Healthcare affordability remains major hurdle for Tanzanians: Afrobarometer survey

This figure, though promising, leaves a considerable 40 percent still struggling to navigate the public healthcare system—an indication that structural and economic barriers continue to affect service delivery.

The report points to a disconnect between policy-level healthcare reforms and the lived realities of ordinary citizens, especially with regard to affordability.

Only 16 percent of Tanzanians currently benefit from any form of medical aid coverage, a figure that experts argue is dangerously low for a country still working to achieve Universal Health Coverage (UHC).

For the 84 percent without insurance, the situation is even more troubling. A majority—57 percent—cite cost as the primary reason they lack medical cover.

At least seven in ten Tanzanians express concern about their ability to afford medical treatment if they or their family members fall ill, with three in ten admitting they worry ‘a lot.’

These figures reveal a society under significant health-related financial stress.

On a positive note however, the government has been undertaking efforts to make healthcare more affordable through a raft of measures including the implementation of Universal Health Insurance.

In the 2025/26 fiscal year's budget the government has allocated Sh49.80 billion to be used to support the implementation of the Universal Health Insurance Act, including the distribution of health insurance cards to various groups of citizens.

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Experts have weighed in on the issue.

Speaking to The Citizen, Sinza Palestina Hospital’s medical doctor, Dr Ayubu Ngere observed that while healthcare infrastructure has expanded, the cost burden on patients remains alarmingly high.

He noted that many low-income patients are unable to afford even basic diagnostic services, which compromises their overall health outcomes.

“People walk into our facility hoping to get treatment, but they leave disappointed when they realise they must pay for tests or drugs outside. This defeats the whole purpose of public healthcare,” he said.

With similar sentiments, a public health policy analyst, Dr Sophia Mwitula said the current state of healthcare affordability is unsustainable.

“We do see a lot of patients delaying their hospital visits because they fear the cost implications. By the time they arrive, their conditions have worsened,” she said.

She added that even when services at public hospitals are subsidised, patients often have to pay for tests or medicines that are not available in the hospital pharmacy.

“This forces people to buy from private pharmacies at higher prices,” she noted.

For his part, a dermatologist from Muhimbili National Hospital, Dr Gilbert Lucas, pointed out that government investment in infrastructure has not been matched by financial protection for patients.

“It’s one thing to build health centres in rural areas, but quite another to ensure that the people using them can afford care,” he said.

He shared that more must be done to integrate community health insurance schemes and subsidise contributions for low-income households.

“We need an inclusive healthcare financing model. Otherwise, we're building beautiful facilities that people can’t afford to use,” he added.

On the other hand, a health economist, Mr Adam Rumbya weighed in, noting that healthcare costs have a significant impact on household finances.

“Many families in Tanzania are just one illness away from financial disaster. Healthcare-related out-of-pocket spending is among the top causes of household impoverishment,” he said.

Mr Rumbya said the government should consider making the national health insurance scheme mandatory, with graded contributions based on income.

“This will help pool resources and ensure that those who are better off subsidise the poor. It’s a common model in many countries moving toward universal coverage,” he said.

Another economist, Dr Isac Safari from Saint Augustine University of Tanzania, emphasised the role of education in bridging the healthcare access gap.

“Health literacy is low, costs are quite high in comparison to our economic state and we really need to do something. Many people don’t even understand the concept of health insurance. The government must launch strong awareness campaigns and remove administrative bottlenecks that discourage people from enrolling,” she said.

On the ground, the public health reality remains bleak for many. A medical doctor from Bugando Medical Centre, Dr Hellen Bihongoye said that healthcare affordability is not just about insurance.

“Patients come in and tell us that even consultation fees are too high. That’s the reality. Poverty and healthcare are deeply linked. We really need to fix our health systems before anything else, whether it’s public or even private hospitals, health services should be affordable and accessible to everyone,” he explained.