Tanzania’s Healthcare System: Local Insurance, Hospitals, Evacuation and Health Risks

Tanzania combines public facilities and a private care sector, with very uneven provision between the large cities and the rest of the country. France Diplomatie passes no judgement on the quality of the system, but describes the facilities to which a patient should be directed in an emergency: reference hospitals in and around Dar es Salaam, in Arusha and in Zanzibar, and, for serious cases, evacuation to Kenya or South Africa.

The National Health Insurance Fund (NHIF, “Mfuko wa Taifa wa Bima ya Afya”) promotes the goal of “health insurance for all” and offers several packages, including individual plans and packages for children. The National Social Security Fund (NSSF) for its part lists a social health benefit. For a French resident, the most common combination pairs a first-contact doctor in Dar es Salaam or Arusha with international insurance that organises evacuation. See also living in Tanzania.

The NHIF pages consulted present the packages, online registration and the registration guides for dependants. They give neither contribution rates nor eligibility rules for a foreigner; they indicate that the government has accelerated the implementation of the first phase of insurance for all. These conditions are confirmed with the NHIF (Dodoma) and the employer.

• Local employee: the employer may offer NHIF cover or private insurance; ceilings, network and evacuation are read in the contract.
• Seconded employee: the French scheme remains applicable for 3 years renewable once (CLEISS, the French liaison centre for international social security); see healthcare reimbursement in Tanzania.
• Other profiles: the CFE (Caisse des Français de l’étranger, the French social security fund for French nationals abroad) or international insurance with medical repatriation.

The first-contact doctor is chosen in Dar es Salaam, Arusha or Zanzibar; the embassy has a French medical contact who can be reached on +255 754 25 46 42 from Monday to Friday, 8 a.m. to 5 p.m., and on Saturday, 8 a.m. to 1 p.m. For out-of-hours emergencies, the embassy line is +255 784 210 396, and the switchboard +255 22 219 88 00. The France Diplomatie pages consulted give no national emergency number: it is useful to save those of your contract’s assistance and of the hospitals near your home.

For Zanzibar, travel insurance has been compulsory since 1 October 2024 (USD 44 per person, valid for 90 days, on the archipelago only). France Diplomatie specifies that most quality care facilities do not accept it, that activating it may prevent you from using other insurance and that it is better to contact your French insurer in case of difficulty. For the mountains (Meru, Kilimanjaro), guides from recognised agencies and specialised rescue insurance are needed; medical evacuations on site are limited.

France Diplomatie recommends bringing only the medicines that are strictly necessary, in their original packaging with the labels, together with a prescription giving the names as international non-proprietary names. You must check that the medicines are authorised in Tanzania and never buy medicines in the street, because of counterfeits. For a chronic treatment, a sufficient reserve and the prescription ease checks; the conditions for reimbursement of medicines abroad are confirmed with the insurer.

Malaria is transmitted by mosquito bites; prevention combines protection against bites and preventive treatment after consulting a doctor or a travel medicine centre before any stay in an endemic area. In case of symptoms during the stay or in the weeks following the return, a prompt consultation is essential.

• Dengue: on the rise in recent years, notably in the Dar es Salaam region; no curative treatment, anti-inflammatory drugs to be avoided.
• Rift Valley fever: cases reported in the north, Arusha region.
• Cholera: present, above all in unsanitary urban and informal neighbourhoods; leptospirosis: several cases reported; trypanosomiasis: rare, a few tourist cases in the large parks.
• HIV: Tanzania is heavily affected, with a higher prevalence among women and in urban areas.
• Others: Ebola, Marburg, typhoid, meningococcal meningitis, rabies, tuberculosis and mpox are described with their prevention measures.

France Diplomatie recommends being up to date with the French vaccination schedule, notably diphtheria, tetanus, poliomyelitis, whooping cough and measles. Depending on the situation: hepatitis A and typhoid (conditions and length of stay), hepatitis B (frequent or long stays), meningitis ACWY (dry season, generally winter and spring, or a reported epidemic), tuberculosis (children under fifteen on frequent or prolonged stays), rabies (young children, stays in rural areas), chikungunya and dengue (epidemic or long stay in an endemic area) and mpox (at-risk exposure).

Yellow fever: the requirements are described as unclear; proof of vaccination is often requested at the airport, but without being a legal or medical requirement according to the page. Bringing your vaccination record and consulting a doctor or an international vaccination centre well before departure remains the simplest precaution.

France Diplomatie considers imperative an assistance contract or insurance covering all medical costs, including surgery, hospitalisation and medical repatriation. With no social security agreement between France and Tanzania (CLEISS list), no coordination exists between the schemes: the choice is between the employer’s insurance, the CFE and international insurance. Reference points can be found in the pages on expat health insurance and repatriation and assistance; Expavy helps you weigh these options against your situation.