NHIF Achieves TZS 95 Billion Surplus, Strengthens Services

NHIF Achieves Financial Growth, Amasses TZS 95 Billion in Surplus

March 11, 2025

The National Health Insurance Fund (NHIF) has recorded a financial surplus of TZS 95 billion as of December last year, marking a significant achievement in its financial stability and operational efficiency.

NHIF Director General, Dr. Irene Isaka, attributed this success to stringent measures against fraudulent claims and the extensive adoption of Information and Communication Technology (ICT), which has been a key priority of Tanzania’s Sixth Phase Government.

Fraud Prevention and Efficiency Gains

Dr. Isaka highlighted that the shift towards technology-driven processes has played a crucial role in streamlining NHIF operations. She noted that fraudulent claims had significantly drained resources, but proactive interventions have helped recover more than TZS 22 billion within the reported period.

“The Sixth Phase Government has implemented robust mechanisms to combat fraud, reducing financial inefficiencies that previously cost us TZS 120 billion,” she stated. “By enhancing internal controls and promoting accountability, NHIF has managed to optimize spending and improve service delivery.”

Technology Transforming Service Delivery

Speaking at a press conference in Dodoma, Dr. Isaka underscored the impact of ICT advancements on NHIF’s operational framework. The fund has successfully digitalized various services, making it easier for members to register and contribute through registered service points.

“Over the past few years, NHIF has made remarkable progress. Under the Sixth Phase Government, we have registered 2.2 million new members, including 284,543 between July and December 2024 alone. Our contribution collection has risen to TZS 2.3 trillion, with 92% coming from members, 7% from investments, and 1% from other sources,” she explained.

Dr. Isaka also revealed that NHIF has integrated its data systems with key government institutions such as the National Identification Authority (NIDA), enabling members to access healthcare services using their national identification cards instead of physical NHIF cards.

Reduced Claims Processing Time and Improved Payments

NHIF has significantly cut down the time required to process medical claims. Previously, claims took up to 120 days to be settled, but with digital transformation, the processing period has been reduced to between 45 and 60 days.

The fund has also expanded its payments to healthcare providers, covering a wider range of specialized medical services for its members. According to Dr. Isaka, NHIF has recognized and incorporated specialized treatments, ensuring members receive comprehensive healthcare services.

“The government accounts for 37% of all claims, while private facilities handle 35%, and faith-based institutions manage 28%. Over the past four years, the government has disbursed more than TZS 2.29 trillion to healthcare providers. These are substantial funds that circulate within our economy,” she said.

Increased Support for Retired Members and Chronic Disease Management

NHIF has also boosted financial support for retired members who no longer contribute to the scheme. In the past year alone, the fund disbursed TZS 91 billion to healthcare facilities treating retirees, reinforcing its commitment to ensuring continued medical coverage.

Moreover, Dr. Isaka emphasized the rising burden of non-communicable diseases (NCDs), which now account for 60% of NHIF’s total claims. She urged Tanzanians to adopt healthier lifestyles, stating that the fund had already spent TZS 371 billion on NCD treatments. “These conditions are no longer just affecting the elderly; even young people are increasingly being diagnosed. We need to prioritize awareness campaigns and promote healthy living,” she added.

Strategic Investments and Future Plans

NHIF has also extended financial support to healthcare facilities through its credit program. So far, it has issued TZS 19.6 billion in loans to 94 institutions to help them acquire medical equipment and upgrade their infrastructure.

Looking ahead, NHIF plans to further integrate artificial intelligence in its customer service operations to enhance communication and efficiency. Additionally, the fund is committed to expanding health insurance coverage to informal sector workers, including small-scale traders, farmers, and fishermen, in line with President Samia Suluhu Hassan’s directive to ensure universal health coverage.

“Our goal is for every Tanzanian to have health insurance. We have made great strides, particularly after the passing of the Universal Health Insurance Law in 2023. With regulations approved in August 2024 by Minister Jenista Mhagama, we have now entered the implementation phase,” Dr. Isaka stated.

NHIF is currently collaborating with the President’s Office—Regional Administration and Local Government (TAMISEMI) to identify and register low-income households for health insurance coverage.

“We urge all Tanzanians to take advantage of this opportunity and enroll in health insurance while they are still healthy. Many only seek coverage when they are already ill, but early enrollment ensures they receive timely medical care whenever needed,” she advised.