Investigating sustainability challenges for the National Health Insurance Fund in Tanzania: a modelling approach

Objective This study aimed to model the long-term cost associated with expanding public health insurance coverage in Tanzania. Design, setting and participants We analysed 2016 claims of 2 923 524 beneficiaries National Health Insurance Fund The analysis focused on determining average per beneficiary across 5-year age groups separated by gender, grouped broad condition categories. then modelled three different scenarios from 2020 2050 we estimated costs. Outcome measures Average projected financing requirements, 2050. Results revealed that for was $38.58. Among males over 75 years, costs were highest, amounting $125. total annual $151 million. Under status quo scenario, increase $415 million Increasing 7% 50% would result an additional requirement $2.27 billion. If 10% annually, reaching 56% population 2050, need amount $2.84 Conclusion highlights critical importance assessing financial viability schemes cover large segments low-income countries. findings demonstrate even without expansion coverage, requirements will more than triple Furthermore, increasing is likely substantially escalate claims, potentially requiring significant government or external contributions finance these Policymakers stakeholders should carefully evaluate sustainability ensure adequate support improving healthcare access settings.