Contributions of Community Health Fund to Social Health Security in Kalambo District Rukwa, Tanzania

Community Health Fund (CHF) was established in 1996 as a District Council based pre-payment health insurance scheme in Tanzania with the aim of improving health of communities working in the informal sectors. However, since its formulation, it has been performing unsatisfactorily, and hence majority of Households (HHs) are not members while other members are withdrawing from the scheme. This necessitated the need for assessing the contribution of CHF on social health security among members. Specifically, this paper examined the challenges faced by households regarding CHF membership and analysed the contributions of CHF on its member. The study area was Kalambo District Council. A cross-sectional research design was used, whereas a simple random sampling technique through lottery method was employed to select the sample size of 354 respondents. Qualitative data were collected using Focus Group Discussions (FGDs) and Key Informant Interviews (KIIs), while quantitative data were collected using a questionnaire. Quantitative data were coded and analysed using IBM-SPSS. Qualitative data were analysed through content analysis. The results show that CHF contributed to social health security among its members in the study area, through provision of health services to its members once they fall sick. On other hand, CHF had few members as only 24.3% of HHs had membership to CHF. One of the barriers for CHF was lack of awareness among communities about the existence of CHF, while other cited lack of money for contributing to CHF. Thus, the study concludes that CHF has not contributed significantly to the health security among targeted members. The study recommends that, CHF officials should widely sensitize communities through seminars and meetings about CHF and its benefits to them. Furthermore, CHF stakeholders should coordinate communities in the area to establish financial institutions such as Village Community Banks (VICOBA) where they can save and borrow money for registration cards.