Paving the Way to Universal Health Coverage in Tanzania

Munshi, Zaheer Rik; Blue, M. Connor; Rahim, Faraan O.; Mahatara, Erick; Reddy, Raghuram; Tamirisa, Ketan; Ajay Jadav, Arnav; Ashar, Perisa; Rugakingira, Anzibert

Paving the Way to Universal Health Coverage in Tanzania

Articles in Press

Document Type : Viewpoint

Authors

Zaheer Rik Munshi ¹

M. Connor Blue ²

Faraan O. Rahim ³

Erick Mahatara ⁴

Raghuram Reddy ⁵

Ketan Tamirisa ⁶

Arnav Ajay Jadav ⁶

Perisa Ashar ⁷

Anzibert Rugakingira ⁸

¹ The College, University of Chicago, Chicago, IL, USA

² University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA

³ Harvard Medical School, Boston, MA, USA

⁴ School of Medicine, KCMC University, Moshi, Tanzania

⁵ Department of Humanities, Health and Society, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA

⁶ University of California, San Francisco, San Francisco, CA, USA

⁷ Duke University, Durham, NC, USA

⁸ The World Bank Tanzania, Dar es Salaam, Tanzania

Keywords

Health Reform

Health Innovation

Health Priorities

Global Health

Africa

1. Wang H, Rosemberg N. Universal Health Coverage in Low-Income Countries: Tanzania’s Efforts to Overcome Barriers to Equitable Health Service Access. World Bank Group. https://openknowledge.worldbank.org/entities/publication/64bb3e90-d983-5c3d-843b-de4e202cd3d2. Published 2018. Accessed April 12, 2025.

2. Transforming our world: the 2030 Agenda for Sustainable Development. United Nations; 2015. https://sdgs.un.org/2030agenda. Accessed April 12, 2025.

3. Kapologwe NA, Kalolo A, Kibusi SM, et al. Understanding the implementation of Direct Health Facility Financing and its effect on health system performance in Tanzania: a non-controlled before and after mixed method study protocol. Health Res Policy Syst. 2019;17(1):11. doi:10.1186/s12961-018-0400-3

4. Ruhago GM, Ngalesoni FN, Kapologwe NA, et al. Strengthening financial management systems at primary health care: Performance assessment of the Facility Financial Accounting and Reporting System (FFARS) in Tanzania. Front Health Serv. 2023;2:787940. doi:10.3389/frhs.2022.787940

5. The United Republic of Tanzania Ministry of Health, National Health Accounts for Financial Years. https://p4h.world/app/uploads/2024/09/NATIONAL-MINISTRY-OF-HEALTH-FINAL-2021.22.x23411.pdf. Published 2023. Accessed February 10, 2026.

6. UNICEF, Zanzibar Health Budget. https://www.unicef.org/esa/media/11306/file/UNICEF-Tanzania-Zanzibar-2022-Health-Budget-Brief.pdf. Published 2022. Accessed February 10, 2026.

7. The United Republic of Tanzania Ministry of Health. https://www.moh.go.tz/storage/app/uploads/public/687/898/572/68789857246a6332887710.pdf. Published 2024. Accessed February 10, 2026.

8. World Bank. Tanzania Human Resources for Health Assessment. https://documents1.worldbank.org/curated/en/099063023140031025/pdf/P17987004053560808a1a0d12af8e73a38.pdf. Accessed February 10, 2026.

9. Health-National Adaptation Plan (HNAP) To Climate Change in Tanzania 2018-2023. The United Republic of Tanzania Ministry of Health, Community Development, Gender, Elderly and Children. https://climahealth.info/wp-content/uploads/2022/02/HNAP-FINAL-CLEAN-1-1.pdf. Accessed April 12, 2025.

10. UHC service coverage index - Tanzania. Global Health Observatory. Geneva: World Health Organization; 2023. https://donnees.banquemondiale.org/indicateur/SH.UHC.SRVS.CV.XD?locations=TZ. Accessed April 12, 2025.

11. Durizzo K, Harttgen K, Tediosi F, et al. Toward mandatory health insurance in low-income countries? An analysis of claims data in Tanzania. Health Econ. 2022;31(10):2187-2207. doi:10.1002/hec.4568

12. Langat EC, Ward P, Gesesew H, Mwanri L. Challenges and opportunities of universal health coverage in Africa: a scoping review. Int J Environ Res Public Health. 2025;22(1):86. doi:10.3390/ijerph22010086

13. Tanzania’s Success to Reduce Maternal Mortality Ushers in a Model for Africa. Africa Centres for Disease Control and Prevention. https://africacdc.org/news-item/tanzanias-success-to-reduce-maternal-mortality-ushers-in-a-model-for-africa/. Accessed April 12, 2025.

14. Ahmed S, Ali M, Shah I, Tsui A. Effect of maternity care improvement, fertility decline, and contraceptive use on global maternal mortality reduction between 2000 and 2023: results from a decomposition analysis. Lancet Glob Health. 2026;14(1):e33-e48. doi:10.1016/S2214-109X(25)00409-7

15. Nakkazi E. Marburg virus disease in Tanzania. Lancet Infect Dis. 2025;25(3):e140. doi:10.1016/S1473-3099(25)00103-3

16. Barry A, Impouma B, Wolfe CM, et al. Non-communicable diseases in the WHO African region: analysis of risk factors, mortality, and responses based on WHO data. Sci Rep. 2025;15(1):12288. doi:10.1038/s41598-025-97180-3

17. World Health Organization, Country Disease Outlook. https://www.afro.who.int/sites/default/files/2023-08/Tanzania.pdf. Published 2023. Accessed February 9, 2026.

18. The United Republic of Tanzania, NCD Action Plan. https://tzdpg.or.tz/wp-content/uploads/2022/04/NCD-ACTION-PLAN-2021-2026.pdf. Accessed February 7, 2026.

19. Mosadeghrad AM, Isfahani P, Eslambolchi L, Zahmatkesh M, Afshari M. Strategies to strengthen a climate-resilient health system: a scoping review. Global Health. 2023;19(1):62. doi:10.1186/s12992-023-00965-2

20. U.S. Support Helps Tanzania Secure $25 Million in Pandemic Preparedness. U.S. Embassy in Tanzania. https://tz.usembassy.gov/u-s-support-helps-tanzania-secure-25-million-in-pandemic-preparedness/#:~:text=U.S.%20Embassy%20in%20Tanzania%20Dar%20es%20Salaam,in%2040%20countries%20across%20six%20geographical%20regions. Published 2024. Accessed April 12, 2025.

21. Joint external evaluation of the International Health Regulations (‎2005)‎ core capacities of the United Republic of Tanzania-Zanzibar. World Health Organization; 2024. https://www.who.int/publications/i/item/9789240095632. Accessed April 12, 2025.

22. Mori AT. Mandatory health insurance for the informal sector in Tanzania-has it worked anywhere! Front Health Serv. 2023;3:1247301. doi:10.3389/frhs.2023.1247301

23. World Health Assembly. https://cdn.who.int/media/docs/default-source/health-financing/sustainable-health-financing-universal-coverage-and-social-health-insurance.pdf?sfvrsn=f8358323_3. Published 2005. Accessed February 11, 2026..

24. World Health Assembly. https://cdn.who.int/media/docs/default-source/health-financing/sustainable-health-financing-structures-and-universal-coverage.pdf?sfvrsn=d5d909b3_3. Published 2011. Accessed February 7, 2026.

25. Omari SK, Mosses LI. Assessing the implementation gap of disability inclusive health in Tanzania’s universal health insurance act. Discover Public Health. 2025;22(1):814.

26. World Health Organization, Work Force 2030. https://www.who.int/publications/i/item/9789241511131 Published 2020. Accessed February 4, 2026.

27. National One Health Strategic Plan 2022-2027. The United Republic of Tanzania Prime Minister's Office. https://www.pmo.go.tz/uploads/documents/sw-1677564782-National%20One%20Health%20Strategic%20Plan%202022%20-2027.pdf. Accessed April 12, 2025.

28. Tanzania: New Financing to Support Inclusive and Resilient Economic Recovery and Improved Healthcare Services. World Bank Group. https://www.worldbank.org/en/news/press-release/2022/12/20/tanzania-new-financing-to-support-inclusive-and-resilient-economic-recovery-and-improved-healthcare-services. Published 2022. Accessed April 12, 2025.

29. Tanzania Civil Society Report. https://tgnp.or.tz/wp-content/uploads/The-2023-CSO-Report-on-SDGs.pdf. Published 2023. Accessed February 4, 2026.

30. The United Republic of Tanzania. Health Sector Strategic Plan. https://mitu.or.tz/wp-content/uploads/2021/07/Tanzania-Health-Sector-Strategic-Plan-V-17-06-2021-Final-signed.pdf. Accessed February 4, 2026.

31. Policy Advisory. https://www.esrf.or.tz/usaidreflections.pdf. Published 2025. Accessed February 4, 2026.

32. World Health Organization. Integrating palliative care and symptom relief into primary health care: a WHO guide for planners, implementers and managers. https://www.who.int/publications/i/item/integrating-palliative-care-and-symptom-relief-into-primary-health-care. Published October 16, 2018.