DODOMA, Tanzania: Tanzania has begun the first phase of a nationwide universal health insurance programme, placing the country among a growing number of African states seeking to expand access to healthcare through state-backed insurance systems.
The Universal Health Insurance (UHI) scheme, which begins on 26 January, aims to guarantee essential health services for more than 1.45 million vulnerable people in its initial phase, including elderly citizens, children, pregnant women and people with disabilities.
The reform is being rolled out as part of President Samia Suluhu Hassan’s broader agenda to strengthen social protection and reduce inequality, with officials describing it as a key early milestone within the government’s first 100 days under the current phase of administration.
Speaking in the capital Dodoma, Health Minister Mohamed Mchengerwa said the programme marked a shift in how healthcare is understood and delivered in Tanzania.
“This reform reflects a commitment to recognising healthcare as a fundamental right, not a privilege,” he said. “It lays the foundation for long-term protection of all citizens.”
Under the first phase, the government will fully cover 276,004 vulnerable households through a Basic Essential Services Package valued at 150,000 Tanzanian shillings per household. The package covers up to six family members, including spouses and dependants such as children under 21 and close relatives.
Health services will be accessed through Tanzania’s national referral system at facilities accredited by the National Health Insurance Fund.
Across East Africa, governments have adopted different models to expand healthcare coverage, with varying levels of success. Rwanda is often cited for its community-based health insurance system, while Kenya has focused on expanding its national insurance scheme to informal workers and low-income households. Tanzania’s approach combines state-funded coverage for vulnerable groups with a phased expansion aimed at eventually covering the entire population.
Mr Mchengerwa said strong leadership at the regional and local levels would be critical to ensuring the reform translates into real access to care.
“This is not a technical exercise for health professionals alone,” he said. “It is a leadership responsibility that requires direct involvement, oversight and accountability.”
He added that progress would be assessed based on outcomes in regions and communities, rather than national-level announcements.
“Where citizens are well-informed, widely registered and accessing services without barriers, that is where success will be evident,” he said. “Delays will reflect implementation challenges, not flaws in the policy itself.”
Preparations are already under way nationwide, with UHI implementation featuring prominently in Regional Consultative Committee meetings. District Commissioners and council directors have been instructed to oversee registration at the grassroots level, ensuring enrolment reaches villages, wards and urban neighbourhoods.
“Registration is not a one-off campaign,” the minister said. “It is a continuous administrative responsibility that requires planning, supervision and follow-up at the lowest levels of government.”
The government has opted for a phased rollout to allow time for the completion of supporting systems, including a unified national digital platform designed to manage enrolment, benefits and service delivery across all health facilities.
According to the health ministry, the interoperable digital system is expected to be operational within three to six months. Once in place, the second phase of UHI will expand coverage to the wider population, including citizens outside the vulnerable groups currently prioritised.
Similar digital platforms have played a central role in health insurance reforms in countries such as Ghana and Rwanda, helping to improve transparency, reduce duplication and streamline service delivery. Tanzanian officials say the system will be critical to scaling the programme sustainably.
To support implementation, the government has developed a national public awareness strategy, with regional and local leaders tasked with coordinating community outreach. Health facility managers have also been urged to prioritise service quality, with authorities stressing that public confidence will be essential to long-term participation.
Analysts say Tanzania’s reform reflects a broader continental trend, as African governments seek to reduce out-of-pocket health spending and move closer to the global goal of universal health coverage.
For Tanzania, officials say the launch of UHI represents one of the most significant health policy shifts in recent years — transforming universal healthcare from a long-term ambition into an active, phased programme now under way.
