Findings from Swiss Tropical and Public Health Institute Provides New Data about Managed Care (Understanding the Role of the Tanzania National Health Insurance Fund In Improving Service Coverage and Quality of Care): Managed Care

2024 MAY 23 (NewsRx) -- By a News Reporter-Staff News Editor at Health & Medicine Business Daily -- Investigators discuss new findings in Managed Care. According to news originating from Basel, Switzerland, by NewsRx correspondents, research stated, “Health insurance is one of the main financing mechanisms currently being used in low and middle -income countries to improve access to quality services. Tanzania has been running its National Health Insurance Fund (NHIF) since 2001 and has recently undergone significant reforms.”

Financial support for this research came from Swiss National Science Foundation (SNSF).

Our news journalists obtained a quote from the research from Swiss Tropical and Public Health Institute, “However, there is limited attention to the causal mechanisms through which NHIF improves service coverage and quality of care. This paper aims to use a system dynamics (qualitative) approach to understand NHIF causal pathways and feedback loops for improving service coverage and quality of care at the primary healthcare level in Tanzania. We used qualitative interviews with 32 stakeholders from national, regional, district, and health facility levels conducted between May to July 2021. Based on the main findings and themes generated from the interviews, causal mechanisms, and feedback loops were created. The majority of feedback loops in the CLDs were reinforcing cycles for improving service coverage among beneficiaries and the quality of care by providers, with different external factors affecting these two actions. Our main feedback loop shows that the NHIF plays a crucial role in providing additional financial resources to facilities to purchase essential medical commodities to deliver care. However, this cycle is often interrupted by reimbursement delays. Additionally, beneficiaries ‘ perception that lower -level facilities have poorer quality of care has reinforced care seeking at higher -levels. This has decreased lower level facilities ‘ ability to benefit from the insurance and improve their capacity to deliver quality care. Another key finding was that the NHIF funding has resulted in better services for insured populations compared to the uninsured.”

According to the news editors, the research concluded: “To increase quality of care, the NHIF may benefit from improving its reimbursement administrative processes, increasing the capacity of lower levels of care to benefit from the insurance and appropriately incentivizing providers for continuity of care.”

This research has been peer-reviewed.

For more information on this research see: Understanding the Role of the Tanzania National Health Insurance Fund In Improving Service Coverage and Quality of Care. Social Science & Medicine, 2024;347. Social Science & Medicine can be contacted at: Pergamon-elsevier Science Ltd, The Boulevard, Langford Lane, Kidlington, Oxford OX5 1GB, England. (Elsevier - www.elsevier.com; Social Science & Medicine - http://www.journals.elsevier.com/social-science-and-medicine/)

The news correspondents report that additional information may be obtained from Doris Osei Afriyie, Swiss Tropical and Public Health Institute, Dept. of Epidemiology and Public Health, Basel, Switzerland. Additional authors for this research include Pei Shan Loo, Tani Kassimu, Gunther Fink, Fabrizio Tediosi, August Kuwawenaruwa and Sally Mtenga.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1016/j.socscimed.2024.116714. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

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