The Community Health Fund Act

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CHAPTER 409
THE COMMUNITY HEALTH FUND ACT
[PRINCIPAL LEGISLATION]
Arrangement of Sections
Section Title
part i
PRELIMINARY PROVISIONS
1. Short title.
2. Application.
3. Interpretation.
part ii
COMMUNITY HEALTH FUND
4. Community Health Fund.
5. Objectives of Fund.
part iii
MEMBERSHIP, CONTRIBUTIONS AND HEALTH SERVICES
6. Registration.
7. Membership.
8. Contribution level.
9. Health care services to members.
10. Exemptions.
part iv
MANAGEMENT AND ADMINISTRATION OF
COMMUNITY HEALTH FUND
11. Management and administration.
12. Functions of Council.
13. Composition of Council Health Services Board.
14. Tenure of office.
15. Functions of Council Health Services Board.
16. Functions of Council Health Management Team.
17. Composition of Ward Health Committee.
18. Tenure of office.
19. Functions of Ward Health Committee.

. Functions of Council Health Management Team.
17. Composition of Ward Health Committee.
18. Tenure of office.
19. Functions of Ward Health Committee.

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50
20. Requirements for Councils and Ward Development Committees.
21. Health care facility.
22. Amendment of Second Schedule.
part v
FINANCIAL PROVISIONS
23. Sources of Fund.
24. Uses of funds.
25. Financial management.
part vi
COMPLAINTS AND DISPUTE SETTLEMENT
26. Dispute settlement.
27. Grounds for complaints.
28. Complaints.
part vii
GENERAL PROVISIONS
29. Offences and penalties.
30. Regulations.
31. By-laws.
SCHEDULES

ettlement.
27. Grounds for complaints.
28. Complaints.
part vii
GENERAL PROVISIONS
29. Offences and penalties.
30. Regulations.
31. By-laws.
SCHEDULES

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PART I
PRELIMINARY PROVISIONS
1. This Act may be cited as the Community Health Fund Act. 2. This Act shall apply to local government authorities
specified in the First Schedule to this Act, and to such other
local government authorities as the Minister may declare by
order published in the Gazette. 3. In this Act, unless the context otherwise requires-
“Board” means a Council Health Services Board established
by the respective Council;
“card” means a community health fund card;
“collector” means a person appointed for the purpose of
collecting Community Health Fund contributions;
“community” means a group of households organised in a
recognised government administrative structure;
“contribution” means an annual voluntary contribution to
the Fund;
“Council” means-
(a) a district council established under the Local
Government (District Authorities) Act; or
(b) an urban council established under the Local
Government (Urban Authorities) Act;
Short title
Application
Interpretation
Cap. 287
Cap.

ies) Act; or
(b) an urban council established under the Local
Government (Urban Authorities) Act;
Short title
Application
Interpretation
Cap. 287
Cap.

288
CHAPTER 409
THE COMMUNITY HEALTH FUND ACT
An Act to provide for the mechanism of establishment of the Community
Health Fund and to provide for the constitution of the management
organs, and the administration of the Fund and other related matters. [1st September, 2001]
[GN. No. 313 of 2009]
Act No. 1 of 2001

of the management
organs, and the administration of the Fund and other related matters. [1st September, 2001]
[GN. No. 313 of 2009]
Act No. 1 of 2001

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nia. All rights reserved. No part of this book may be reproduced or distributed without permission of OAG.THE COMMUNITY HEALTH FUND ACT [CAP. 409 R.E.

2023]
52
“Council Health Management Team” means the Council Health
Management Team established by the respective Council;
“Fund” means the Community Health Fund established
by a local government authority in accordance with the
provisions of this Act;
“health care facility” means Government or private health
facility and includes any other facility established or
organised for purposes of delivering health services;
“health care provider” means a government health care
facility or a private registered health care facility;
“health plan” means a council or ward health plan;
“hospital” means a district hospital or a designated district
hospital providing level I referral medical services;
“household” means-
(a) a mother, father and children under the age of eighteen
years;
(b) a member who has attained the age of eighteen years
or more with or without children under the age of
eighteen years; or
(c) an institution;
“member” means a contributing household to the Fund;
“Minister” means the Minister responsible for health;
“local government authority” means-
(a) in relation to a district, a district council established
under the provisions of the Local Government (District
Authorities) Act; or
(b) in relation to an urban, an urban council established
under the provisions of the Local Government (Urban
Authorities) Act;
“user fee” means a fee charged by a health care facility for
services rendered;
“Village Council” means a council of a village registered in
accordance with the provisions of the Local Government
(District Authorities) Act, or existing as such in
accordance with the provisions of the Local Government
(Urban Authorities) Act; and
Cap.

Government
(District Authorities) Act, or existing as such in
accordance with the provisions of the Local Government
(Urban Authorities) Act; and
Cap.

287
Cap. 288
Cap. 287
Cap. 288

287
Cap. 288
Cap. 287
Cap. 288

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THE COMMUNITY HEALTH FUND ACT [CAP. 409 R.E. 2023]
“Ward Health Committee” means the Ward Health
Committee established by the respective Council. PART II
COMMUNITY HEALTH FUND
4.–(1) There shall be a Community Health Fund which is
a voluntary community based financing scheme whereby
households pay contributions to finance part of their basic
health care services to complement the Government health
care financing efforts. (2) A local government authority may establish a
Community Health Fund in respect of its area of jurisdiction. (3) The Community Health Fund established by a local
government authority shall be managed and administered in
accordance with the provisions of this Act. 5.

Community Health Fund established by a local
government authority shall be managed and administered in
accordance with the provisions of this Act. 5.

The objectives of the Fund shall be-
(a) to mobilise financial resources from the community for
provision of health care services to its members;
(b) to provide quality and affordable health care services
through a sustainable financial mechanism; and
(c) to improve health care services management in the
communities through decentralisation by empowering
the communities in making decisions and by
contributing on matters affecting their health. PART III
MEMBERSHIP, CONTRIBUTIONS
AND HEALTH SERVICES
6. All contributing members shall be registered with the Fund
and shall be issued with a membership card. 7. Membership shall be restricted to a paid up household
except for exemptions as may be issued by the Council under
the provisions of this Act. Community
Health Fund
Objectives of
Fund
Registration
Membership

cept for exemptions as may be issued by the Council under
the provisions of this Act. Community
Health Fund
Objectives of
Fund
Registration
Membership

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54
8.–(1) Every Council shall determine after consultation with
members of that community the level of annual contributions
to be paid by each household depending on whether the
contribution is for outpatient or inpatient health care services. (2) The level of annual contributions may be varied by
the Council after consultations with the members of that
community. (3) The Government may, through the respective Council,
contribute to the Fund any specified amount of money. 9. Subject to the provisions of this Act, every members’
household shall be entitled to medical services of its choice
which have been prepaid for at a preselected health care facility
within the respective district. 10.–(1) The powers to issue exemptions to pay Community
Health Fund annual contribution to any person shall be
vested into the Ward Health Committee after receiving
recommendations from the Village Council and the Council
shall authorise that person to obtain a Community Health
Fund card.

Committee after receiving
recommendations from the Village Council and the Council
shall authorise that person to obtain a Community Health
Fund card.

(2) The exempting authority shall seek alternative means of
compensating the Fund. (3) Notwithstanding subsection (1) of this section, the
Minister after consultations with the respective Council, may,
by order published in the Gazette, issue exemptions as he may
deem fit. PART IV
MANAGEMENT AND ADMINISTRATION
OF COMMUNITY HEALTH FUND
11.–(1) At the national level the Ministry responsible for health
and the Ministry responsible for local government shall-
(a) provide advice and technical support to the Fund; and
(b) monitor and evaluate the activities of the Fund. Contribution level
Health care
services to
members
Exemptions
Management and
administration

; and
(b) monitor and evaluate the activities of the Fund. Contribution level
Health care
services to
members
Exemptions
Management and
administration

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THE COMMUNITY HEALTH FUND ACT [CAP. 409 R.E. 2023]
(2) The management and administration of the Fund shall
vest-
(a) at district level, to the Council, through a Council
Health Service Board;
(b) at ward level, to the Ward Development Committee
through the Ward Health Committee; and
(c) at village level, to the Village Council through the
Village Social Services Committee. 12. The Functions of Council shall be-
(a) to provide operational guidelines for health activities
to the Board;
(b) to provide guidelines that facilitate management of the
Fund;
(c) to receive Fund management report;
(d) to ensure that the Board works harmoniously with
other implementing agencies;
(e) to ensure that funds are available for health development
activities in the Council and essential drugs, medical
supplies and vaccines are timely available; and
(f) to make by-laws for the Community Health Fund.

ivities in the Council and essential drugs, medical
supplies and vaccines are timely available; and
(f) to make by-laws for the Community Health Fund.

13.–(1) The Board shall be composed of the following
members, namely-
(a) four community service users of whom at least two
shall be female;
(b) one representative each from a non-profit voluntary
agency and a private for profit health care facility,
appointed by the Council from amongst health care
facilities which have entered into a service agreement
with the Board;
(c) the head of the Council Social Services Committee;
(d) the Council Planning Officer;
(e) the District Medical Officer who shall be the Secretary
to the Board;
Functions of
Council
Composition of
Council Health
Services Board

g Officer;
(e) the District Medical Officer who shall be the Secretary
to the Board;
Functions of
Council
Composition of
Council Health
Services Board

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56
(f) one representative from the Regional Health
Management Team; and
(g) one representative from the hospital. (2) The Chairman shall be elected from amongst members
specified under paragraph (a), (b), and (c) of subsection (1) of
this section. (3) Members specified under paragraphs (a), (b), and (c)
other than members specified under paragraphs (d), (e),
(f), and (g) of subsection (1), shall have voting rights in any
decision of the Board. 14. Members of the Board who have voting rights under
section 13(3) shall each hold office for a period of three years
and may be re-elected for another one term only.

e Board who have voting rights under
section 13(3) shall each hold office for a period of three years
and may be re-elected for another one term only.

15.–(1) The functions of a Council Health Services Board
shall be-
(a) to provide district health services and monitor
Community Health Fund operations and activities;
(b) to work in consultation with the Council Health
Management Team to ensure quality health care and
professionalism;
(c) to mobilise and administer funds for Community
Health Fund;
(d) to set exemption criteria for users of the health care
services provided by the Fund;
(e) to set targets for the Fund;
(f) to review reports from Ward Health Committees or
any other source;
(g) to monitor and make verification on collection,
expenditure and control of funds; and
(h) to design an annual health plan for approval by the
respective Council. (2) The provisions of the Second Schedule shall have
effect as to the tenure of its members, quorum, meetings and
proceedings and such other matters in relation to the Council
Health Services Board. Tenure of office
Functions of
Council Health
Services Board

s and
proceedings and such other matters in relation to the Council
Health Services Board. Tenure of office
Functions of
Council Health
Services Board

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THE COMMUNITY HEALTH FUND ACT [CAP. 409 R.E. 2023]
16.–(1) The functions of a Council Health Management Team
shall be-
(a) to monitor activities of both private and public health
facilities in relation to the Fund;
(b) to advise the Committee responsible for health
regarding the Fund;
(c) to set mechanisms of monitoring and evaluation of the
Community Health Fund; and
(d) to assure quality assurance of the health care services
provided. (2) The provisions of the Second Schedule to this Act
shall have effect as to the quorum, meetings and proceedings
and such other matters in relation to the Council Health
Management Team.

ule to this Act
shall have effect as to the quorum, meetings and proceedings
and such other matters in relation to the Council Health
Management Team.

17.–(1) Members of the Ward Health Committee shall be-
(a) the Councillor of the respective Ward;
(b) the Ward Executive Officer;
(c) one head teacher from a primary school located in the
ward who shall be appointed by the Ward Development
Committee;
(d) two members from the community elected by the
community of which one of whom shall be a female;
(e) a clinical officer or an assistant clinical officer in charge
of a health care facility, who shall be the secretary to the
Committee;
(f) one member appointed by the Ward Development
Committee from amongst persons proposed by the
village councils within the area of that Ward; and
(g) one representative from a community based organisation
appointed by the Ward Development Committee. (2) The Chairperson and Vice-Chairperson of the
Committee shall be elected from amongst the members. 18. Members of the Committee shall each hold office for a
period of three years and may be re-elected for a further period
of three years. Functions of
Council Health
Management
Team
Composition
of Ward Health
Committee
Tenure of office

y be re-elected for a further period
of three years. Functions of
Council Health
Management
Team
Composition
of Ward Health
Committee
Tenure of office

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58
19.–(1) The functions of a Ward Health Committee shall be-
(a) to mobilise the community to be members of the Fund;
(b) to prepare the list of members and monitor the number
of members in the community;
(c) to supervise the collectors of annual contributions;
(d) to monitor the level of contributions and user-fee
revenue;
(e) to review Fund’s operations, make recommendations
and take remedial actions;
(f) to initiate and co-ordinate community health plans;
and
(g) to organise general meetings and any other meetings of
members of the Fund. (2) The provisions of the Second Schedule to this Act shall
have effect as to the quorum, meetings and proceedings and
such other matters in relation to the Ward Health Committee. 20.

Schedule to this Act shall
have effect as to the quorum, meetings and proceedings and
such other matters in relation to the Ward Health Committee. 20.

The Fund requires a Council and a Ward Development
Committee to ensure the following-
(a) compliance with their own plans and budget;
(b) careful procurement in a transparent and open manner
using acceptable government procedures;
(c) keeping of accurate records of income and expenditure
of the resources of the Fund; and
(d) holding of regular meetings by the established
Committees. 21.–(1) A private health care facility shall not provide health
care services to Community Health Fund members unless that
facility is registered under the relevant law. (2) A registered private health care facility shall enter into
a service agreement with the Board for the provision of health
care services in the respective community. (3) Before a Board enters into a service agreement with
any health care facility for provision of health care services,
the Board shall first afford an opportunity to the public and
privately owned health care facility established within its area
Functions of
Ward Health
Committee
Requirements
for Councils
and Ward
Development
Committees
Health care
facility

facility established within its area
Functions of
Ward Health
Committee
Requirements
for Councils
and Ward
Development
Committees
Health care
facility

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THE COMMUNITY HEALTH FUND ACT [CAP. 409 R.E. 2023]
of operations to bid competitively for the provision of health
care services to members. 22. The Minister may amend the Second Schedule to this Act
by order published in the Gazette. PART V
FINANCIAL PROVISIONS
23. The funds and resources of the Fund shall consist of-
(a) all moneys received in respect of contributions paid by
members;
(b) user fees payable for using a government health centre
or dispensary;
(c) Government contributions;
(d) grants from councils, organisations or any other donor;
or
(e) any other money lawfully acquired from any other
source. 24. The money accrued to the Fund shall be used for the
following purposes, namely-
(a) health related purposes specified in the health plans
and approved by the Board; and
(b) any other essential health purposes or activities as may
deem relevant and approved by the Board.

the health plans
and approved by the Board; and
(b) any other essential health purposes or activities as may
deem relevant and approved by the Board.

25.–(1) The Board shall keep proper accounts and other
records in relation thereto and shall prepare in respect of each
financial year of the Council statement of accounts as the
Council may direct. (2) The accounts of the Fund shall be audited by competent
and qualified auditors in accordance with regulations
governing auditing of Council’s accounts. (3) The Board shall, as soon as practicable after the end of
each financial year of the Council, prepare a full report on the
performance of its functions during that financial year, and
Amendment of
Second Schedule
Sources of Fund
Uses of funds
Financial
management

rt on the
performance of its functions during that financial year, and
Amendment of
Second Schedule
Sources of Fund
Uses of funds
Financial
management

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60
one copy of such report together with a copy of the audited
accounts shall be submitted to the Council and the Ministry
responsible for health. PART VI
COMPLAINTS AND DISPUTE SETTLEMENT
26. A mechanism of dispute settlement shall be as prescribed
by regulations made under this Act. 27.–(1) The following acts shall constitute valid grounds for
complaints between a Board and a health care facility-
(a) the quality of health care services is not in line with the
granted fees;
(b) fee levels are smaller than the agreed amount; or
(c) there are delays in payment for provision of health care
services. (2) In the case of a member and a Board, the following
constitutes valid grounds for a complaint-
(a) provision of low quality health care services; or
(b) any other act or omission that undermines the purposes
of the Community Health Fund.

plaint-
(a) provision of low quality health care services; or
(b) any other act or omission that undermines the purposes
of the Community Health Fund.

(3) In the case of a member and a health care facility, the
following constitutes valid grounds for a complaint-
(a) the quality of health care services provided by the
health care facility;
(b) unjustifiable denial of certain health care services by a
health care facility;
(c) delay in the provision of a required health care service; or
(d) poor attitude to beneficiaries of health care services
under the Fund. 28. Any member, Board or health care facility may lodge a
complaint to the Ward Health Committee, or to the Board or
Council as the case may be, in accordance with the dispute
settlement mechanism prescribed by regulations made under
this Act. Dispute
settlement
Grounds for
complaints
Complaints

n accordance with the dispute
settlement mechanism prescribed by regulations made under
this Act. Dispute
settlement
Grounds for
complaints
Complaints

©2025 Government of Tanzania. All rights reserved. No part of this book may be reproduced or distributed without permission of OAG.61
THE COMMUNITY HEALTH FUND ACT [CAP. 409 R.E. 2023]
PART VII
GENERAL PROVISIONS
29. A person who-
(a) for the purpose of obtaining a health care service-
(i) knowingly makes any false statement or
representation or produces or causes to be
produced any document or information which he
knows to be false in any material particular; or
(ii) presents a forged card or document; or
(b) fails to disclose any material fact as a result of which he
obtains the health care services which he is not entitled,
commits an offence and on conviction, shall be liable to a
fine not exceeding one hundred thousand shillings or to
imprisonment for a term not exceeding one year or to both. 30.–(1) The Minister may, after consultation with the Minister
responsible for local government affairs, make regulations for
the better carrying out of the objectives of this Act.

r consultation with the Minister
responsible for local government affairs, make regulations for
the better carrying out of the objectives of this Act.

(2) Without prejudice to the generality of subsection (1),
the Minister may make regulations-
(a) regulating the Community Health Fund;
(b) providing for the mechanism of dispute settlement;
(c) providing for the manner of payment and collection of
contributions and user-fees;
(d) providing for criteria and procedures of exemptions;
and
(e) prescribing the selection procedure of members to the
Board. 31. A Council may make by-laws to provide for establishment of
Community Health Fund in its respective areas of jurisdiction
for operations and running of the Fund. Offences and
penalties
Regulations
By-laws

nt of
Community Health Fund in its respective areas of jurisdiction
for operations and running of the Fund. Offences and
penalties
Regulations
By-laws

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62
FIRST SCHEDULE
(Made under section 2)
1. Hanang District Council. 2. Igunga District Council
3. Iramba District Council. 4. Iringa District Council. 5. Kilosa District Council. 6. Mbinga District Council. 7. Nzega District Council. 8. Singida District Council. 9. Songea District Council. 10. Songea Town Council. SECOND SCHEDULE
(Made under sections 15(2), 16(2) and 19(2))
PROCEEDINGS OF THE COUNCIL HEALTH
SERVICES BOARD, COUNCIL HEALTH MANAGEMENT
TEAM AND WARD HEALTH COMMITTEE
1. In this Schedule-
“Chairman”, “Vice-Chairman” and “member” means the Chairman,
Vice-Chairman and member, as the case may be of-
(a) the Council Health Services Board;
(b) the Council Health Management Team; and
(c) the Ward Health Committee. 2.

nd member, as the case may be of-
(a) the Council Health Services Board;
(b) the Council Health Management Team; and
(c) the Ward Health Committee. 2.

The office of a member shall become vacant-
(a) on his death;
(b) upon resignation;
(c) where the member without sufficient cause fails to attend
three consecutive ordinary meetings;
(d) where the member becomes in any manner disqualified from
membership;
(e) where the member is declared in accordance with any written
law to have body or mental infirmity; or
(f) where the member has ceased to hold the post which entitles
him to be a member. 3.–(1) An ordinary meeting shall be held once after every three months
and convened by the Chairman and the notice of the meeting shall be
Interpretation
Vacation of office
Meetings and
quorum

nce after every three months
and convened by the Chairman and the notice of the meeting shall be
Interpretation
Vacation of office
Meetings and
quorum

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THE COMMUNITY HEALTH FUND ACT [CAP. 409 R.E. 2023]
sent to each member in not less than fourteen days before the date of
the meeting. (2) The Chairman, or in his absence, the Vice-Chairman, shall be
bound to convene a special meeting upon receipt of a request signed
by not less than five members, and not less than two days’ notice of the
meeting shall be given to the members. (3) One half of the total number of members shall form a quorum
for any meeting. (4) There shall preside at any meeting-
(a) the Chairman;
(b) in the absence of the Chairman, the Vice-Chairman;
(c) in the absence of the Chairman and the Vice-Chairman,
such member as may be elected by other members for the
purpose of that meeting. 4.–(1) At any meeting a decision of the majority of the members present
and voting shall be deemed to be the decision of that meeting. (2) In the event of equality of votes, the Chairman of that meeting
shall have a casting vote in addition to his deliberative vote. 5.

f that meeting. (2) In the event of equality of votes, the Chairman of that meeting
shall have a casting vote in addition to his deliberative vote. 5.

A decision may be made without a meeting by circulation of the
relevant papers to all members and the expression in writing of their
views, but a member may require that any such decision shall be
deferred until the matter is considered at another meeting. 6. Minutes in proper form of each meeting shall be kept and shall
be confirmed by the members at the next meeting and signed by the
Chairman and the Secretary of the meeting. 7. Members may act notwithstanding any vacancy in its composition
of membership. 8. The validity of any proceedings shall not be affected by any defect in
the appointment of any member. 9. All orders, directions, notices or other documents made or issued
shall be signed by-
(a) the Chairman;
(b) the Secretary; or
(c) any officer authorised in writing in that behalf by the
Secretary. 10. Subject to the provisions of this Schedule, members shall have
power to regulate proceedings of their meetings. Voting
Decision by
circulation of
papers
Minutes
Vacancy
Validity of
proceedings
Orders and
directions
Proceedings

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