Drivers for implementing e-claim process of improved Community Health
Fund from two districts in Central Tanzania.
Abstract
Background: In most Low and Middle-Income Countries (LMICs),
enrolment in community-based health insurance (CBHI) is still low. In
Sub-Saharan Africa enrolment rate is less than 10%. There have been
efforts and strategies being put in place in many countries to overcome
this problem. In 1996, Tanzania introduced Community Health Fund (CHF)
which was modified in 2011 whereby the government came up with the
improved community health fund (iCHF). The introduction of iCHF was
intended to improve service delivery to the population where an
electronic integrated management information system was introduced.
Objective: This study was set to explore the drivers for
implementing the e-claim process of improved Community Health
Funds from two districts in Central Tanzania. Methods: An
exploratory case study design using a qualitative approach was adopted
to explore information on the drivers of the implementation of the iCHF
electronic claim process in Mkalama and Iramba districts in Singida
region. In-depth interviews were used to collect data from the Eighteen
(18) participants including regional health managers, district health
managers, Information Technology (IT) officers, facility in charge and
iCHF focal persons from dispensaries, health centres and hospitals. Data
were analyzed using a thematic content analysis. Results: The
drivers for implementing the iCHF e-claim process were adherence to
supervision directives and government policy, resource management and
client satisfaction but the e-claim system does not attract Health
Community Workers (HCWs) to comply with the iCHF e-claim process
Conclusion: The iCHF e-claim process is inadequately
implemented and does not attract Health care workers (HCWs) due to the
challenges that have been observed. These findings inform decision
makers to joint efforts to improve the implementation of iCHF claim
process from all levels of stakeholders.