DAR ES SALAAM: WITHIN just 100 days of the administration formed after the October 29, 2025 General Election, President Samia Suluhu Hassan demonstrated that her campaign pledge on the Universal Health Insurance (UHI) was not rhetorical ambition but a structured governance priority.
At the centre of this rapid and coordinated implementation stood the Tanzania Insurance Regulatory Authority (TIRA). Far from playing a passive oversight role, the Authority became the operational engine translating executive direction into enforceable systems, regulatory frameworks and nationwide rollout mechanisms.
Under the leadership of Commissioner of Insurance Baghayo Saqware, TIRA assumed a central coordinating and supervisory mandate. Its responsibility extended beyond licensing and compliance to constructing the regulatory infrastructure necessary to sustain universal coverage over the long term.
Within the 100-day timeframe, one of the Authority’s most consequential decisions was the formal integration of Universal Health Insurance into TIRA’s Sixth Strategic Plan (2026/27–2030/31).
By embedding UHI as a core strategic pillar, complete with defined objectives, performance indicators, monitoring benchmarks and institutional accountability mechanisms, the Authority ensured that implementation would be driven by measurable outcomes rather than symbolic milestones.
According to the Director of Health Insurance Services at TIRA, Samwel Mwiru positioning UHI within the five-year institutional road map guarantees continuity beyond the initial rollout phase.
It anchors the programme within established performance management systems, reinforces inter-departmental accountability and institutionalises structured coordination between public and private stakeholders.
This integration affirms that UHI is not a temporary reform initiative, but an enduring pillar of Tanzania’s regulatory and social protection framework. Recognising that universal coverage cannot succeed without public trust and understanding, TIRA prioritised civic education as a foundational pillar of implementation.
Commissioner Saqware underscored that citizens must understand both their rights and responsibilities under the new system.
TIRA collaborated closely with the Ministry of Health, the Prime Minister’s Office – Regional Administration and Local Government (PMORALG), the National Health Insurance Fund (NHIF), Regional Commissioners and other key stakeholders to conduct nationwide sensitisation campaigns across all 25 regions of the country.
The outreach clarified the Essential Benefits Package, explained enrolment procedures and highlighted the financial protection dimension of UHI particularly its role in shielding families from catastrophic health expenditures.
The education strategy combined community meetings, stakeholder forums, media engagements and institutional outreach platforms to ensure inclusivity.
Special emphasis was placed on rural communities and informal sector workers, populations historically underserved by insurance systems and most vulnerable to health-related financial shocks.
In fulfilling its statutory responsibilities under the Universal Health Insurance Act, TIRA undertook the critical task of registering health insurance schemes to safeguard consumer interests and maintain market integrity.
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Regulatory clarity was essential to prevent fragmentation, eliminate regulatory arbitrage and ensure uniform standards across providers.
Within the first 100 days, the Authority formally registered two schemes including the public scheme operated by NHIF and the private scheme, Jubilee Health Insurance.
In addition, several providers including Strategis Insurance, GA Insurance Tanzania, MO Assurance and Britam Insurance Tanzania were granted a transitional compliance period extending to December 2026.
TIRA emphasised that once the transition window closes, full compliance and formal registration will become mandatory for all entities operating within the UHI framework. Beyond scheme registration, TIRA embarked on large-scale registration of healthcare facilities authorised to serve insured beneficiaries.
The Act requires clinics, dispensaries, health centres, hospitals, laboratories and pharmacies to be registered and monitored prior to participation in the UHI system.
This measure strengthens quality assurance, enhances supervisory oversight, and protects consumers from substandard services. As of December 31, 2025, TIRA had registered 10,032 health facilities representing 72.8 per cent of the 13,776 facilities recorded nationwide by the Ministry of Health.
The Authority described this milestone as foundational in constructing an accountable and transparent service delivery network. Registration of the remaining facilities continues in tandem with the phased national roll out, ensuring expansion proceeds in a structured and controlled manner.
Another critical achievement within the 100-day period was the review and confirmation of the Essential Benefits Package submitted by the Ministry of Health.
In accordance with Regulation 31(4) of the Universal Health Insurance Regulations of 2024, TIRA confirmed a comprehensive package comprising 372 services.
These include consultation and registration services, medicines and medical supplies, laboratory diagnostics, radiology services and surgical procedures. Under the public scheme administered by NHIF, the package is priced at 150,000/- per household annually.
TIRA indicated that the pricing structure reflects a deliberate balance between affordability and breadth of coverage. Authority further strengthened internal governance systems to support the expanded mandate.
As part of preparations for quality assurance certification in the supervision of UHI, the Authority developed Standard Operating Procedures (SOPs) for the Health Insurance Services Unit.
The SOP framework clarifies workflows, delineates roles and responsibilities, codifies compliance processes and establishes documentation standards. This procedural codification enhances institutional consistency, transparency and service reliability.
For the remaining period of the 2025/26 financial year (December 2025 – June 2026), TIRA, through the Health Insurance Services Unit, has outlined a structured implementation plan designed to consolidate early gains and deepen system integration.
Between February and March 2026, TIRA will finalise agreements with ministries responsible for community development and with PMO-RALG to utilise Community Development Officers (CDOs) at regional and district levels as TIRA Liaison Insurance Officers.
An ongoing programme will strengthen the institutional capacity of the Health Insurance Services Unit and zonal offices in supervising the UHI system.
This includes technical training, compliance monitoring skills, data management enhancement and performance evaluation mechanisms.
TIRA will actively participate in the development of the government’s integrated end-to-end ICT system for health service delivery under the Ministry of Health.
This engagement ensures that regulatory priorities data integrity, claims oversight, enrolment tracking and financial monitoring are embedded within the national digital architecture.
The Authority also will complete the integration of its ICT systems with those of the Ministry of Health, registered health insurance schemes and the national health services ICT backbone and it will continue collaborating with government and key stakeholders in delivering nationwide public education campaigns on UHI.
TIRA’s Manager for Public Relations and Communications, Ms Hadija Maulid, described the enactment and early implementation of the UHI Act as transformative for Tanzania’s health sector.
She said within just 100 days, foundational regulatory systems were established, schemes and facilities were registered, public awareness campaigns were deployed nationwide, performance monitoring frameworks were embedded within institutional planning and digital integration strategies were activated.