Co-operative Health Insurance in Tanzania
Perceptions and Determinants.
DOI:
https://doi.org/10.58547/809fy075Keywords:
Ushirika Afya Scheme, Health Insurance, Co-operatives, Relative Importance IndexAbstract
Co-operative health insurance refers mainly to community-based and mutual health insurance schemes especially important for people in the informal and rural sectors, who are often excluded from formal employment-based health insurance. This study was conducted to investigate the cooperative members’ perceptions of the Ushirika Afya scheme (UAS) and to identify the key determinants of members’ engagement. The study was guided by the theory of planned behaviour (TPB). The study adopted a cross-sectional research design. The target population and the unit of analysis included all Agricultural and Marketing Co-operative (AMCOS) members (both UAS members and non-members), resulting in a sample size of 300. Two other methods were involved in the process of data collection, which are focus group discussions; a total of five FGDs were conducted, and the interview method was used to interview five key informants. The study findings indicated that socio-demographic factors, including age, marital status, household income and size, level of education, and economic activity, significantly influence cooperative members in the UAS. Thematic analysis revealed that cooperative members’ perceptions towards Ushirika afya were focused on health concerns, health protection, and support for old and aged cooperative members. Additionally, it was seen as a government-established programme for cooperative members in AMCOS, specifically for sick people. Moreover, the study concludes that there is limited engagement with the UAS among the youth and women. In contrast, the perception in many people’s minds is that the UAS is for elderly people, sick people, and poor people. This is because the study has shown that there is a high rate of elders enrolled in the scheme compared to the youth. There is a need for increased investment in awareness campaigns and capacity-building programmes to enhance the publicity of the Ushirika Afya scheme, which will lead to an increased number of members.
References
Adesina, A. E. (2011). Perceived Impact of Primary Education on the Attainment of Nigerian Vision 2020. Mediterranean Journal of Social Sciences, 2, 2117-2039.
Ajzen, I. (1991). The Theory of Planned Behaviour. Organisational Behaviour and Human Decision Processes, 50, 179-211.
Amu, H., Dickson, K.S., Kumi-Kyereme, A., and Darteh, E.K.M. (2018). Understanding variations in health insurance coverage in Ghana, Kenya, Nigeria, and Tanzania: Evidence from demographic and health surveys. PLoS ONE, 13(8), e0201833. https://doi.org/10.1371/journal.pone.0201833
Asfaw, A. and Braun, J. (2004). Is Consumption Insured against Illness? Evidence on Vulnerability of Households to Health Shocks in Rural Ethiopia. Economic Development and Cultural Change, Volume 53, Number 1. https://doi.org/10.1086/423255
Cebul R., Rebitzer, J., Taylor, L. and Votruba, M. (2011). Unhealthy Insurance Markets: Search Frictions and the Cost and Quality of Health Insurance. American Economic Review, 101(5):1842-1871
Chen, S., Zhang, Y.E. and Long, M. (2010). Supporting Online Material. Science, 330 (6011): 1682-1685 [DOI:10.1126/science.1196].
Green, P. (2014). The Importance of Reduced Meat and Dairy Consumption for Meeting Stringent Climate Change Targets, Climatic Change. Journal of Agriculture, Ecosystem and Environment, 1(24), 79-91.
Katundu, M. A. & Gabagambi, D. M. (2014). Entrepreneurial Tendencies of Tanzanian University Graduates: Evidence from the University of Dar-es-Salaam. European Journal of Research, 1(12), 5525-5558.
Komba, C. K. (2024). Factors Affecting People with Disabilities’ Access to Micro-Finance Services in Kilimanjaro, Tanzania. East African Journal of Management and Business Studies 4(1), 73-79. DOI: https://doi.org/10.46606/eajmbs2024v04i01.0044.
Leedy, P. D. (1989). Practical Research: Planning and Design. New York: Macmillan.
Msuya, J., Jutting, J.P. & Asfaw, A. (2007). Impact of Community Health Funds on the Access to Health Care: Empirical Evidence from Rural Tanzania. International Journal of Public Administration, 30 (8-9), 813-833.
Mwinuka, B., Echoka, E. and Nyaberi, J.M. (2022). Uptake of Health Insurance and Its Associated Factors Among Informal Sector Workers in Dar Es Salaam, Tanzania. Journal of Healthcare in Developing Countries, 1(2), 20-25.
NHIF (2020) Fact sheet as at 30th June 2020.
Nzowa, P.G., Nandonde, F.A. & Seimu, S.M.L. (2023). Participation in health insurance and changes in the well-being status of co-operative members in Tanzania. Decision, 49 (5), 1-14. https://doi.org/10.1007/s40622-023-00362-z
Sambuo, D. (2022). The Sixth Principle of Cooperatives: Does Tanzania Succeed in Sectoral Cooperation Among Cooperatives during the Post-COVID-19 Era. In: 9th Technical Committee of the Africa Ministerial Co-operative Conference (TCAMCCO). Sarova Whitesand: Mombasa, Kenya.
TCDC (2022). Establishment of National Cooperative Bank. https://www.ushirika.go.tz/index.php/resources/view/benki-ya-taifa-ya-ushirika-kuanzishwa]. Retrieved on March 11, 2023,
Tungu, M., Amani, P. J., Hurtig, A. K., Dennis Kiwara, A., Mwangu, M., Lindholm, L., & San Sebastiån, M. (2020). Does health insurance contribute to improved utilization of health care services for the elderly in rural Tanzania? A cross-sectional study. Global health action, 13(1), 1841962. https://doi.org/10.1080/16549716.2020.1841962
URT. (2018). Social Security Laws and Regulations. Dodoma: URT.
WHO (2019) Global Spending on Health: A World in Transition Global Report. Geneva.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Dr. Cyril Kalembana Komba, Dr. Emmanuel Lulandala, PhD., Godamen Naiman
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Papers published in AJCDT Journal must be the original work of the author/s that has not been published previously in any manner. Authors retain the copyright of the published papers.
Deprecated: json_decode(): Passing null to parameter #1 ($json) of type string is deprecated in /var/www/html/ojs/plugins/generic/citations/CitationsPlugin.php on line 68
