The Community Health Fund (CHF) in Tanzania was established in 2001. Due to the dual role of “Provider” and “Purchaser” of health service played by the Council Health Boards (CHBs) such a design setup has faced challenges of poor management of funds, persistent shortage of services and unreliable membership data. CHF members access services from dispensary level up to district hospital within the Council. As such, unsatisfactory performance of the CHF in most of the councils continue to discourage people to enrol with CHFs subsequently sharply dropout rate of members each year.

NHIF (T) came up with a new initiative and advised the Government to establish “Improved Community Health Fund” (iCHF) in 2016 where members can access medical services up to regional referral hospital across regions thereby allowing portability of services.

iCHF pave the way for NHIF to be the purchaser of the medical services and Councils as the health service providers. By implementing such changes in some of the district councils as the pilot, the overall enrolment of members under CHFs has increased by 38 per cent in one year.