Transcript TAARIFA YA MFUKO WA AFYA YA JAMII NA BODI YA AFYA

KILOSA DISTRICT COUNCIL
Challenges of low CHF Enrolment
CHF KILOSA
Dr. Mapunjo
Ag. DMO Kilosa
INTRODUCTION :
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CHF implementation in Kilosa District started
in 1999
It operates in all government health facilities
Annual membership fee per household /
family is 5000/= and a 100% matching grant
for the pooled community health fund is
provided by the government
The user fees contribution was decided to be T
shs 1000/= in dispensaries, 1500/= in Health
centre and 2000/= for the district Hospital
TRENDS OF CHF ENROLMENT SINCE THE
YEAR 200O IN KILOSA DISTRICT
ENROLMENT OF MEMBERS IN
COMMUNITY HEALTH FUND :
Kilosa District struggles with low enrolment levels
(on average 2.6% of the population) even
though CHF has been in operation for six years .
Among the Reasons for Low enrolment:
• Introduction of National Health Insurance for
Civil Servants in 2002.
ENROLMENT OF MEMBERS IN COMMUNITY HEALTH FUND (Cont. 2)
Among the Reasons for Low enrolment:
• Shortage of drugs and other supplies from
medical stores department at a particular period.
• Inadequate cooperation and sensitization from
community leaders and community health
committees.
• Shortage of adequate qualified human resource
for health.
• Insufficient laboratory facilities at lower facility
level particularly at dispensary level.
REASONS FOR LOW ENROLMENT cont.
• CHF membership not valid at referral level and
does not cover secondary care.
• Broad National exemption policy.
• Low user fees
• Poor perception of the community about the
benefits provided by the community health fund
and services provided in Health facilities.
AMONG THE ACHIVEMENTS
The funds collected have been contributing in
various areas in improving health services
such as:
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To renovate several buildings such as 4
wards at the District Hospital, toilets,
Outpatient clinics e.t.c in District hospital , 4
Health centers and 32 dispensaries
buildings.
AMONG THE ACHIVEMENTS (cont. 2)
• To build some facilities such as 8
toilets in hospital ,dispensaries, and
health centre, 1 maternal and child
health clinic , mortuary and inpatient
ward in two health centre ,health staffs
houses in 2 dispensaries.
AMONG THE ACHIVEMENTS (cont. 3)
• Installation of electricity in 4
dispensaries and to connect piped
water supply in 3 dispensaries.
• To support buildings of District hospital
fence and corridor.
• To purchase essential drugs and
supplies when need arises
PROBLEMS IN IMPLEMENTING
CHF:
• Politicians discourage community
to contribute in CHF in order to
gain popularity in communities
especially during election
campaign.
PROBLEMS IN IMPLEMENTING
CHF (Cont. 2)
– Guidelines for identifying poor people for
exemption in the society are not clear its
very difficult to identify who is poor.
– Community leaders are not playing
there required roles in sensitization,
collection and storage of CHF
information all tasks are done by Health
workers
RECOMMENDATION
•Politician and community
leaders they have to understand
importance of cost sharing in
health in order to improve Health
services.
RECOMMENDATION (Cont. 2)
• There is a need to revise some of the
guidelines and criteria for granting
exemption and waivers.
• The coverage of CHF has to be increased
up to secondary care so as to increase
risk pooling for poor people in the
community.