Errant health providers suspended

By Queenter Mawinda

Raphael Mwamoto

 

The National Health Insurance Fund (NHIF) has suspended 12 health facilities for prescribing medicine using branded names, to caution against high financial implications upon the national economy.

“Adherence to standard and rational prescribing, including use of generic formulations and names is not an option,” NHIF executive Raphael Mwamoto declared.

Speaking in an exclusive interview with The Guardian in Dar es Salaam, Mwamoto, who is the NHIF Director of Marketing and Research, said health care practitioners should use common names.

 

But he declined to make public the names of health facilities suspended because of prescribing medicine using branded names.

 

Legal action would be taken against health providers violating the National Essential Medicine List (NEMLIT) price list and medical supplies, he specified.

 

 “Some medical centres still prescribe medicine using branded names, a situation which causes a high financial insinuation for a development of a country like Tanzania,” he said.

 

Mwamoto observed that NEMLIT has a binding agreement with various providers to the effect that medicines are made available on the basis of the list or any other type provided for in NHIF guidelines on the basis of developments, plus recommendations of medical professionals.

 

 NEMLIT includes cancer drugs, selective combination medicines and immune deficiency suppressants.

 

 Mwamoto mentioned challenges encountered by NHIF as including non-availability and unpredictable changes in the prices of medicines and shortages, especially in rural areas. 

 

However, he said the issues were being addressed through the Primary Health Care Development Programme (2007-2017), where though much work was still needed, signs of improvement have been noted. 

 

Other challenges are the authenticity of claims submitted by some medical providers who collude to inflate bills. As a measure to curb frauds, NHIF has established a department for early warning alarms, trained staff in deception management, improve inspections and review claims systems, the director elaborated.

 

The fund was established in 2001 to provide health insurance to civil servants.  It has since increased coverage by extending membership to private, informal and semi-formal sectors. 

 

In 2009, the government mandated NHIF to manage the Community Health Funds (CHF), initially under local government authorities. The objective was to promote the CHF scheme in terms of coverage, number of members and quality of health services accessible to beneficiaries, he added.