Across the continent, the poorest families suffer the biggest hits from unexpected health care service costs. This is not different for Tanzania. In Moshi, MHI Tanzania,a non-governmental organization
brings together public and private stakeholders to improve access to affordable quality health coupled with micro insurance health covers designed for low-income earners, started an inclusive health micro insurance program named MpangowaAfya Kilimanjaro for all income tiers. MHI innovated the MpangowaAfya Kilimanjaro to help the low income earners contribute to a pool through premium and later allow those who will fall sick to receive treatment without additional payments at contracted health care facilities (cashless cover). More than 7,000 members now enjoy the services. MHI Director -Marketing, Operation & Public Relations, Mr. Sadick Massawe says the organisation  is reaching more Tanzanians.
He explains in this Q and A interview:
Question:  Tell us about Micro Health Initiative (MHI), what it does,
its background, how it started.

Response: Way back in 2014, two young men working for ‘KNCU health plan’, a program sponsored by Pharm access realized the need to administer using innovative approaches an all-inclusive health scheme that will incorporate every member of the community. The result was a Micro Health Initiative which was established with a vision to enable low and middle level income earners have equal access to health care. MHI employs a dynamic approach, bringing together public and private stakeholders to improve access to affordable quality health coupled with micro insurance health cover designed for low income earners MHI currently administering an inclusive health micro insurance program named Mpango wa Afya Kilimanjaro for all income tiers within the rural and urban districts of Tanzania. This plan is managed by MHI and underwritten by AAR, a Tanzanian expert in health insurance products with a strong network of providers. Within Tanzania, individuals, families and groups will have the opportunity to select four tiers, each with differing benefits and premium costs. The founding members of MHI are experienced administrators who have previously successfully managed health schemes, such as KNCU Health Plan and Mpango wa Afya Kilimanjaro. MHI is headquartered in Moshi Tanzania but is licensed to operate in Tanzania mainland and currently has an office along Lema road in Moshi. The management team of MHI comprises of a Governing board, Health Operations Managers, Field Operations Manager, Finance Manager and Special Projects Manager.
Question: Can you take us through a number of activities of Micro Health Initiative (MHI) and how you have impacted on people who consume your services?
Response: Insurance Education: The problem in Tanzania is not about insurance or even ability to pay but the awareness on availability (how and where to buy insurance) and the benefits of using a cover. We use different approaches to ensure our members are well informed before even attempting to buy health insurance. We conduct education through churches, and community gatherings, we also do custom made road shows to ensure that we have interactive gathering. Do they also use this as a mechanism to obtain feedback on the products they offer? This has raised awareness especially in Kilimanjaro where we began .
Free health Checks: We sometimes offer medical checkup as means to arose interest and create awareness in the community. Participating members are given advice on how best and cheaply they can access health care through use of insurance.
Sales Points: Through the FSDT funding we were able to create and develop new and innovative sales points in the community where members can enroll and get educated on the importance of health insurance.
Provider engagement: Providers are key as they offer services to members and are eyes through which members are able to see through an insurance scheme. Every day we wake up in the morning with a target to create a new provider in a certain region along our areas of operation. It takes roughly 14 days to have a provider contracted and offering services. We have increased the awareness on the availability
of some providers whom the community weren’t aware of and have enabled our member’s access high quality health services from some providers they even never thought of reaching. Touching on need, convenience and accessibility. Service Providers Training: We do in house training to our service providers to ensure that they are up to date with our technology and processes. We keep updating them as the software is updated and upgraded which keep on changing.
Question: What space does Micro Health Initiative (MHI) occupy in Tanzania’s Insurance industry?
Response: Micro Health Initiative has continued to make the case of micro insurance relevant in Tanzania by insisting on friendly regulations especially for micro insurance products to ensure penetration. The health micro insurance space is almost un-occupied save for the government initiatives and some mobile insurance products penetrations, therefore MHI holds quite some space and lead especially from the private sector perspective, presently MHI stands as the only micro insurance agency that seeks to interact directly with the client before selling a micro health insurance policy.
Question: What inspired Micro Health Initiative (MHI) to apply for Bima Challenge?
Response: Back in 2015 MHI embarked on a serious mission to find out means to scale as well as who else in the sector is playing what role, our efforts took us through banks, other insurance companies, government organizations such as SSRA, NSSF and NHIF among others. All of this wanted a solid organization or company with 10 years’ experience wherethey could do direct investment or who could bring reasonable business on the table. When MHI directors read about Bima Challenge on the Citizen newspaper they immediately identified with FSDT meaning that we found ourselves as a best fit, organization which serves the low income earners, a start-up try to figure out innovative ways to increase access were some of the most striking words that made spring into action. We knew we needed someone to hand hold us and guide through the space, the idea of winning $100,000 kept us on our toes as in principal we needed this amount of money to tie most of the loose ends and gaps that were standing between us and scale. MHI was operating in Kilimanjaro region and had plans to scale its
activities in the other regions of Northern zone of Arusha, Manyara and Tanga. For us, the Bima challenge came at the right time to enable us reach our targets.
Question: Take us through the journey of how Micro Health Initiative
(MHI)applied for Bima Challenge, every step that you went through to
emerge winners.

Response: We first saw the advert on the newspapers and then we went through to find the details on the FSDT website. The Directors then formed a committee and each member was tasked with answers for a number of sectional questions as asked by FSDT. One Director was tasked to create the account online and ensure that all responses were filed as they came in. We consulted ANZA our accelerators on the tone and manner of response in some questions and would have long discussions trying to reflect
what FSDT wanted. After four weeks of back and through exchange of emails and long typing hours we felt were ready to submit back to the challenge but not before the directors and Anza consultant met and tried imagine ourselves in the shoes of the panel sifting through applications.It took quite a while and we had even despaired and likened this to other numerous applications we had done when on 11 October 2016, we received a letter from FSDT acknowledging receipt of our application and informing us that our application presents a potentially viable ideas for inclusive insurance. We were then invited for presentation on 01 November, 2016. Nervous and optimistic together with our AAR counter parts we made a 3 hours presentation to a team of experts answering numerous questions ranging from innovation, to regulation and community involvement. We left the presentation meeting feeling challenged but very hopeful and still optimistic. On 05 December 2016, the evaluation team visited our head office in Moshi, Kilimanjaro for due diligence and final proposal consideration. This required through presentation of documents, seeing structures, identifying gaps and visiting partners. It was 2 days fully packed activity.
Question: What impact will the Bima Challenge support have on Micro Health Initiative (MHI) and the market?
Response: First and foremost, our impact indicator through Bima challenge is the successful availing of a range of products that low income earners machoose from. Previously mistakes have been done whereby we have seen a one fit size for all  but as MHI we felt we needed to allow low incomes a choice as well within their brackets. So we made partnerships that assisted us craft products that would provide .Examples are: only OPD services, or only available for a certain gender, or would provide OPD and limited IPD while doing so, we ensured that we kept premiums at the lowest so that we interest the market and also measure the reaction as we progress. Additionally this support is directed towards increasing:
•     Sales points in the community where members can enroll and get
educated on the importance of health insurance – accessibility,
convenience and affordability.
•     Creation of member’s registration mobile APP that runs on
Android to enable members submit their enrolment data to MHI
•     Strengthen our payment gateway so that it connected with MAXCOM
& SELCOM and M-Pesa thus enabling members to pay at their convenience
either through M-Pesa or Maxcom / Selcom payment points.
•     Strengthen the Members management system to allow renewals and
sending renewal sms directly one month before a member falls due.
•     Increase the sign up of quality low cost health care providers across the community
•     Computer system strengthening on patient identification and claims submission
•     Customer call centre automation so as to be able to serve the
clients more effectively
•     SMS acquisition system development for client
•     Increase on number of VAS (Value added service)
o  Market
•     Enable to serve 1mil clients readiness
All the above are meant to strengthen MHI and make them synonymous with micro health insurance however the Bima challenge is also meant to ensure that by increasing the penetration then we can lower premiums and by improving the quality of care we can build client confidence on health micro insurance therefore increasing awareness and readiness to buy MI products.
MHI has also been able to influence other players who have come into the picture either through partnerships or strategic associations. In early 2017 MHI convinced BUMACO insurance to become a distribution point for products that MHI sells together with AAR a very unique and interesting partnership that brings along insurers with dissimilar interest together to ensure access. Late in 2017, MHI signed an MOU with Resolution insurance to see how the latter can utilize some of the MHI innovations in ensuring that claims are delivered on time,paid on time and that agents do not disappear with client’s premiums.
Although is work in progress is also another of a very interesting association enabled through aspects of Bima challenge. Early 2018, MHI also created a partnership with Mwanga community bank to venture into premium financing and distribution. It is therefore quite interesting to see some back and forth and re adjustments that the market is doing in ensuring penetration of Micro insurance among the community, some of which would not have happened without the role of the Bima challenge and existence of MHI.