Tanzanians Applaud Government Performance On Health, but It Remains Their Top Concern

Majority of citizens say they worry about being unable to obtain or afford medical care.

Key findings

• Health tops the list of important problems that Tanzanians say their government must address.
• Only 16% of citizens have medical aid coverage. Among those who do, most (82%) say they are “fairly” or “very” satisfied with their coverage. o Among those who don’t have health insurance, the most common reason is that they can’t afford it (cited by 57%).
• More than three-fourths (77%) of respondents say they worry at least “a little bit” about being unable to obtain or afford medical care if they or their family members become sick. Three in 10 (30%) say they worry “a lot.”
• More than two-thirds (69%) of respondents say the government should ensure that all citizens have access to adequate health care, even if it means raising taxes.
• Among the 70% of respondents who had contact with a public clinic or hospital during the year preceding the survey, six in 10 (60%) say it was easy to obtain the services they needed. o But 16% say they had to pay a bribe, give a gift, or do a favour to obtain the needed services. o And many say they encountered problems such as long wait times (72%), a lack of medicines or supplies (66%), care or medicines they could not afford (60%), absent medical personnel (48%), and poor facility conditions (37%).
• Nearly half (47%) of citizens say they or a family member went without medicines or medical treatment at least once during the previous year.
• Overall, more than two-thirds (68%) of Tanzanians approve of their government’s performance on improving basic health services. o And 84% say they trust the Ministry of Health “somewhat” or “a lot.”
• Tanzanians overwhelmingly (94%) say that vaccination against childhood illnesses should be mandatory.

Health is a top item on policy agendas across the globe. In Tanzania, where the government runs 60% of health facilities, the health-sector budget increased by 6.2% this year. But government health expenditures make up only about 2% of gross domestic product (GDP), far short of the 5% target in the government’s strategic plan and the 15% goal that countries set themselves in the Abuja Declaration (United Republic of Tanzania, 2021, 2024; World Health Organization, 2010).

In addition to financial constraints, the public health sector faces a variety of other challenges, including corruption and a lack of professionalism among some health-care staff (United Republic of Tanzania, 2020, 2024; Leonard & Masatu, 2010). While medical care and medicines are free for the elderly, children under age 5, and pregnant women, others must pay, and widespread poverty is an important barrier to access to services ((National Bureau of Statistics, 2020; United Republic of Tanzania, 2024). One case made headlines last December when a woman died of a snakebite because she didn’t have the TZS 150,000 (about USD 56) to pay for treatment (Jasson, 2024).