“Universal health insurance is not a TASAF programme and it is not a TASAF fund,” said District Executive Director Ms Shamimu Mwariko.
Tanzania registered all 276,004 households targeted in the first phase of its Universal Health Insurance rollout by June 2026, meeting 100 per cent of its initial household goal.
The nationwide financing reform, central to the ambitions of building a healthy population under Dira 2050, addresses a longstanding financial barrier where paying directly at the point of service burdens individuals and households facing prolonged or specialised care.
Assistant Director for Policy, Research and Innovation in the Ministry of Health, Mr Tumainiel Macha, announced on October 22, 2026, that the government had decentralised supervision of the second phase of Universal Health Coverage to regional authorities to boost community mobilisation and public enrolment.
The first phase focused on low-income families, elderly people, and children in residential care facilities, with the government financing coverage for those unable to make contributions. In Newala District, Mtwara Region, District Commissioner Mr Mwangi Kundya said the state provided 150,000/- per household to help up to six members secure coverage.
“The government has decided to take steps that will enable citizens who face health problems to receive treatment without worrying about the amount of money they have in their pockets,” Mr Kundya said.
Dr Chandika said that the National Health Insurance Fund carried out the nationwide exercise alongside the Ministry of Health, the President’s Office–Regional Administration and Local Government, and the Ministry of Community Development, Gender, Women and Special Groups.
“The government pays for this group because they do not have the ability,” Dr Chandika said.
During the initial push, Mlele District Commissioner Alhaji Mwanga reported 1,186 targeted households covering 5,215 beneficiaries. In Mpimbwe District, Ms Mwariko said that more than 4,000 people benefited, allowing them to bypass traditional exemption windows.
“Those in these special groups will no longer pass through the exemption window. They go directly with their cards,” Ms Mwariko said, adding that beneficiaries accessed over 200 listed healthcare services using insurance cards.
Nationwide insurance enrolment increased from eight per cent in 2023 to 11 per cent by November 2026, according to Mr Macha. The government aims to reach 25 million beneficiaries by July 2027, assigning specific targets to each region and council. Dodoma Region, featuring eight councils, received an objective to raise insurance coverage to 42 per cent during the second phase.
Minister for Health Mohamed Mchengerwa opened a special seminar in Dodoma for members of parliament, emphasizing that the second phase targets citizens capable of paying for their own insurance packages.
“Those who can afford it will contribute, while those who cannot will be supported by the government. No Tanzanian will be left out of this because they cannot contribute,” Mr Mchengerwa said.
Mr Macha urged legislators to monitor progress and encourage constituents to participate in the enrolment frameworks established by the Universal Health Insurance Act.
“We believe you are the representatives of the people. Through your positions, we ask you to become ambassadors of this programme. Make health insurance part of the agenda in your internal and public meetings,” Mr Macha said.
Meanwhile, sustainability considerations persist alongside expansion. In April 2026, NHIF staff requested their Board to advise the government on reviewing employee contribution rates. Current public- and private-sector arrangements involve a combined monthly contribution of six per cent, split evenly between employees and employers. Staff pointed out that escalating expenses for specialised treatments place financial demands on the existing resource structure.
