Tanzania: NHIF saves Sh34 billion by combating fraud in healthcare

The National Health Insurance Fund (NHIF) has announced significant success in combating fraud within the healthcare sector, resulting in savings of Sh34 billion over the past five years.

NHIF Director General Bernard Konga disclosed this achievement during a press briefing on Thursday, March 7, 2024, highlighting the fund's accomplishments under the leadership of the sixth-phase government of President Samia Suluhu Hassan.

"Five years ago, the NHIF established a dedicated unit to investigate fraud claims. We identified 168 staff members who were involved in fraudulent activities. Disciplinary actions were taken against these individuals," stated Mr. Konga.

He further revealed that 42 health facilities were suspended from NHIF service provision, and punitive measures were imposed on 147 healthcare workers.

Among these, 16 were dismissed, five received warnings, two faced salary reductions, and two were demoted.

The fraud unit has recorded a total of 596 cases thus far, with ongoing investigations expected to yield further actions against perpetrators.

In addition to healthcare professionals, 68 NHIF policy holders were identified for misusing their insurance cards, leading to the filing of charges against them.

"To counter fraud, we are enhancing beneficiary identification through biometric measures such as fingerprints and facial recognition.

We are also upgrading our ICT systems to facilitate electronic registration and payment number issuance for members," Mr Konga explained.

Moreover, NHIF plans to introduce the National ID as an alternative to membership cards for selected groups, aiming to streamline identification processes.

In line with its commitment to service improvement, NHIF is implementing a feedback mechanism to address complaints from stakeholders effectively.

Expansion plans include establishing new offices in Kigamboni, Ubungo, and Gongo la Mboto, with further assessments underway in Kahama, Tunduma, and Njombe to enhance healthcare service accessibility based on community needs.

NHIF's proactive measures underscore its dedication to ensuring transparency, accountability, and efficiency in healthcare service delivery.