Background:

According to World Health Organization (WHO), the pediatric age group is between 0 to 18 years and this population faces different major health concerns (1,2).The World Health Organization (WHO) reports that, leading causes of death in children are preterm birth complications, birth asphyxia/trauma, pneumonia, congenital anomalies, diarrhea and malaria which require health care services and the children under 5 years are at more risk (3).

Worldwide, there have been efforts to foster the universal health coverage and protection of people from out-of-pocket expenses over health costs (4). World Health Organization (WHO) has observed that, high costs of out-of-pocket money have been one of the factors hindering the achievement of universal health coverage (UHC) (4). Reports from World Health Organization (WHO) and world Bank of 2017 estimated that over 800 million people in the world spend more than 10% of their budgets to cover health expenses for a single sick child (5). However, analysis of 2020 in 36 sub-Saharan countries, only four countries were found having health insurance coverage over 20%. These countries were Rwanda, Ghana, Gabon and Burundi, and in most of the countries the coverage was from the high-income households posing a level of inequality in population coverage of the health insurance schemes available in these countries (6).

In Tanzania, 2020 The National Health Insurance Fund (NHIF) reported only about 32% of Tanzania population were covered with health insurance and only 1% of this being insured by private insurance funds and the rest by the National Health Insurance Fund (14).


However, according to Tanzania census of 2022 children comprises 31% of the whole population (15). In 2016, through National Health Insurance Fund Tanzania initiated a program of “TOTO AFYA KAZI” which managed to cover 210,664 children which was equal to 1% of the total pediatric population, though, this program was amended in 2023 (7).