A study of the effects of HIV/AIDS on national health insurance fund (NHIF)

This study investigated the extent of the effect of HIV/AIDS to the National Health Insurance Fund and more specifically, it explored the impact of the extent of the treatnent of HIV related cases to the sustainability of the Fund. The HIV/AIDS has had an impact on National health Insurance Fund due to increased health care spending resulting to increased outpatient visits and prolonged inpatient admissions of which most of the affected patients are admitted for more than 120 days which is over and above the allowable days as per NHIF regulations. A combination of qualitative and quantitative methods were used to alive at a sample of 78 active accredited health facilities flom Dar es salaam and Coast regions, which seemed as the most valid and reliable way to develop understanding of such a complex social reality as HIV/ADS in the health insurance scheme. The study revealed that, NHIF beneficiaries who are living with HIV/AIDS have no big impact on the payments done by NHIF to the accredited health providers. More specifically the financial sustainability of the Fund is not much affected or eroded with the payments related to opportunistic infections. Nevertheless, dte Fund is urged to have proper intervention to monitor the trends in terms of visits payments related to opportunistic infections. The study recommended that the National Health Insurance Fund should participate fully in prevention of HIV infection activities and providing care to people living with HIV/AIDS so that the number of members prone to be infected by the disease can be reduced