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Tanzania has undertaken important health sector reforms in the last decade with the goal of attaining universal health coverage (UHC). In the recent Health Sector Strategic Plan (2021–26), the country lays out ambitious targets to achieve UHC. Yet, women in Tanzania continue to face significant barriers in accessing healthcare and the country is grappling with important gender-biased health challenges disadvantaging women. In this paper, the authors sought to examine the evolution of Tanzania’s health policy over the past two decades (2000–21) from the perspective of enhancing financial protection for working-age women. The paper draws on a scoping study of diverse literature and data and a review of evidence from other contexts with public health insurance schemes. The results show that Tanzania has a fragmented health system that relies on several independent schemes, characterized by insufficient risk-pooling. Such a system provides insufficient financial protection for working- age women and female-headed households, which are financially less secure than dual-earner households.
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