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Update on HFS, RBF, fiscal space study... -/12/2014 - P4H Network

Update on HFS, RBF, fiscal space study… -/12/2014

Below an update from the Health Financing Technical Working Group on various health financing issues. Source: P4H Coordinator, Tanzania

Health Financing Strategy

  • Work on the Health Financing Strategy (HFS) for Tanzania is in its final stages. In the coming two months the last loose ends of the strategy draft will be tied together, particularly as regards the costing of the proposed Minimum Benefit Package, the estimates for implementation of the strategy as a whole and re-modeling of the fiscal space for the foreseen reforms.This work is closely supported by the P4H partners in Tanzania and assisted by Futures Group, through the One Health costing approach and through technical guidance on sequencing of suggested implementation steps of the strategy by WHO and Abt Associates.  2014_12_16_Tanzania_HFS_2nd-draft
  • Costing of the Strategy expected in January 2015.
  • Though the technical work on the strategy has largely been completed, the next important step requires to lift the strategy to the political level and obtain broader government support and political leverage.
  • P4H partners will be discussing an appropriate strategy to best communicate and position the health financing strategy, particularly against competing priorities such as the Big Results Now (BRN) targets.  It is still felt that – despite the Inter-Ministerial Steering Committee – the HFS has not yet gained sufficient government support yet, neither from within the MOHSW nor across linked line ministries.  A working session might be proposed among ISC members and key development partners in January 2015 in order to jointly agree on key arguments for the strategy (in terms of proposed reforms and their cost implications) before cabinet submission.
  • At next HF TWG: Discussion on any parallel funding flows not touched upon in the strategy yet such as the HIV/ AIDS Trust Fund and the new Global Financing Facility for reproductive health and mother and child services.


 According to a news item on 2.12. 2014 “ The Government is in the final preparation stages of a bill that will make it mandatory for all households to enroll with health insurance arrangements, so as to avoid disasters emanating from sickness and accidents. The Minister for Health and Social Welfare, Dr Seif Rashid, said here that the bill has been approved by the Cabinet already and has been forwarded to the Parliamentary Committee on Social Services. This means it will be tabled soon in Parliament. This is breaking news if it is confirmed and a decision/ move of which development partners working in support of the HFS have not been informed to this moment.  Here alignment and the process of the HFS development have to be questioned once the Ministry of Health confirms this news.

Results Based Financing:

  • Tanzania has further refined its RBF design as part of the Health Financing Strategy:  2014_11_13_Tanzania_RBF_Design This is a process assisted by World Bank and to some extent also by other P4H partners, like SDC and GIZ who provide consultants and capacity development on an adhoc basis.
  • The pre-pilot of this revised RBF design is aimed at staring in February 2015, in the region of Shynianga. 
  • SDC is in the process of hiring of a longer term consultant to continue the RBF team support 

Fiscal Space Study:

  • The One Health/ futures team will be adding to the work of the OPM fiscal space paper and calculate the fiscal space taking costing assumptions relating to the HFS into account.  Expected results in January 2015.
  • There is a FS study for Social Protection currently going on in TZ to which linkages should be drawn.  To be discussed at next HF TWG.

Future DP support to Health Basket Fund:

The attached letter from Development Partners (DPs) raises some issues regarding essential health commodities and government dept to MSD; Community Health Fund (CHF) matching funds; follow-up on audit recommendations; and DP commitements.

DP Letter – Future Support to HBF by Development Partners

16 Dec 2014