Performance-based Health Basket Fund

The Health Basket Fund was created in 1999 as a pooling mechanism of donor resources to support the implementation of the national health strategic plan. On the one hand, this strategy, as well as efforts from global health initiatives, allowed Tanzania to reach Millennium Development Goals 4 & 6, and reduced out of pocket health expenditure by households. Furthermore, it promoted decentralised planning, budgeting and expenditure tracking for sound public financial management and stimulated the generation of local revenues by primary health care facilities. On the other hand, this first period of health sector budget support did not fully produce the expected progress in term of access to health services. The new national Health Sector Strategic Plan (2015-20) calls for intensified focus on quality health service delivery in public and private health facilities in support of universal health coverage. The Health Basket Fund has been redesigned as a performance-based health financing instrument to addresses the primary weaknesses of the past phases. Switzerland’s leadership of health partners in policy dialogue with Tanzania will use transparent and accountable diplomatic dialogue to develop further the redesigned results-oriented Health Basket Fund.

The agreed aim of the Government of the United Republic of Tanzania and Development Partners of the pooled funding arrangement is to reach underserved populations with essential, effective and affordable health services, and to contribute to effective decentralisation to enhance delivery of quality primary health care, by increasing financial resources in the health sector, with a focus on local governments.

The beneficiaries are the people resident on the mainland Tanzania (>47 mio), in particular poor people and women and children as main users of primary health care services.

The major share (up to 90%) of the performance-based Health Basket Fund is allocated to primary health care facilities through local governments who are responsible for providing basic health care and social protection to local communities.

Improved performance of 33’800 primary care health workers and quality of health services

Better access to quality primary care  through 6800 health facilities and improved social accountability

The creation of a new health financing modality is accelerated through Switzerland’s leadership in policy dialogue, by chairing the health development partners group

Results from previous phases:  

Between 2000 and 2010:

The deaths of young children have been reduced by 50% or more nationwide.

Malaria cases in health centres and hospitals have dropped by 75%. Similar progress was made with malaria control in pregnancy. 

Households in Tanzania reduced out of pocket health spending by 50% thus increasing available financial resources for schooling and productive activities.

Local governments improved management of public funds by using progressively IT tools in planning, budgeting and expenditure reporting.

The 6800 public health facilities increased locally generated revenues through user fees and community health funds for social protection, allowing them to address community priorities.

Development Partners: DFATD-Canada, DANIDA-Denmark, Irish Aid-Ireland, UNICEF, UNFPA, World Bank

Phase 7 01.11.2015 - 31.12.2021   (Completed)