DAR ES SALAAM: DIGITAL transformation has become a cornerstone in supervising the implementation of Universal Health Insurance (UHI) in Tanzania, with the Tanzania Insurance Regulatory Authority (TIRA) playing a pivotal role in steering this transition.
By leveraging modern technology, TIRA is enhancing efficiency, transparency and accountability across the health insurance ecosystem, ensuring that regulatory oversight keeps pace with the country’s ambitious health financing reforms.
Currently, the insurance market operates entirely through digital platforms, notably the Tanzania Insurance Regulatory Authority Management Information System (TIRAMIS) and the Online Registration System (ORS).
These advanced systems are fully integrated with other national platforms, including those of the Police Force, the National Health Insurance Fund (NHIF), the Land Transport Regulatory Authority (LATRA), the Tanzania Revenue Authority (TRA), the National Identification Authority (NIDA) and the Business Registrations and Licensing Agency (BRELA).
This interoperability enables seamless registration, verification and compliance processes, allowing users to access insurance services from anywhere in the country.
Through the TIRAMIS system, insurance policies are issued and verified digitally, enhancing accuracy and convenience.
Members of the public can also verify the validity of motor insurance policies through a dedicated mobile application available on the Google Play Store for Android devices.
This innovation not only protects consumers but also strengthens enforcement and reduces fraud within the insurance sector.
The enactment of the Universal Health Insurance Act, Chapter 161 of 2023, which came into force on August 16, 2024, laid a firm legal foundation for ensuring that every Tanzanian can access quality health services without facing financial hardship.
The law establishes a comprehensive and inclusive system through which citizens obtain health insurance either through individual contributions or government sponsored arrangements for special groups.
Entrusted with supervising this transformative agenda, TIRA is mandated to regulate, monitor and strengthen the health insurance framework nationwide.
Recognising that datadriven decision-making is essential in modern regulation, the Authority is actively participating in the development of the government’s integrated end-to-end ICT system for health service delivery under the Ministry of Health.
TIRA’s involvement ensures that regulatory requirements, compliance mechanisms and financial oversight structures are embedded within the national digital health infrastructure from the outset.
In its second quarter implementation report for the 2025/26 financial year, TIRA’s Commissioner of Insurance, Dr Baghayo Saqware, underscored that ICT integration is not merely a technological upgrade but a structural reform designed to transform supervision.
He emphasised that digitalisation enables the regulator to shift from reactive oversight to proactive, risk-based supervision anchored in realtime data.
According to Dr Saqware, TIRA is working to link its digital platforms with those of the Ministry of Health, health insurance schemes and the national health services ICT backbone.
This interconnected framework will facilitate realtime data exchange, efficient claims monitoring, verification of service delivery and strengthened financial surveillance of health insurance schemes.
“With integrated systems, we are able to see the full picture from member registration to claims settlement and financial performance of schemes. It enhances transparency and gives us the tools to intervene early where risks are detected,” Dr Saqware said.
He further explained that digital integration will enable TIRA to monitor whether schemes are delivering the legally required essential benefits package, assess alignment between contributions and services provided and track liquidity positions with greater precision.
Automation of reporting and surveillance processes will reduce manual errors, curb fraud risks and significantly improve regulatory response time.
Under Section 7(2) of the Universal Health Insurance Act, TIRA is entrusted with broad responsibilities, including registering health insurance schemes, ensuring compliance with prescribed benefit packages, issuing payment guidelines to service providers, maintaining a database of contracted health facilities, conducting inspections and ensuring that schemes maintain adequate reserves and liquidity.
Digital systems are strengthening the Authority’s capacity to execute these responsibilities with enhanced accuracy and accountability.
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To further institutionalise digital supervision, TIRA is preparing comprehensive Standard Operating Procedures (SOPs) for the Health Insurance Services Unit.
These SOPs define clear workflows for registration, product approval, offsite surveillance, onsite inspections and liquidity assessments.
By aligning standardised procedures with digital tools, the Authority is building a transparent and performancedriven regulatory framework that supports the long-term sustainability of UHI.
For the remainder of the 2025/2026 financial year, the Health Insurance Services Unit has outlined a structured work plan aligned with ongoing digital enhancements.
Planned activities include completing the registration of health service providers nationwide, conducting a baseline onsite inspection of the NHIF in accordance with the Universal Health Insurance Act and carrying out inspections of selected private health insurance schemes to assess compliance with the new legal framework.
Liquidity assessments are also scheduled, supported by digital financial reporting mechanisms that enable detailed analysis of reserves, claims ratios and exposure to risk.
Dr Saqware stressed that financial soundness is fundamental to protecting members and sustaining public confidence in the health insurance system.
Ensuring that schemes remain solvent and capable of meeting their obligations is central to the credibility and stability of UHI. Capacity building remains another key pillar of the digital transformation agenda.
TIRA plans to train zonal office staff on newly approved health insurance guidelines and facilitate knowledge exchange programmes for officers within the Health Insurance Services Unit.
As digital systems grow more sophisticated, equipping regulatory staff with advanced technical expertise is essential for effective supervision.
In addition, TIRA is finalising critical operational manuals, including the Health Insurance Scheme Offsite Surveillance Manual, the Onsite Inspection Manual and the Health Insurance Products Approval Manual.
These documents complement the digital infrastructure by establishing clear standards for electronic reporting, data analysis and risk-based inspections.
Public awareness is equally vital to the success of UHI. TIRA’s Manager for Public Relations and Communications, Hadija Maulid, emphasised that digital transformation enhances communication with stakeholders and the public.
By embedding regulatory controls within integrated ICT systems, the Authority is not only enforcing compliance but also generating reliable data that informs policy improvements and strengthens public trust.
According to Ms Maulid, digital platforms will enable citizens to verify registered schemes and accredited health facilities, understand benefit packages and access timely updates.
She noted that transparency and accessibility of information are essential pillars in building confidence in Universal Health Insurance while supporting the maintenance of a comprehensive and up-to-date database of health facilities contracted by insurance schemes.