Health insurance and health system (un) responsiveness: a qualitative study with elderly in rural Tanzania

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Health insurance and health system (un) responsiveness : a qualitative study with elderly in rural Tanzania

Amani, Paul Joseph (author): Umeå universitet,Institutionen för epidemiologi och global hälsa,Department of Health Systems Management, School of Public Administration and Management, Mzumbe University, Morogoro, Tanzania

Hurtig, Anna-Karin (author): Umeå universitet,Institutionen för epidemiologi och global hälsa

Frumence, Gasto (author): Department of Development Studies, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania

Kiwara, Angwara Denis (author): Department of Development Studies, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania

Goicolea, Isabel (author): Umeå universitet,Institutionen för epidemiologi och global hälsa

San Sebastian, Miguel (author): Umeå universitet,Institutionen för epidemiologi och global hälsa

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2021-10-22
2021
English.
In: BMC Health Services Research. - : BioMed Central. - 1472-6963. ; 21:1

Related links:: https://doi.org/10.1...; show more...; https://umu.diva-por... (primary) (Raw object); https://bmchealthser...; https://urn.kb.se/re...; https://doi.org/10.1...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

BACKGROUND: Health insurance (HI) has increasingly been accepted as a mechanism to facilitate access to healthcare in low and middle-income countries. However, health insurance members, especially those in Sub-Saharan Africa, have reported a low responsiveness in health systems. This study aimed to explore the experiences and perceptions of healthcare services from the perspective of insured and uninsured elderly in rural Tanzania.METHOD: An explanatory qualitative study was conducted in the rural districts of Igunga and Nzega, located in western-central Tanzania. Eight focus group discussions were carried out with 78 insured and uninsured elderly men and women who were purposely selected because they were 60 years of age or older and had utilised healthcare services in the past 12 months prior to the study. The interview questions were inspired by the domains of health systems' responsiveness. Qualitative content analysis was used to analyse the data.RESULTS: Elderly participants appreciated that HI had facilitated the access to healthcare and protected them from certain costs. But they also complained that HI had failed to provide equitable access due to limited service benefits and restricted use of services within schemes. Although elderly perspectives varied widely across the domains of responsiveness, insured individuals generally expressed dissatisfaction with their healthcare.CONCLUSIONS: The national health insurance policy should be revisited in order to improve its implementation and expand the scope of service coverage. Strategic decisions are required to improve the healthcare infrastructure, increase the number of healthcare workers, ensure the availability of medicines and testing facilities at healthcare centers, and reduce long administrative procedures related to HI. A continuous training plan for healthcare workers focused on patients' communication skills and care rights is highly recommended.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)

Keyword

Tanzania
elderly
health insurance
healthcare use
responsiveness

Publication and Content Type

ref (subject category)
art (subject category)

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