DPG Tanzania

The Health Basket Fund

“The Health Basket Fund has played a particularly important role in supporting the meaningful implementation of decentralization of responsibility for health services to Local Government Authorities” Joint External Evaluation of the Health Sector, 2007

The Health Basket is a funding mechanism initiated in1999 as part of the Government of Tanzania’s decision to pursue a sector wide approach (SWAp) in the health sector. The basket is funded by a number of Development Agencies that pool un-earmarked resources to support the implementation of the Health Sector Strategic Plan III.

At present, there are seven Development Partners contributing to the Health Basket Fund: Canada, Denmark, Ireland, Switzerland, UNFPA, UNICEF and World Bank. Channeling resources through such a modality confirms a commitment towards a more effective and efficient use of aid resources that is line with both the Paris Declaration and the aspirations of the Tanzanian Government as elaborated in the Joint Assistance Strategy (JAST).

A Memorandum of Understanding (MOU), signed by all parties, sets out the roles and responsibilities between development partners and the Government of Tanzania in supporting the basket mechanism.

“The health basket fund represents a significant source of funding for the districts” Joint Annual Health Sector Review, 2012

Approximately 80% of the Tanzania’s population live in rural areas. For this reason, most of the basket funding is channeled directly to the district level where it is allocated according to local need and demand. This district basket grant contributes to the development budget of the district health plans and funds items such as medicines, supplies and equipment, fuel, sanitation and community outreach for eye care, ante-natal care, family planning and immunizations.

The Health Basket has strengthened health service Delivery throughout Tanzania:

  • Between 2007 and 2012 the Health Basket channeled approx. USD 419 million to the health sector.

  • The Health Basket has played a crucial role in the devolution of health services’ responsibility to the Local Government Authorities, and for the set up of comprehensive and participatory district level health planning, budgeting, monitoring and reporting.

  • The Health Basket has played a crucial role in supporting the provision of primary health care services through funding Central level MTEF to purchase essential drugs and commodities, support to programmes in reproductive and child health, nutrition, immunization, Malaria, Human Resource Development etc. as well as strengthening Referral Hospitals, Zonal Training Centres, Chief Government Chemist etc.

  • The combination of increased funding with financial decentralization has given the districts the possibility to selectively increase resources for key interventions. This has contributed to a 38% reduction of under 5 mortality in Tanzania between 1999 and 2007/08 (THMIS 2007/8).