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Abstract

This qualitative research and interpretative paradigm study investigated the challenges and constraints of the National Health Insurance Fund (NHIF) inclusion of the informal sector in Dar es Salaam, Tanzania. Sixteen respondents were involved in this study through an in-depth interview as a primary method of data collection. Content and thematic analysis were used to draw themes from data. Findings revealed that the operation of the NHIF in the informal sector is facing challenges such as a lack of information about health insurance; the packages attract sicker than healthy individuals and informal social protection attracts individuals more than NHIF. Furthermore, the study revealed that the implementation of the NHIF in the informal sector is constrained by the limitation of other family members, waiting time after joining the NHIF, limited services to the first-year members, and the exclusion of people above 59 years in special insurance packages. The study concludes that the inclusion of the informal sector in the NHIF packages is experiencing challenges and constraints, areas that need to be addressed for the successful widening of the coverage. The study recommends that NHIF should expand its coverage to promote universal health coverage and enhance sustainable development goal number three.