[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-detail-108843-en":3,"doc-seo-108843-105":30,"detail-sidebar-cat-0-en-105":92},{"code":4,"msg":5,"data":6},0,"success",{"doc_id":7,"user_id":8,"nickname":9,"user_avatar":10,"doc_module":4,"category_id":11,"category_name":12,"doc_title":13,"doc_description":14,"doc_content":15,"file_id":16,"file_url":17,"file_type":18,"file_size":19,"view_count":20,"is_deleted":4,"is_public":21,"is_downloadable":21,"audit_status":21,"page_count":22,"language":23,"language_code":24,"site_id":25,"html_lang":24,"table_of_contents":26,"faqs":27,"seo_title":13,"seo_description":14,"update_tm":28,"read_time":29},108843,1374391974468,"Eden","https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0",8,"Research & Report","Tanzania Health Financing Policy Notes - Complementary Financing Mechanisms - Role in Tanzania’s Health Financing Architecture","This policy note reviews the role of domestic, non-general-budget sources in Tanzania’s health financing architecture. It covers complementary financing mechanisms such as user fees and cost sharing, NHIF reimbursements, iCHF, insurance for workers in the urban informal sector (TIKA), and other private insurance. The note explains that complementary financing is a small share of total public health spending (around 1–2%), yet it is an important and growing component of facility-level revenue. It also discusses how complementary funds help offset declines in government non-wage recurrent spending and highlights reforms like the Health Basket Fund (HBF) that shift resources toward service providers. Finally, it analyzes the rising importance of user fees and the equity concerns for poorer households, along with measures improving accountability through electronic financial management.","2  \nTanzania HEALTH FINANCING Policy Notes  \nMarch 2020  \nPub lic Disclosure Authorized Pub lic Disclosure Authorized Pub lic Disclosure Authorized Pub lic Disclosure Authorized  \n1. COMPLEMENTARY FINANCING MECHANISMS IN TANZANIA  \nThis note reviews the role of domestic financing sources other than general government budget allocations in Tanzania’s health financing architecture. These include funds raised from user fees or cost sharing, reimbursements from the national health insurance fund (NHIF), funds made available from the improved community health fund (iCHF), insurance for workers in the urban informal sector (TIKA), and other private insurance. In Tanzania, these are referred to as complimentary financing mechanisms.  \nComplementary financing sources makeup a small share of total public spending  \non health. Complementary financing is received and spent at the facility level. These sources represent only a small percentage of total public spending on health and is ranging from 1 to 2 percent of total public spending (Table 1) . Revenues from complementary financing are eclipsed by government budget provisions, which are predominantly allocated for wages and infrastructure investments. Donors also contribute significantly, especially for vertical programs, medical supplies and vaccines, which diminishes the relative share of complimentary financing sources further.  \nTable 1: Domestic Financing for Health (in US$ Millions and percentages)  \n\n|  | 2013 | 2014 | 2015 | 2016 | 2017 |\n| --- | --- | --- | --- | --- | --- |\n| Government expenditure | 529.4 | 558.5 | 509.8 | 546.1 | 662.1 |\n|  | (98.7%) | (97.9%) | (98.0%) | (97.7%) | (98.2%) |\n| NHIF | 1.3 | 2.8 | 2.5 | 3.8 | 3.8 |\n|  | (0.2%) | (0.5%) | (0.5%) | (0.7%) | (0.6%) |\n| CHF/TIKA | 2.0 | 3.2 | 2.9 | 2.8 | 2.7 |\n|  | (0.4%) | (0.6%) | (0.6%) | (0.5%) | (0.4%) |\n| User Fees in Public Facilities (Out of pocket) | 3.8 | 5.7 | 5.1 | 6.4 | 5.5 |\n|  | (0. 7%) | (1.0%) | (1.0%) | (1.1%) | (0.8%) |\n| Total | 1,466 | 1,459 | 1,240 | 1,417 | 1,633 |\n|  | (100%) | (100%) | (100%) | (100%) | (100%) |\n\nSource: Government FMIS, PlanRep 1.  \nComplementary financing sources makeup an important share of facility revenue. While these sources are small in terms of total public financing for health, they make up an important and growing share of total revenue availability at the provider level. Total revenue collected  \nfrom complementary financing mechanisms has increased steadily over the last 5 years from all sources.  \nThe increase in complementary financing has protected providers from a decline in funding from the government’s non-wage recurrent budget. The “other charge” budget  \n1 PlanRep is a planning and reporting database used by local government authorities. Data on private spending on private providers were not available. All figures are in current US dollars. Estimated using the calendar year interbank exchange rate.  \ncategory is meant to cover operational expenditures. At the local government level, spending at this level has declined significantly while complementary financing has become increasingly necessary (Figures 1 and 2) . In 2016 and 2017, the amount of complementary financing available to health facilities was  \nhigher than the regular government budget allocations for health. Furthermore, the government’s “other charges” budget allocations were given to the councils, and thereis some evidence that these resources did not always reach providers.2  \n\n| Figure 1: Complimentary Financing Compared to Other Charges (Absolute) |  |  | Figure 2: Complimentary Financing Compared to Other Charges (Relative) |  |\n| --- | --- | --- | --- | --- |\n| TZS | 60,000 M\u003Cbr>50,000 M\u003Cbr>40,000 M\u003Cbr>30,000 M\u003Cbr>20,000 M\u003Cbr>10,000 M\u003Cbr>0 M |  | 100%\u003Cbr>90%\u003Cbr>80%\u003Cbr>70%\u003Cbr>60%\u003Cbr>50%\u003Cbr>40%\u003Cbr>30%\u003Cbr>20%\u003Cbr>10%\u003Cbr>0% |  |\n|  OC  ComplFin |  |  | 2012-13 2013-14 2014-15 2015-16 2016-17\u003Cbr> OC  ComplFin |  |\n\nSource: PlanRep.  \nNote: OC = “Other Charges” from the government budget. ","cbCaibPwTWgJgxop","https://ap.wps.com/l/cbCaibPwTWgJgxop","pdf",824202,5,1,9,"English","en",105,"# Complementary financing mechanisms in Tanzania\n## Financing sources covered\n## Share of total public spending vs facility revenue\n## Comparison with other charges and budget allocation\n## Health Basket Fund and donor financing considerations\n## User fees and equity implications\n## Accountability and financial management systems","[{\"question\":\"What are “complimentary financing mechanisms” in Tanzania’s health financing architecture?\",\"answer\":\"They include funds from user fees and cost sharing, NHIF reimbursements, improved community health fund (iCHF) resources, insurance for workers in the urban informal sector (TIKA), and other private insurance sources.\"},{\"question\":\"How large is complementary financing in total public health spending?\",\"answer\":\"Complementary financing accounts for a small share of total public spending on health, ranging from about 1% to 2% in the presented figures.\"},{\"question\":\"Why does complementary financing matter at the facility level even if it is small overall?\",\"answer\":\"It makes up an important and growing share of provider revenue, helping protect facilities from funding declines in government non-wage recurrent budgets and becoming increasingly necessary for operations.\"}]",1784474339,23,{"code":4,"msg":31,"data":32},"ok",{"site_id":25,"language":24,"slug":33,"title":13,"keywords":34,"description":14,"schema_data":35,"social_meta":87,"head_meta":89,"extra_data":91,"updated_unix":28},"tanzania-health-financing-policy-notes-complementary-financing-mechanisms-role-in-tanzanias-health-financing-architecture","",{"@graph":36,"@context":86},[37,54,69],{"@type":38,"itemListElement":39},"BreadcrumbList",[40,44,48,51],{"item":41,"name":42,"@type":43,"position":21},"https://docshare.wps.com","Home","ListItem",{"item":45,"name":46,"@type":43,"position":47},"https://docshare.wps.com/document/","Document",2,{"item":49,"name":12,"@type":43,"position":50},"https://docshare.wps.com/document/research-report/",3,{"item":52,"name":13,"@type":43,"position":53},"https://docshare.wps.com/document/tanzania-health-financing-policy-notes-complementary-financing-mechanisms-role-in-tanzanias-health-financing-architecture/108843/",4,{"url":52,"name":13,"@type":55,"author":56,"headline":13,"publisher":58,"fileFormat":61,"inLanguage":24,"description":14,"dateModified":62,"datePublished":63,"encodingFormat":61,"isAccessibleForFree":64,"interactionStatistic":65},"DigitalDocument",{"name":9,"@type":57},"Person",{"url":41,"name":59,"@type":60},"DocShare","Organization","application/pdf","2026-07-30","2026-07-19",true,{"@type":66,"interactionType":67,"userInteractionCount":20},"InteractionCounter",{"@type":68},"ViewAction",{"@type":70,"mainEntity":71},"FAQPage",[72,78,82],{"name":73,"@type":74,"acceptedAnswer":75},"What 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