1. Tanzanian German Programme to Support Health The Health Financing Component Supporting Social Health Protection and Health Financial Management in Tanzania

2. 2 Indicators Indicator 1: A mid-to long-term health financing strategy is in place until the end of 2013 Indicator 2: 30% of the population is enrolled in social health insurance in our programm area by end of 2013 Indicator 3: Reduction of payment processing time is reduced from over 20 days to less than 5 days at all districts in our programme areas until 2013 Indicator 4: Each public health facitiliy (100%) in our programme area has direct access to its funds by owning and operating a bank account until 2013 Indicator 5: % of financial means which are correctly accounted for according to the national guidelines is increasing by at least 10% points per year in the programme region 26 May 2016 Health Financing Component

3. 3 Indicators and impact-chain 26 May 2016 Health Financing Component

4. 4 Approach The Health Financing Component of TGPSH is advising its partners on the different levels on how to ensure access to affordable health care. The main objectives are to support and strengthen the areas of Social Health Protection as well as Health Financial Management The Health Financing Component is and working with various different stakeholders on district, regional and national level (multilevel-approach) 26 May 2016 Health Financing Component

5. 5 Activities Strengthening of Social Health Protection Support of the Development of Health Financing Strategy, including activities to support (e.g. Costing and Health Sector Regulation) Future management and implementation of CHF/TIKA Scaling-up CHF through group enrolment and PPP Support of Health Financial Management Improving District accountability and flow of funds at district level Coordination and linkage to the national level Support to health sector budget Contribution to the health basket Technical support to sector budget development (e.g. PER, MTEF) 26 May 2016 Health Financing Component

6. 6 Activities – Social Health Protection 26 May 2016 Support of National Policy and Strategy Process (Development of Health Financing Strategy and health sector regulation) Interventions to strengthen Social Health Insurance (NHIF-CHF partnering, Project with NHIF to reduce maternal mortality) Framework for efficient and equitable allocation and use of resources Increase in enrolment into SHI, better mechanisms for SHI Better accessibility (incl. affordability) of health care services, especially for the vulnerable population Improvement of health status of the population INTERVENTIONS/ACTIVITIESEXPECTED OUTPUT EXPECTED OUTCOME EXPECTED IMPACT Health Financing Component

7. 7 Activities – Health Financial Management 26 May 2016 Interventions to strengthen district systems Interventions to improve bottom-up planning and fund management Interventions to improve availability of funds Improved management of funds and accountability Increase of funds Better health care services provided to the population Improvement of health status of the population INTERVENTIONS/ACTIVITIESEXPECTED OUTPUT EXPECTED OUTCOME EXPECTED IMPACT Health Financing Component

8. 8 Challenges Social Health Protection No mid-term health financing strategy yet developed, health services are not costed, stakeholder processes are cumbersome Low coverage of Social Health Insurance, especially targeting and enrolling the informal sector is difficult Health Financial Management Intransparent flow of funds Insufficient reporting of districts on usage of funds Funds (financial and in-kind) are not reaching lower-level facilities Drugs are often out-of-stock Insufficient claiming and reimbursement mechanisms 26 May 2016 Health Financing Component

9. 9 Next steps Further support to national level through technical and financial assistance (especially active participation and assistance through Working Groups) Implementation and roll-out of activities from pilots to other districts Generating impact and evidence of innovations Linking with partners and creating networks 26 May 2016 Health Financing Component