title: Household perceptions towards a redistributive policy across health insurance funds in Tanzania.
abstract: BACKGROUND
  The Tanzanian health insurance system comprises multiple health insurance funds targeting different population groups but which operate in parallel, with no mechanisms for redistribution across the funds. Establishing such redistributive mechanisms requires public support, which is grounded on the level of solidarity within the country. The aim of this paper is to analyse the perceptions of CHF, NHIF and non-member households towards cross-subsidisation of the poor as an indication of the level of solidarity and acceptance of redistributive mechanisms.
  
  
  METHODS
  This study analyses data collected from a survey of 695 households relating to perceptions of household heads towards cross-subsidisation of the poor to enable them to access health services. Kruskal-Wallis test is used to compare perceptions by membership status. Generalized ordinal logistic regression models are used to identify factors associated with support for cross-subsidisation of the poor.
  
  
  RESULTS
  Compared to CHF and NHIF households, non-member households expressed the highest support for subsidised CHF membership for the poor. The odds of expressing support for subsidised CHF membership are higher for NHIF households and non-member households, households that are wealthier, whose household heads have lower education levels, and have sick members. The majority of households support a partial rather than fully subsidised CHF membership for the poor and there were no significant differences by membership status. The odds of expressing willingness to contribute towards subsidised CHF membership are higher for households that are wealthier, with young household heads and have confidence in scheme management.
  
  
  CONCLUSIONS
  The majority may support a redistributive policy, but there are indications that this support and willingness to contribute to its achievement are influenced by the perceived benefits, amount of subsidy considered, and trust in scheme management. These present important issues for consideration when designing redistributive policies.
authors.affiliation: Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania. e_chomi@yahoo.com.|Aarhus University, Aarhus, Denmark. e_chomi@yahoo.com.
authors.forename: Eunice N
authors.initials: EN
authors.lastname: Chomi
authors.affiliation: Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania. pharemujinja@yahoo.co.uk.
authors.forename: Phares G M
authors.initials: PG
authors.lastname: Mujinja
authors.affiliation: London School of Hygiene and Tropical Medicine, London, UK. Kristian.Hansen@Ishtm.ac.uk.
authors.forename: Kristian
authors.initials: K
authors.lastname: Hansen
authors.affiliation: Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania. angwarakiwara@yahoo.com.
authors.forename: Angwara D
authors.initials: AD
authors.lastname: Kiwara
authors.affiliation: Aarhus University, Aarhus, Denmark. ue@soci.au.dk.
authors.forename: Ulrika
authors.initials: U
authors.lastname: Enemark
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005191:Family Characteristics; D005260:Female; D005376:Financial Management / Q000191:economics* / Q000706:statistics & numerical data; D005380:Financing, Government / Q000191:economics* / Q000706:statistics & numerical data; D006296:Health Services / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007348:Insurance, Health / Q000191:economics* / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics* / Q000706:statistics & numerical data; D011203:Poverty / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D013636:Tanzania; D055815:Young Adult