The peer-reviewed study assesses equity and efficiency in health financing across 26 regions in Tanzania for four funding sources in 2017/18. Data from government authorities and national surveys were used to analyze regional funding equity and efficiency. Per capita regional funding varied significantly, particularly in insurance contributions and service coverage performance. Government spending was proportional to regional economic status, while health basket fund (HBF) spending was significantly progressive, targeting regions with high economic need.
Contributions to social health insurance were proportional, while community-based insurance and out-of-pocket payments were regressive, burdening the poor more. The average efficiency score across regions was 90%, suggesting that 90% of financial resources were optimally used. The study suggests mobilizing domestic resources for health, reducing reliance on inequitable payments, and improving resource allocation and tracking at the sub-national level to enhance equity and efficiency in health financing.
