parliament and the Committee Chairperson.

Following the meeting, the team received word that the Parliamentary Committee on Health had submitted its recommendations for the inclusion of family planning in the Insurance fund. However, due to resistance from the Ministry of Health the team were advised to engage directly with them. They therefore teamed up with Mwananchi Communications, a major media outlet in Tanzania and the East African Region, to have a conversation with Dr Macha, the Director of Policy and Planning through X (formerly twitter) space.

For the first time, the Ministry of Health, represented by Dr Macha, confirmed that including family Planning in the insurance package aligns with the President’s broader goal of achieving Universal Health Coverage and that minor adjustments will be made to the National Health Insurance Fund Bill to reflect this. The space was also attended by the Chairperson of the Parliamentary Health Committee affirming that family Planning should be part of the core services under the fund, highlighting its importance to both the health and economy of Tanzania. The Director of Tanzania Insurance Regulatory Authority highlighted that seven health insurance providers in Tanzania already include family Planning in their packages and urged the national fund to follow suit to improve beneficiary access.

The team worked with a journalist to publicise why the inclusion of family planning in this Bill is so important, which is available to read here.

Next Steps for the advocacy team will be to conduct a follow-up with the family Planning Department at the Ministry of Health to ensure their commitment is translated into action as well as to encourage media to maintain pressure by continuing to engage with decision-makers on this issue.