AFTER being silent for a while, health sector stakeholders tied to faith-based organisations (FBOs) are asking for improvements in the service provision agreement with the government, where the National Health Insurance Fund (NHIF) is the sole institution targeted by this demand.

The agencies are saying that short of alterations in that regard they don’t see much scope for successful implementation of the universal health coverage (UHC) policy.

Private hospitals have stayed out of the limelight for a while, with FBOs said to have adopted the recent NHIF guidelines without putting up undue questions, a position they are now altering.

Worries to that effect have been raised by the former Evangelical Lutheran Church in Tanzania (ELCT) presiding bishop who has chaired the board of the KCMC referral hospital in Moshi, and so is in a position to advise the government knowledgeably enough.

The highly regarded elder is on record as having said that success by UHC largely depends on the nature of the terms agreed upon by the parties involved.

That is well known, except how to determine whether the current terms are good enough and – if not – how far the government or rather NHIF is prepared to negotiate, with a view to altering those terms. It is unclear if the wake-up call will stand.

What the demand amounts to is just to say that all is not well with the new terms set out for the ‘public private partnership’ in health care and that since it was largely a personal statement rather than a meeting resolution, it isn’t binding on FBOs.

What is however not in doubt is that it sort of lets the cat out of the bag, to use the cliché, in that a huge impression was created that FBOs have no problems with the NHIF terms but private health providers are overly mindful of profits and commonly overcharge.

The registrar of health facilities was even alerted on the issue; things soon calmed down, or so it appeared.

Not much of that view can be considered for FBOs as community organisations usually in tandem with government expectations in the sector, while private hospitals have had a rather tortured itinerary with health sector policies over the past 60 years or so.

So long as FBOs are satisfied with the NHIF offer, the government will be at ease, as access to private hospitals is not an overly sensitive matter, while FBOs hospital lockouts would shake the sector.

That is why unease with a key health sector adviser for ELCT would matter. So it is advisable for NHIF and the government, by implication, to find ways around a few less contested issues until they come to some sustainable agreement.