CHF BEST PRACTICE WORKSHOPTIKA – CHF - URBAN SETTINGWhat is the difference?

Ludovick NduhiyeEconomist

CHF/TIKA COORDINATIONUNIT

MOHSW

GOLDEN TULIP HOTEL 31st Jan– 02nd Feb. 2007

Definition

TIKA is an abbreviation of kiswahili word “TIBA KWA KADI” That simply refer to Treatment by Health Card.

It is a Community Health Fund Scheme made for Urban and Peri-Urban Communities.

Its design extends beyond CHF design to meet some special urban features/characteristics.

Definition Cont… TIKA works within the CHF Act of

Parliament No. 1 of April 2001.

It is a voluntary pre-payment scheme that offer an opportunity to the community to contribute for health care before they fall sick and when they have money to avoid the burden of user fees.

TIKA Concept Development and Designing The Need for different approach rather than CHF

emerged from unconvincing CHF pre-test experience of Songea Town(1997-1999).

The Ministry of Health by then commissioned a critical examination study to Development Studies MUCHS (Prof. Kiwara and Kapinga).

The results suggested different CHF design in urban settings due to high differences between urban and rural communities.

TIKA Design was presented in 2000 for discussions and decision.

TIKA Concept Development and Designing Cont…

Stakeholders meeting and forums were convened to discuss the TIKA design.

Technical meetings, forums, workshops were held to develop the implementation and training guidelines.

In 2005/06 financial year the decision was reached by MOHSW to start the Implementation.

Main Objective of TIKAIs to enhance or improve the health status of urban and peri-urban informal sector communities through promotion of community empowerment and ensuring availability, accessibility, affordable, equitable health care services at the time of need in a sustainable way.

Specific Objectives Promote Community Participation,

Empowerment and Solidarity.

Provide framework for partnership between Community and Government as such Community take a leading role in needs identification and decision making, while the government offers technical support.

Specific Objective Cont… Mobilize financial resources from the

community for provision of health services.

Provide quality and affordable health care services through sustainable financial mechanism

Improve health care management in the communities through decentralization.

Specific Objective Cont…

Ensure Equity and Access for poor families by providing them with free TIKA- membership card that gives them an opportunity to access better health service on demand.

Act as a mechanism in promoting partnership between public and private in health care service provision.

TIKA Implementation Status In 2005/06 MOHSW-MTEF provided

funds and two municipalities (Tabora and Moshi) were supported.

The MOHSW will support 10 urban councils in TIKA Sensitization and formulation of By Law and other Instruments this Financial year.

Lessons From Tabora and Moshi Sensitization training

Participatory training approach were used.

This picture was taken during group discussion in Tabora 2006..

Lessons From Tabora and Moshi Sensitization training Cont…

TIKA is highly acceptable Stakeholders were happy for being involved at early

stage

There is some reluctance for accepting TIKA design proposal such as categorization of membership and services

Councils needs external support to ensure continuous advocacy, capacity building and procurement of essential materials and equipments.

Closely monitoring and assessment are vital.

Group Picture of Participants of TIKA Sensitization Forum in Tabora 2006.

Mayor of Tabora Municipal Council Underlining the importance of introducing TIKA.

Group Picture of Participants of TIKA Sensitization Forum in Moshi 2006.

Cooperation with Others CBHIS

Lessons from their experience Need for inventory and literature

review Regulatory mechanism Subsidization

Way forward

Support the remained 13 Urban Councils to introduce TIKA from July to December 2007.

Undertake facilitative supervision

Promote TIKA advocacy at all levels

Promote Cooperation with other Community Based health Insurance Schemes in urban.

Regulatory Mechanism of CBHIS