HEALTH INSURANCE TO PROFESSIONAL FOOTBALLERS IN TANZANIA by Kiswgaer JR

MZUMBE UNIVERSITY
FACULTY OF LAW
MINI-DISSERTATION
ON
HEALTH INSURANCE TO PROFFESSIONAL FOOTBALLERS IN

TANZANIA: LAW AND PRACTICE.
NAME: YUSUPH H. KISWAGA
REG. NO: 1236009/T.20.
SUPERVISOR: MR; SEM A. MNZAVA
A COMPULSORY MINI-DISSERTATION SUBMITTED IN PARTIAL

FULFILLMENT OF THE REQUIREMENTS FOR AN AWARD OF
BACHELOR OF LAWS (LL. B) DEGREE OF MZUMBE UNIVERSITY
FEBRUARY, 2023
HEALTH INSURANCE TO PROFFESSIONAL FOOTBALLERS IN
TANZANIA: LAW AND PRACTICE.
DECLARATION AND CERTIFICATION
I, Yusuph Hamisi Kiswaga, do hereby declare that this Mini-Dissertation is my own
original work and it has not been submitted for a similar or any other degree in any
University or learning institution prior to this date of submission at Mzumbe
University.
Signature……………………………….
CERTIFICATION
I, Sem Amin Mnzava do hereby certify that I have read this work and find it
acceptable for examination by Mzumbe University.
Signature…………………………………………….
COPYRIGHT
This Mini-Dissertation is a copyright material protected under the Berne Convention
of 1886, the Copyright and Neighboring Rights Act, No. 7 of 1999 and any other
relevant laws on intellectual property. It may not be reproduced by any means in part
or in full, except for short extracts in fair dealings for research, private study, critical
scholarly review or discourse without prior permission of the author or Mzumbe
University on that behalf.
© Yusuph Hamisi Kiswaga,

Mzumbe University,
February, 2023.
ACKNOWLEDGMENTS
The achievement of this mini-dissertation paper has been assisted greatly from
greater and valuable contributions of many people, scholars from various sectors. It
is difficult to mention the names of all who have contributed towards the completion
of this work, therefore I would genuinely request them with due respect to accept my
sincere gratitude for their obliging support.
On the special way I would like to submit my special thanks to Almighty Allah for
my presence in this world since, I’m nothing beyond his power, special thanks to my
parents and family at large for being so patient and always being there for me in the
whole period of writing my dissertation.
In regard to that, I would like to express my special thanks and prayer to my

supervisor, Mr; Sem Amin Mnzava. I have no more rather than saying thank you for
your patient, buildable comments and advice, and unforgettable encouragement.
Your input has always been appreciated and has enabled me to complete this mini-
dissertation. May the Blessings of the Almighty God be upon you.
DEDICATION
I dedicate this work to my Mother Mayasa Hussien Amani and my Grand Mother
Hawa Juma Baruth for their great support in my academic success and
achievements since I started primary education up to date, without forget huge
contribution given of my uncle Respiace Fundi. In deed I’ll always be grateful and
proud of them.
ABBREVIATION
CAF Confederation of African Football
CHAN African Championship Competitions
FIFA Federal International Football Association
TFF Tanzania Football Federation
TPLB Tanzania Premium League Board
TABLE OF CONTENT
S
DECLARATION AND CERTIFICATION............................................................................iii

CERTIFICATION...................................................................................................................iii
ACKNOWLEDGMENTS.........................................................................................................v
DEDICATION.........................................................................................................................vi
ABBREVIATION...................................................................................................................vii
ABSTRACT.............................................................................................................................xi
LIST OF INTERNATIONAL LEGAL INSTRUMENT........................................................xii
LIST OF REGIONAL LEGISLATIONS..............................................................................xiv
LIST OF LOCAL LEGISLATIONS......................................................................................xv
CHAPTER ONE.....................................................................................................................16
1.0 Introduction.......................................................................................................................16
1.2 Statement of problem........................................................................................................19
1.3 Objective of the study.......................................................................................................19
1.3.1 General objective of the study........................................................................................19
1.3.2 Specific objectives.........................................................................................................19
1.4 Research questions............................................................................................................19
1.5. Significance of the study..................................................................................................20
1.6 Research Methodology.....................................................................................................20
1.6.1 Research Design.............................................................................................................20
1.6.2 Population and area of study..........................................................................................21
1.6.3 Sample size and Sampling Technique............................................................................21
1.6.4 Source of data.................................................................................................................21
1.6.5 Data Collection Method.................................................................................................22
1.6.5.1 Interview.....................................................................................................................22
1.6.5.2 Questionnaires.............................................................................................................22
1.6.5.3 Documentary review...................................................................................................22
1.7. Ethical consideration........................................................................................................22
1.8. Literature review..............................................................................................................23
Introduction.............................................................................................................................23
CHAPTER TWO..................................................................................................................29
CONEPTUAL FRAME WORK ON HEALTH INSURANCE TO PROFESSIONAL
FOOTBALLERS IN TANZANIA.......................................................................................29
2.0. Introduction......................................................................................................................29
2.1. Professional footballer.....................................................................................................29
2.2. Out of pockets payments..................................................................................................30
2.3. Health insurance...............................................................................................................31
CHAPTER THREE..............................................................................................................33
LEGAL FRAME WORK ON HEALTH INSURANCE TO PROFESSIONAL
FOOTBALERS IN TANZANIA..........................................................................................33
Introduction.............................................................................................................................33
2.1. International legal frame work.........................................................................................33
2.2. Regional Legal frame works............................................................................................34
2.2.1 African Legal Frame work.............................................................................................34
2.3. Domestic legal frame work..............................................................................................35
2.3.1 Tanzania Legal frame work...........................................................................................35
Conclusion...............................................................................................................................35
CHAPTER FOUR.................................................................................................................36
RESEARCH FINDINGS, DISCUSSION AND ANALYSIS.............................................36
4.0. Introduction......................................................................................................................36
4.1. General results of the research.........................................................................................36
4.2 Results in relation to research questions...........................................................................38
4.4 Conclusion.........................................................................................................................44
CHAPTER FIVE...................................................................................................................45
CONCLUSION AND RECOMMENDATION..................................................................45
5.0. Introduction......................................................................................................................45
5.1. Conclusion........................................................................................................................45
5.2 Recommendations.............................................................................................................46
REFERENCES........................................................................................................................48
APENDEX I............................................................................................................................51
ABSTRACT
This study mainly focuses on Health insurance to professional footballers in
Tanzania Law and the Practice. Despite of having specific legislation that provide for
the mandatory requirement for clubs to provide health insurance to footballers,
massive death and permanents injuries due to failure to access health care brought
some issues to be researched so as to stipulate on problems and ways forward
towards enforcement of those laws.
The general objective of this study is to assess the legal and practical challenges
facing the enforcement of laws governing mandatory health insurance to footballers
in Tanzania. In doing so the researcher employed both field research as to include the
methods like Questionnaire and Interview and library research as method of data
collection including reading previous research reports so as to examine what has
already been written by others, books, journal Articles and other online publication
materials.
This study observed that there are several challenges facing the enforcement of the
laws regulating football industry of which they have to be taken in paramount
consideration. Those challenges includes, weak economy of most of participants
clubs, Low level of knowledge among the players concerning the legal aspect
governing football matters, Poverty of most of the Professional footballer families
and poor administrative system.
The researcher recommendations towards this problem are; creation of good

condition to welcome investors in the football field, to ensure accessibility of
regulations to the stake holder so as to make them aware about laws and lastly
Provision of education to both footballers and clubs on value of health insurance.
Key Words; Professional footballers, Health insurance, Out of pockets, injuries,

LIST OF INTERNATIONAL LEGAL INSTRUMENT
FIFA Statutes on the Status and Transfer of Player of 2022.
INTERNATINAL CASE LAW
Redwn Hamid v Mills and Tottenham Hotspurs Fc Ltd [2015] EWHC 298
QB
LIST OF REGIONAL LEGISLATIONS
CAF Champions League Regulations of 2022.
CAF Statutes, edition of 2021.
CAF Women Champion League Regulations edition of 2022.
CAF Women Championship Regulation edition of 2021.
Regulation of African Cup of Nations, edition of 2020.
Regulation of African Nation Championship edition of 2020.
LIST OF LOCAL LEGISLATIONS
Tanzania Championship Kanuni of 2021
Tanzania Premium League (NBC Premium League) Competition Regulation

of 2022/2023.
CHAPTER ONE
1.0 Introduction
Football is a high speed and contact sport with a high incidence of injuries. Several studies have
reported the prevalence, severity, and types of injuries associated with playing football at the
elite level. Most of common injuries for the footballers are sprains and strains evicting mainly
the ankle and knee joints1.Research has generally shown that, professional players are on
increased risk of life injuries and death, less attention has been paid to describing how the
footballers health related quality of life is valuable and of the outer most important. This is a
great omission because general population studies have consistently shown that injuries are
common cause of pain and disability 2. Moreover, disease can have a negative impact on many
other dimensions including psychological wellbeing, employment, and activities of the
professional players3.
Currently there is vast number of events which are reported in Africa including Tanzania,
involving football players suffer and other die due to failure to access health care properly due to
number of reasons including financial problem to pay for health care, example the situation faced
Ally Mtoni Sonso Ruvu shooting Fc player, which lead to his death for failure to access adequate
health care due to coast and also current situation facing Gerreld Mdam from Police Tanzania Fc
who suffer at home while his health care remain to be great problem 4.
From the above writings, one may found that, health insurance to professional footballers is more
important and serious one to the extent that, the laws regulating football competitions have to
deal with it. This research will focus on the challenges on enforcement of health insurance to
footballer’s clause in Tanzania.
1
Ekstrand J, and Gillquist J; The avoidability of soccer injuries, (1983), V 4 no 124 Intellectual Sports Medical
Journal, Pp 89.
2
Decker J, Boot B, et al. Pain and disability in osteoarthritis: a review of biobehavioural mechanisms. (1992) V. 15.
Journal on Medical Behavior at Pp. 189
3
Yelin E, Lubeck D, Holman H, et al. The impact of rheumatoid arthritis and osteoarthritis: the activities of patients
with arthritis compared to controls. (1987) V.14 Journal of Rheumatol at Pp. 710.
4
Makongoro, I AND Saddick, S; “Bima za wachezaji fupa gumu kwa klabu’(Mwanasport ,Tanzania,Sept 29 2021)
https://www.mwanasport.co.tz/ms/kolamu-3566986. Accessed at 20 october2022.
15
1.1 Backgrounds to the study.
Professional football in Tanzania has long historical back ground from 1921 where by British
government organized the league in Dar es Salaam. By 1929 it had six participants. In the 1930s,
it included street teams such as Arab Sports (Kariakoo) and New Strong Team (Kisutu), made up
mainly of Arabs and Africans respectively. The Sudanese community had its own team, though it
featured other communities too, it joined in 1941. Other contemporary teams included Khalsas,
an exclusively Sikh team, and the Ilala Staff, a team with Ilala residents. In 1942, public
institutions such as the Government School, Post Office, Railways SC, King's African Rifles SC,
Police SC and Medical Department, started to dominate the league 5. However, after World War
II, most teams were disbanded, many European players stopped taking part in the league, and
their clubs, which included Gymkhana Club, Police, King's African Rifles, and Railways among
others, eventually withdrew. They were replaced, from the 1940s on, by African street teams
such as Young Africans (Yanga) and Sunderland (known as Old Boys in 1942 and later to
become Simba), as well as the Goan's Club manned by Goans, and the Agha Khan Club by
Ismaili Khojas6
In 1965 it incorporated most of the major teams in Tanzania 7. Its name later changed to the "First
Division Soccer League” and to the "Premier League" in 1997. Tanzania Breweries LTD became
the sponsor of the championship, after which the League was called the Tanzania Breweries
League (TBL). The contract with Breweries was terminated in 2001. In 2002, a contract was
signed with the telephone company Vodacom, which lasted until 2009, after which it was re-
signed the same year the league known Vodacom Premium League. 8 Current it is known as NBC
Premium League due to sponsorship contract with National Microfinance of commerce Bank.
Also there is number of the competitions in Tanzania as to include Championship competitions,
Azam sports Federation Cup, Women Premium League, Zanzibar Premium league, Mapinduzi
Cup9.
5
Tadasu, T; popular music, sports, and politics: A development of urban cultural movements in Dar es salaam, in
1930s-1960s. (2003) African Study Monographs. https://doi.org/10.14989%2F68221 . Retrieved 18 October 2022.
6
TFF; ‘Tanzania List of Champions" http://www.rsssf.com/tablest/tanzchamp.html. . Retrieved 18 October 2022.
7
Tanzania Football Federation; “About the Premier League" (26 February 2010)
https://web.archive.org/web/20101028040902/http://www.tff.or.tz/i ndex.php Retrieved 21 october,2022
8
Ibid
9
https://web.archive.org/web/20101028040902/http://www.tff.or.tz/i ndex.php Retrieved 21 october,2022
16
Before 2000’s footballers’ health was not considered in many countries, even in the developed
countries footballers were unsatisfied with the health care given by their clubs, though health
care to players in developed countries like European and Americans countries much differ from
that of Africa despite the fact that by that time even these developed countries had some delays
in the health of the footballers though were not like the African countries. Africa is the last
continent for the satisfaction of players by the health care provided by the clubs 10. South Africa
and Zimbabwe are the among of some place in Africa in which to some extent there is
percentage of footballers satisfied with the health care left behind the countries like Morocco,
Ghana, Ivory coast, Kenya, Tanzania and other related countries like aforementioned 11.On 2012
the former President of World football federation (FIFA) Sepp Blatter emphasized on the Health
insurance to all footballers when participating in the international competitions, He was in the
meeting with the member of Union of European Football Association, more he said that, soon as
possible all football associations will sign the agreement that all footballers and their staffs under
FIFA control are covered by the Health insurance12.
In Tanzania, Football is regulated by Federal International Football Association (FIFA)

Confederation of African Football (CAF) and Tanzania Football Federation (TFF); these
organizations have been always amending their competitions Laws and Regulations to adhere
with the current demands especially on the health aspect. Followed signing of the agreement,
TPBL amended Competitions regulation and included Health insurance clause and burden vested
on the hands of football clubs13.
1.2 Statement of problem

In Tanzania laws that regulating football Competitions set provisions which requires football
clubs to provide health insurance for every registered professional footballer more over the law
10
I, Swila; In sickness and health? Not so for Kenyan Premier League clubs and their players.” The Nation.
(Kenya,January 18, 2014). http://www.nation.co.ke/sports/football/Kenyan-Premier-League-clubs-and-their-
players/-/1102/2151258/-/m9sqsx/-/index.html accesed at 12,October 2022
11
FIFPRO World player’s Union; FIFPRO Global Employment Report in working conditions of footballer.2016
12
Makonogoro I and Sadick S; Bima za wachezaji fupa gumu kwa klabu , Mwanaspoti , (Dar es salaam,Tanzania,
Wednesday September 2021,);at pp.12 https://www.mwanasporti.co.tz/ms/kolamu-3566986. accessed at,3 oct,
2022.
13
Makonogoro I and Sadick S; Bima za wachezaji fupa gumu kwa klabu , Mwanaspoti , (Dar es salaam,Tanzania,
Wednesday September 2021,);at pp.12 https://www.mwanasporti.co.tz/ms/kolamu-3566986. Accessed at, 16
October, 2022.
17
set penalty of deregistration and being unrecognized as a football club if failed to provide health
insurance to their players14.Despite existence of clear laws covers mandatory health insurance to
footballers, still there is large number of footballers who have not covered under health insurance
and bad enough there is no any enforcement over it.
Therefore, this research looks on the problem of effectiveness of laws, that is to say, researcher
need to know why the laws are not effectively enforced.
1.3 Objective of the study
1.3.1 General objective of the study

To evaluate challenges facing enforcement of health insurance to professional footballers in
Tanzania.
1.3.2 Specific objectives

i. To assess the mode used by the football clubs to finance health services to footballers.
ii. To evaluate the position of law and its enforcement and practice on provision of health
insurance to footballers
iii. To examine negative implications of failure to enforce health insurance to professional

footballers.
1.4 Research questions

i. Whether modes used by clubs afford to insure access of health services to footballers?
ii.Why health insurance to professional footballers is not enforced in Tanzania?
iii. What are the negative effects of failure to provide health insurance to footballers?
14
Rule 12 of Tanzania Premium League (NBC Premium League) Competition Regulations of 2022/2023 and Rule
21 of Championship Kanuni of 2021
18
1.5. Significance of the study
i. To helps law students, stakeholders and the general public to develop other areas for
future research.
ii. To bring awareness to the society concerned to advantage of health insurance to all
people including professional footballers.
iii. To enable the authority evaluate the value and duty to enforcing the laws so as solve
the intended problem.
1.6 Research Methodology.

This research is both doctrinal and non-doctrinal legal research, since it involves both position of
the laws and social practice15.The Reasons is to covers gap between actual social behavior and
the behavior demanded by the legal norm and certain and hence strengthening potentials of law
as a vehicle for social and economic justice. Also number of facts or factors that lie outside a
legal system may be responsible for non-implementation or poor implementation of a given
piece of social legislation. Therefore, with this kind of research becomes necessary to identify
these bottlenecks and to design appropriate strategy to remove them or to minimize16.
This part therefore tells, about the research design, area of the study, population sample,
sampling techniques, types of data, data collection methods, data collection tools and data
analysis techniques.
1.6.1 Research Design

The researcher employed Cross sectional survey design in collecting data, Morogoro and Dar es
Salaam were visited for data collection. Collections of data based on both sources of which primary
data ware obtained through information collected from field respondents, and secondary data were
obtained by reviewing legal texts and reviewing non-authoritative sources like gazettes,
encyclopedias. Methods of data collection included interview, questionnaire and documentary
review.
15
Denzin N and Y. Lincoln: The Discipline and Practice of Qualitative Research (Person Education Limited.2000)
pp1-28
16
Ibid
19
1.6.2 Population and area of study.
Population mainly involved respondents from TFF, football clubs’ officers, footballers and clubs
doctors, this population is the one responsible in the football industry in Tanzania and other are
from Health system. Data obtained from them only and not otherwise and the areas case studies are
Dar es Salaam and Morogoro, this is due to vast number of reasons includes, the nearest from the
offices of headquarter of football federation of Tanzania, Availability of sample of footballers from
difference clubs in premium league from both women’s league, man’s league and under twenty
league also championship players. Also another consideration prompted in the selection of this area
of study is the cost in term of financial and time as the research is conducted during and while the
studies are in the cause17.
1.6.3 Sample size and Sampling Technique.

Sample size will include thirty five respondents, as a sample in the study of which four officials
from TFF, six officials from different clubs, twenty five football players from Dar es Salaam Young
Africans, Simba Sports Clubs, Azam Sports Club, Mtibwa sugar football club, Ruvu shooting Fc
and Yanga prices, Simba Queens. The sampling technique employed in carrying out this study
was purposive sampling. The respondents generally will be chosen by the researcher to shed light
to the study. The aim was to make sure that only the information obtained provide specific
information as purposive kid of sampling technique gives chance to researcher to choose
respondents based on the knowledge18.
1.6.4 Source of data.

Both sources of data were used, that means the primary and secondary sources of data. The primary
source of data involved field research which aimed at collecting more accurate data, research
conducted in Morogoro region and Dar es Salaam region to obtain the set of information’s which
could not found in library. Researcher applied interview method and questionnaire so as to obtain
firsthand information. The secondary method of data collection involve library sources such as
Legislation, books, journals, different publications and gazettes will be which based on the health
insurance in general and these communicate about the health of sports man and footballers.
17
Kothari C. K; research methodology (Methods and Techniques, 2nd Ed, New Age International, 2004)
18
Ibid
20
1.6.5 Data Collection Method.
Under primary source the ways of collecting data included administering standardized
interviews and questionnaire.
1.6.5.1 Interview.
Set of questions were placed within the respondents working offices and through online mode,
structured system was used to obtain deep and more information from the interviewee, as it evolve
verbal communication between the interviewee and interviewer, interview conducted through
telephone and other face to face interview19.
1.6.5.2 Questionnaires.
Piece of questions ware circulated and the respondents given chance to fill them and then the
researcher collected them to analyze and use them. The instruments of the study were
questionnaires interviews. These instruments were purposely employed by the researcher with
the aim of gaining complete and detailed information to support the study.
1.6.5.3 Documentary review.
Herein, documentary review was used to provide useful information as what are the views of
different scholars based on the football and Laws governing football in Tanzania including the
position of International Football regulations like FIFA Medical Concussion Protocol, CAF statutes,
CAF Champions League Regulation, CAF confederation, TFF competitions Regulations (NBC
Premium League Competition regulations of 2022/2023 and Championship Kanuni of 2021).
1.7. Ethical consideration.
In this research, since it is Both doctrinal and non-doctrinal, that is to say it includes primary and
secondary source of data, researcher adhered the issue of citation and acknowledgement of the
documents and ideas to save double purpose as, to avoid academic theft (plagiarism) and also to
acknowledge the source of information not only direct quotations, but also specific facts 20. Another
19
Kothari C. K; research methodology (Methods and Techniques,2nd Ed, New Age International Ltd ,2004)
20
Denzin N and Y. Lincoln: The Discipline and Practice of Qualitative Research (Person Education Limited.2000)
pp1-28
21
to make incidental comments upon source or to amplify textual discussions (to provide a place for
material obtained). Also as the study use the primary source of data which include field collection
of data, researcher used interview and question. Therefore to adhere with the ethics, researcher
avoids the use of the names of respondents to maintain confidentiality. Therefore the office, and
status were use to identify the respondents
1.8. Literature review.

Introduction
This chapter will basically deal with analysis of the different previous research reports and
writing published by different authors and organization consigning health of the footballers and
importance of health insurance and also will involve discussion in connecting those publication
in relation to research topic and at the end of the chapter it will involves limitation on getting
more research especially publication consign Health insurance to footballers in Tanzania as the
case study in this research. Through the critical literature review on secondary source of data will
lead thoroughly. However, the researcher able to review some of the literatures that in one way
or another had some aspects of the covered topic as discussed below.
Moffitt. R. A and Eric P. S (1997)21, argued that; Access to adequate health insurance is a key
concern of families with children at all income levels. Since 1965, mothers and children on
welfare have had health care coverage through the Medicaid program, which has provided a
health care safety net for welfare recipients. Although most Americans are insured through their
employers, families who leave welfare for employment often find themselves in jobs that do not
offer health care coverage, adding to the ranks of the uninsured. This article examines the extent
to which poor children and their mothers have private insurance, Medicaid, or no health
insurance at all. It documents how recent expansions of Medicaid eligibility to low income
children who do not receive welfare have improved the insurance status of children, though these
changes have not helped the mothers who leave welfare for work. Citing evidence that health
insurance options influence the welfare and employment decisions of women whose families
face health problems, the article suggests that implementing welfare reform at a time when rates
21
Moffitt. R.A and Eric P. S; Health Care Coverage for Children Who Are on and off Welfare. The Future of
Children, Welfare to Work,(1997)Vol.7,No.1.Princeton journal.pp.87-98 https://www.jstor.org/stable/1602580.
22
of private insurance coverage are declining will be challenging and may expose some families to
health risk.
This writing is of the valuable in this research since it explains about the importance of Health
insurance. However, it covers only Mother and children, therefore this research is going to show
other group of professional footballers and the challenges faced the provision of health insurance
to them.
James, A and Mooney, G (2011) 22, argued that , the principles underlying Health insurance are
little debated, one of these key principles is ,health to each according to his need and each
according to his means. On the needs side, they examine the issue of vertical equity. The
approach of "communitarian claims" is proposed, both for eliciting the components of need and
for determining the relative weights to be attached to the vertical dimensions of equity in health
service delivery. On the means side, the authors also look to communitarian claims to assist in
determining who should bear what burden in paying for social health insurance. They argue that
with respect to the concept of "from each according to his means," it is useful to incorporate an
element of willingness to pay, but meaning here the community’s willingness to pay.
This writing only shows the principles governing the provision of insurance there is important
however even this article did not cover the challenges facing the provision of health insurance to
the footballers.
Robert Osoro (2014)23, stated that, many footballers lack even a basic education, and this ends
up hurting them in the long run. This has a major effect because many footballers and some with
potential to play in Europe are injured, but do not know who will take care of their medical bills.
Most footballers do not sign contracts they just verbally accept to play for clubs so when they are
injured the club does not cover them at all unless these professional players and these played in
registered league however even these who sign written contract in the health care clause is too
general. With more educated footballers, they could make better decisions for themselves and
ensure that they are getting the proper coverage, and can defend themselves legally. This study is
22
James A and Mooney G; Social health insurance to each according to his needs; from each according to his means
but what might that "mean”? (2011) Vol. 41, No. 4: International Journal of Health Services. At pp.
679.https://www.jstor.org/stable/45140852. accessed on 09-10’2022
23
Osoro,R; “Kenyan footballers suffering thanks to lack of basic education.”(June7, 2014)
http://www.futaa.com/blog/kenyan-footballers-suffering-thanks-to-lack-of-basic-education.
23
important since it deals with the affairs of the footballers, it shows the importance of education
and how it can help them to have an ability to find the way of access of their right including right
to access of health care, and in case of failure they have to know the legal actions to be taken.
However, in his writing Osoro did not show the way forward to the authority and the law makers
as to which way the problem of access to health could be solved so as to help them on the health
aspect. Therefore, this research covers the way issue of Health insurance to footballers as the
possible solution to ward the problem and not challenges facing enforcement of provision of
health insurance thereto.
Isaac Swila (2014). 24, Contends that, many footballers current not accept verbal contracts, more
than enough footballers sign formal written contracts with health care clause. This absolutely
gives the player the confidence and hope that his/her club will look after their physical
wellbeing, however, this is not the case. Many football clubs, even though the player signed a
written contract, will look the other way once the player is injured. He cited Japheth 'Jojo'
Waweru, the former Tusker FC center half. Water, a towering and talented defender, and was
beginning to emerge as one of the greatest Kenyan center halves of his generation.
Unfortunately, he fractured his neck during his time with Tusker, and no one at the club seemed
to take notice and give assistance. Waweru continued to play, and was invited to play at the 2014
African Cup of Nations as the starting center half. Sadly, he left the match when he appeared to
have a 'serious neck injury. Tusker dropped him shortly after, he never found another top flight
club to play for, and now has taken to the bottle and lives in poverty.
The article analyses on how the football clubs prove no mercy to their players once they get huge
injury and the great reason to all of these things are the inadequate of education to among the
footballers and to huge extent the financial health of the most of East African clubs since he cited
the example of Manchester United players Wayn Rooney who injured the same as Waweru and
only for few weeks recovered after Manchester bear the cost of treatment. In his conclusion,
show the advantage and importance of Health Insurance to the footballer however, this article
24
players/-/1102/2151258/-/m9sqsx/-/index.html accessed at 12,October 2022.
24
did not show the challenges facing the enforcement of the provision of health insurance to
footballers.
Vincent Mutiso (2014)25, stated that; the Kenyan Football National Team doctor and certified
orthopedic surgeon did a study on knee injuries during a season of top flight football in Kenya.
Mutiso talks about how many of these footballers came from a financially deprived background
and how any type of injury could produce risks for their future livelihood. This is how they make
a living, and without other resources to help them, football becomes a very risky sport to play. In
addition, very little information about sports injuries comes out of Africa compared to the rest of
the world. Mutiso strongly believes that better data needs to be taken and kept regarding injuries
in sports, so that they can “translate it to injury prevention efforts in addition to the medical
management of these injuries”
This article is very useful to this study since it explain the real situation and on how far did the
footballer is at risk of injuries and therefore need health care .But the gap in this article, it did not
show the solution since only financing health to the footballers will not save them since most of
Africans clubs use out of pockets payment to pay for the health of their players but the problem
is the same, therefore this research come with the agenda of challenges facing the enforcement of
the law concerning health insurance to footballers.
Maximillian Domapielle (2014) 26, argued that, there is growing awareness of the fact that ill-
health perpetuates poverty. In order to prevent the negative downward spiral of poverty and
illness, developing countries in recent years are increasingly implementing various models of
health insurance to increase access to health care for poor households. While there is consistent
evidence that health insurance schemes have caused an increase in access to health generally, the
debate regarding the most appropriate health insurance scheme that suits the poor continues
unabated. The paper argues that irrespective of the model of health insurance being implemented
these dimensions of access govern the poor and the poorest household decisions about enrolling
in a health insurance scheme and utilizing health care services. Policy makers and planners need
25
Mutiso, Vincent, “Knee Injuries in Elite League Football During One Season in Kenya: Preliminary Results.”
(University of Nairobi.Kenya. June 16,2014) http://orthopaedics.uonbi.ac.ke/sites/default/files/chs/medschool/
orthopaedics/Knee accessed at 13,october 2022.
26
Domapielle, M. K; Health insurance and access to health care services in developing countries (PHD thesis
University of Bradford,2014) available in http://dx.doi.org/10.18196/jgp accessed at 05-10-2022.
25
to pay attention to these important dimensions when making decisions regarding health insurance
and health care services utilization to ensure that the peculiar needs of the poor are taken on
board.
The study is of the value that, it shows the importance of having health insurance to ward
attainment of the right of access of health to poor people and solve the poverty problem through
the use of health insurance. However, the Article did not cover on the aspect of professional
footballer since they are not under poor people as they employed.
Afram, A (2014) 27 stated that, Professional football (soccer) is a contact sport, where players are
exposed to high intensity workloads, such as sprinting, jumping and landing with frequently
abrupt changing of direction, that, players are at high risk for acute, recurrent or overuse injuries
with emphasis on the lower extremities. Due to these injuries 10% of players are not able to
participate in training and or matches. Also, these injuries may result in psychosocial and mental
disorders, such as distress, depression and anxiety. In addition, even though its overall incidence
is low, professional athletes, including professional football players, are at higher risk for sudden
cardiac death compared with age matched none. Acute injuries, recurrent or overuse injuries can
lead to long term health problems and disability; In their writing they much cover the aspect
effects of the disease and injury facing the footballer and the position of doctors to ward avoid
death and incapacitation of professional footballers However they did not explain anything about
who have the duty to take care of them and on which way
FIFA (2015)28, argued that, Head injuries can result in substantially different outcomes, ranging
from no detectable effect to transient functional impairments or life threatening structural
lesions. In high-level international football tournaments, one head injury occurs every third
match on average. This makes the immediate diagnosis of a head injury and determination of its
severity, whether on or off the pitch, an essential skill for team physicians. Both elements can be
challenging because clinical signs of a brain injury do not necessarily present immediately, but
rather can develop over several minutes, hours or even days after the incident. There are several
actions that can be performed prior to a concussion that will improve the management of a
27
Afram A, Et all; Medical examinations in Dutch professional football (soccer): A qualitative study (2014) V.17,
International Sport Medical Journal.https://www.jstor.org/stable/45140852.accessed on 09-10-2022.
28
FIFA Medical Concussion Protocol suspect and Protect of 2015
26
concussed player, such as baseline examinations and the implementation of a structured plan for
post-concussion management. Despite the fact that this writing is valuable, as it shows about the
health and how FIFA as the mother and heart of the World football care about health of the
professional footballer and how it supports clubs toward healthcare. However, did not write
anything about the health insurance to professional players.
Roderick, M,(2017)29 explained that; From time to time players gain reputations among
supporters, journalists and other ‘outsiders’ as being injury prone. Former England international
midfielder Darren Anderson, example, became known widely as ‘Sick Note’ because of a string
of injuries which interrupted his playing career and which led him to play fewer than one
hundred times in five seasons. Whilst this label may appear from the outside as little more than a
harmless joke, stigmas such as this have a number of unintended consequences for players. The
networks of relationships in which players are bound up at their workplace involve not only
associations with supporters but what, for them, are more central interdependencies: that is,
relationships with managers, coaches, club physiotherapists and their team mates. It is these
people who determine for the most part the extent to which players may be stigmatized, or the
perceived magnitude of discrediting events. For players, therefore, stigma results from being
identified as flawed, discredited or spoiled.
As far as the study being of important in this research for providing literature review concerning
to the affairs of footballers however it did not show the challenges underlying the provision of
the health insurance..
Conclusion
This chapter was set out to give an overview of the important of health insurance to professional
footballers; also this chapter has discussed different concepts from literatures relating to health of
the footballers and the advantages of health insurance in social and economic development, and
considered different writings within the Africans societies. There is little literature on the subject
matter under discussion; several writers already have some literature on health insurance in
genera and not on the subject matter i
ntended in this paper.
29
Roderick, M; The work of professional football (Taylor and Francis, 2017)
27
CHAPTER TWO
CONEPTUAL FRAME WORK ON HEALTH INSURANCE TO PROFESSIONAL
FOOTBALLERS IN TANZANIA
2.0. Introduction
This chapter provides for the theoretical and conceptual framework of the study, it talks about
the concepts and meaning of various terms in relation to the health insurance to professional
footballers in Tanzania.
2.1. Professional footballer
The meaning of profession player is not subjected to the country where a player born, rather is
affected by quality, performance, nature of clubs and also playing in different nations. However
the great factor here is the extent and number of league played in relation to different nation and
continents. Therefore to me professional player is the one who acquired contact to play in the
league which is recognized by FIFA.
According to McGovern, Professional footballer is person under a labor intensive industry in

which employment is offered by immobile forms of capital to increasingly mobile forms of
labor. Employers are fixed to specific geographical locations while the employees or the players
can move between cities and countries. There is significant global trade in professional football,
which has been the subject of much scrutiny; such high levels of mobility indicate that there is a
great deal of information available about players30.
Being it the case, Stead, D. and Maguire, when discussing the development of from Scandinavia
league to England league, define them as professional players. Therefore to him, Professional
30
McGovern, P; Globalization or internationalization? Foreign footballers in the English league. (2002) Vol 1 no 36
Journal of Sport and Social Issues, at pp 23
28
football is unique’ as an industry because the playing contribution of employees ‘is unusually
transparent’. Potential employers can observe the performances of players and assess at first
hand a player’s relative strengths and weaknesses. Therefore professional footballers are
employer, additionally; employers might seek information about a player’s professional
reputation informally through personal contacts31.
Apart from the above meaning, Roderick, M, defined professional footballer as these player who
engaged and employed by the club under professional contract and who is paid wages by the
club to focus on their sport in lieu of other employment. Generally, begin as amateurs and the
best player’s progress to become professional players. Normally they start at a youth team (any
local team) and from there, based on skill and talent, scouts offer contracts. Once signed, some
learn to play better football and a few advance to the senior or professional teams32.
2.2. Out of pockets payments.
Out of pockets payment is not popular term in the society, in simple way it has been used to
describe direct payment made by person during the time where he is in need of services as
opposed to health insurance or payment by cash system so as to acquires health services, it is on
sport payment of health services
The term has been defined by Health insurance, to refer as the portion of your covered medical
expenses that you can expect to pay during the course of a plan year, although they typically only
refer to in-network costs for essential health benefits, as there are no regulations in place to cap
how much people spend on out-of-network care and insurers are not required to cover services
that aren’t considered essential health benefits. If you receive medical care that’s not covered by
your health plan, you’ll have to pay the full cost of the treatment, but it won’t count towards your
policy’s out-of-pocket limit (an example would be the cost of dental care, assuming your plan
does not include dental coverage)33.
31
Stead, D. and Maguire, J; ‘Rites de passage’ or passage to riches: The motivation and objectives of Nordic/
Scandinavian players in the English league soccer. (2000) Vol 1 no 24. Journal of Sport and Social Issues, at pp 36
32
33
Health insurance; Out of pocket cost.(10-feb-2022) https://www.healthinsurance.org/ retrieved at 17-12-2022.
29
In the different way World Health Organization set out the meaning of Out of Pocket payments
as the individuals’ direct payments to healthcare providers at the time of service use, it include
purely private transactions payments made by individuals to private doctors and pharmacies,
official patient cost sharing within defined public or private benefit packages, payments beyond
the prescriptions entitled as benefits, both in cash and in kind34.
In the other words Davalon, defined the term to represents an amount in which an individual
must pay for a medical product or service that’s not covered by their health insurance. Because
health insurance plans vary by person, provider, and even location, what falls into the category of
out-of-pocket cost and what doesn’t can look different from plan to plan. An out-of-pocket cost
can often dictate which healthcare services someone may want to consider and which someone
may want to hold off on. Example of out of [pocket payment includes copays Deductibles
Coinsurance non covered services Premiums35.
2.3. Health insurance.
The meaning of Health insurance provided by World Health Organization (WHO), as to mean a
formal arrangement in which insured persons are protected from the costs of medical services
that are covered by the health insurance plan. Health insurance works best when risk pools are
large and when the health risks associated with the covered population are diversified, in
essence, when the healthy can subsidize the sick36. Health insurance can be financed and
managed in various ways as to include National health insurance is government-managed
insurance financed through general taxation, usually with mandatory coverage for all citizens,
Private voluntary health insurance is distributed by private for profit or not for profit companies,
and Social health insurance37.
34
World Health Organization. 2019.
35
Davalon, Y; Out of Pocket Costs for Health Insurance (Updated on October 03, 2022) https://Alvin-
almazov.com/healthinsurance/ retrieved at 20-12-2022.
36
Ortiz, C. Catherine Connor Et al; Health Insurance Handbook, (2012) World Bank Working Paper No. 219
https://www.healthinsurance.org/ retreated at 20-12-2022.
37
Ortiz, C. Catherine Connor Et al; Health Insurance Handbook, (2012) World Bank Working Paper No. 219
https://www.healthinsurance.org/ retreated at 20-12-2022.
30
Health insurance is the type of insurance coverage that pays for medical and surgical expenses
that are incurred by the insured. Health insurance can either reimburse the insured for expenses
incurred from illness or injury or pay the care provider directly. Health insurance is often
included in employer benefit packages as a means of enticing quality employees38
In regarding to Mwakisiski in his notes based on insurance law defined health insurance to mean
the way of providing financial protection against health care costs with the objectives of ensuring
financial sufficiency, risk pooling, and effective purchasing 39. Accordingly, it helps in ensuring a
balance between population health investments and health care finance, and is recognized to be
the prevailing method to achieve universal health coverage and protects insured persons from
paying high treatment costs in the event of sickness40.
2.4. Conclusion.
Therefore, the issue of health insurance to footballers is a serious problem in Tanzania which
requires immediate remedial measures. It has impacted negatively on the Tanzanian as to include
ending of the player’s carrier, health problems and incapacitation, death of people and poor
performance of the players in the ground.
38
Denavas, C; Income, poverty, and health insurance coverage in the United States (2005). Available at:
https://books.google.co.tz/books/abou . Accessed on Tuesday, october11, 2022.
39
Mwakisiki, E.M; Introduction to Insurance Law in Tanzania theory and Practice, (Compiled Notes On Insurance
Law in Tanzania, Moshi Cooperative University 2017)
40
Mwakisiki, E.M; Introduction to Insurance Law in Tanzania theory and Practice, (Compiled Notes On Insurance
Law in Tanzania, Moshi Cooperative University 2017)
31
32
CHAPTER THREE
LEGAL FRAME WORK ON HEALTH INSURANCE TO PROFESSIONAL
FOOTBALERS IN TANZANIA
Introduction.
Tanzania football is regulated by Tanzania Football Federation (TFF) which is under the
Ministry of Arts, Sports and, organization is active member of Confederation of African Football
(CAF) and Federal international Football Association (FIFA). It rectified a lot of regulation and
it bound by these international and Regional Organization. Therefore, they form part and parcel
of the law regulating football aspect in Tanzania. In regard to health insurance to footballers, the
laws are not silent each explain in its own way from international Regulations, Regional
regulations and Local regulations as stipulated bellow.
2.1. International legal frame work.

FIFA Regulation on the Status and Transfer of Players, it gives duty to the club with which the
player concerned is registered to be responsible for his insurance cover against illness and
accident during the entire period of his release. This cover also extends to any injuries sustained
by the player during the international match (es) for which he was released. If a professional
player suffers during the period of his release for an international match a bodily injury caused
by an accident and is, as a consequence of such an injury, temporary totally disabled, the club
with which the player concerned is registered will be indemnified by FIFA41.
In the case of Redwn Hamid v Mills and Tottenham Hotspurs Fc Ltd, in this case Spurs were
found to have breached their duty of care to the player who suffered cardiac arrest, after the club
doctor mistakenly recorded that he was fit to train and play while cardiologist had said he may
have possible underlying cardiac condition. It was held that, this case is important remainder to
football clubs of their duty of care to players particular where they have notice some underlying
health condition, Health of the footballers is of the outer most important42.
41
Annexe 3 and 4 of FIFA Statutes on the Status and Transfer of Player, amendment of 2022.
42
[2015] EWHC 298 QB
33
2.2. Regional Legal frame works
2.2.1 African Legal Frame work
CAF Statutes, this is the mother statutes over all regulations in Africa, in simple way it is the
Mother Law of all association found in African Continent regulation professional football, in its
objectives it expressly stated that, it has the duty to protect health of the players and credibility of
the competitions. The Law establishes the Medical committee which has been vested over the
power of recommending and advising CAF on the important aspect of the health of footballers
and recommend proper ways to deal with the health of footballers. Moreover committee required
to prepare report based on the minor injuries and educates trainers, also they have to study
condition of the entire region and to provide their medical recommendation based on the
betterment of the footballers health43.
Regulation of African Cup of Nation, It is the regulation that cover on the nation competitions
that means African Football Competitions of Nations (AFCON), the law requires every
footballer and their staffs who qualify to participate in the competitions to obtain health
insurance and it set as the mandatory requirement for player to qualify to play in the
competitions44.
Regulation African Nation Championship, this is the regulation that regulate competitions of
nation comprising players playing within their mother countries in club rank, without hesitations
it Cleary create mandatory requirement for all people who participate in the competitions must
have health insurance45.
Champions League Regulations and CAF Women Champion League Regulations, However the
law did not Cleary communicate about the health insurance but in the great extent the laws
require every team when participating in the competitions, to have doctors who qualified,
recognized and certified by the health authority and be dully registered with the member
association or league46.
43
Article 2 (1)(j) and 11 (2) CAF Statutes, edition of 2021.
44
Article 110(2) of Regulation of the African Cup of Nations, edition of 2020
45
Article 108(2) of Regulation of African Nation Championship edition of 2020 and CAF Women Championship
Regulation edition of 2021.
46
CAF Champions League Regulations of 2022 and CAF Women Champion League Regulations edition of 2022
34
2.3. Domestic legal frame work
2.3.1 Tanzania Legal frame work.
NBC Premier League Competitions Regulations, the law set provisions which requires football
clubs to deal with health of the players and provide health insurance for every registered
professional footballer more over the law set the penalty of deregistration and being
unrecognized as a football club if failed to provide health insurance to their players, this means
that it is the mandatory requirement for registration of player in the completions 47.
Championship Kanuni, the law set provisions which requires football clubs to deal with health of
the players and provide health insurance for every registered professional footballer more over
the law set the penalty of deregistration and being unrecognized as a football club if failed to
provide health insurance to their players, this means that it is the mandatory requirement for
registration of player in the completions48.
Conclusion
Generally, this chapter provided analysis of laws on the issue of Health insurance to professional
footballers, whereby the laws have been analyzed together with the responsible organs dealing
and football competitions in Tanzania. This chapter has briefly made some critical analysis of the
status of the national and international law instruments, which Regulate football competitions.
By virtue of its membership to these international instruments, Tanzania is obligated to enforce
the laws as enacted.
47
Rule 12 of Tanzania Premium League (NBC Premium League) Competition Regulation of 2022/2023.
48
Rule 21 of Championship Kanuni of 2021
35
CHAPTER FOUR
RESEARCH FINDINGS, DISCUSSION AND ANALYSIS
4.0. Introduction
This chapter presents the research findings and the research analysis on the findings made by
researcher. The analysis is based on the research questions and objectives of the research as
portrayed in Chapter one of this research work. Although this work concerns the whole of
Tanzania Mainland, but the research was conducted in Dar es Salaam and Morogoro specifically,
for the purpose of abide with cost inform of time and money also they are regions comprises of
large Football offices and a lot of participating clubs’ headquarters.
In this study data obtained through interview where by both structured and unstructured method
employed, this method aimed at catching up respondent’s views and experiences in matters
concerning health insurance to footballers. Also questionnaires method applied whereby
researcher put forward some written questionnaires (in both Kiswahili and English). The
questionnaire distributed incorporated questions that attempted to highlight the issues under
research lastly library research as the major secondary method of data collection materials and
information sought includes text books, research papers and journals magazines, newspapers and
other literatures.
4.1. General results of the research

The field study practically revealed that the concept of Health insurance is well understood to
footballers, 100% of respondents were able to explain the meaning of health insurance and the
advantage of health insurance the same. However, over 80% of the respondents know nothing
about the Laws that regulate football competitions, most of them think that these laws if for the
leaders and not for them. Moreover, they even did not know about legal implications for players
and clubs when failed to provides health insurance to footballers. The situation explained as the
poison to the development of players health since they know noting and where to presents their
demand.49
49
players/-/1102/2151258/-/m9sqsx/-/index.html accessed at 12,October 2022
36
Club officials were able to identify the meaning and value of health insurance to footballers; it is
100% percent of the club officials know about it. The study reveals that, officials know about the
Laws those governing football competitions and its legal consequences of failure to provide
health insurance to their players. The study also reveals that, TFF officials have enough
knowledge about the advantage of the health insurance, since they already observe a lot of
incidence that affects the life of the footballer’s due lack of health insurance. They know also
that, TPLB which is the organ that vested with the power to create competitions regulations and
enforcing it, set provision which requires football clubs to provide health insurance to the
footballers50.
4.1.1 Table to show awareness of the people on laws regulating health insurance to
professional footballers in Tanzania.
Total number People who are aware of laws People who are not aware of
Respondents. of respondents regulating health insurance to laws regulating health
footballers insurance to footballers.
Professional 20 5 15
footballers
Clubs officials 6 6 0
TFF officials 4 4 0
Clubs doctors 5 0 5
Total 35 15 20
4.2 Results in relation to research questions.
The researcher in his research was guided by research questions; therefore, data were obtained
from the field study through sample population of 35 respondents as indicated above. The
50
Makongoro, I and Saddick, S; “Bima za wachezaji fupa gumu kwa klabu’(Mwanasport ,Tanzania,Sept 29 2021)
https://www.mwanasport.co.tz/ms/kolamu-3566986. Accessed at 20 october2022
37
researcher interviewed about ten respondents whose number includes Professional footballers,
Clubs officials, TFF officials and Clubs doctors. Twenty-five questionnaires were also collected
from the sample size selected. The sample size selected was sufficient to portray the magnitude
of the problem Enforcement of health insurance to footballers in Tanzania.
Researcher based on his important questions which the respondents were asked to answer so as
to shad a light to the study. The question aimed at fulfilling the objectives of this research as the
research aimed at finding challenges or the obstacles lead to failure for enforcements of health
insurance to the footballers. Therefore, below are the information’s and data collected from the
field based on the question asked.
4.2.1 Value of health insurance toward access of health care.

Data collected through Interviews and questionnaires reveals that, first, respondents managed to
identify the mode used by the clubs which is payment on the time where services is required, in
simple language “out of pockets payment”. Both respondents accepted that, despite the fact that
the modes to some extent managed to solve health problems by managed to finance health
services to footballers but the method not adequate and therefore not afford to ensure access of
health care to footballers. Respondents pointed out reasons behind and their arguments were as
follows.
4.2.1.1. Protection of life and carrier of the players.
TFF officials and club’s official commented that, currently there is huge increase of cost in the
health service; therefore the method causes unexpected delay for the players to get adequate
treatments, to the extent that some of them in hospital ending by checkup and other obtained
only weak services according to their payment at that particular time. More over the situation
may lead to death of the player when is at hard situation. Literature shows that, of Emmanuel
Ericksen and Sergio Kun Aguero who were admitted in hospital while they are in hard situation
after collapse during the match. It was health for them because they have health insurance
therefore it was easily to access health care accordingly51.
For the side of footballers, in their arguments most of them based on the aspects that, system is
too bad for them since it made them suffer a lot for even a small injury, One of Professional
51
Patel, M; "Sports and Exercise Medicine for Athletes and Footballers: The Case of Kenya" (2015). Independent
Study Project (ISP) Collection. https://digitalcollections.sit.edu/isp/collection/2-01-2023
38
player explain about the injury of Radamel Falcao, that followed their health insurance they
managed to access adequate health care and recovery however he cited the example of one
Tanzania Player Gadiel Michel who suffer with little injury, his health care financed by his
family and football funs which make him hard to recover and come back in the pitch.
4.2.1.2. Is the key against cost in health services.
Clubs doctors stated, in different time they receive different footballers injured in a match but
most of them use out of pockets payments to finance health service. The study reveals that, even
doctors themselves suggest that despite of the fact that method denial access to health care for
footballers it is also too cost full, therefore insurance system protect the use of huge amount of
money in health insurance. Since their injury requires more attentions and fast treatments,
therefore most of them once arrived at the hospital ending by given simple treatment according
to their pockets at that time.
4.2.2. Challenges facing enforcement of provisions of health insurance to footballers in

Tanzania.
Respondent had different views, their views based on the major four aspects which are Economic
reasons, low level of knowledge of the laws to the players and administrative matters.
4.2.2.1. Weak administration system in the football arena.
The study reveals that, leader did not put more emphasize to it, there is always drama of
speaking in different meetings about the issue of insurance to the player however still to date
remained to be the paper works. Respondents from the groups of player said that, it is the issue
of administration only; if the law is clear then they have to follow it. But the big problem
according to their views is that, most of the people in the authority are not sports man therefore
they are there for making money and not keeping themselves with the affairs of the players at all.
Literature reviews shows that, Most of the leader in the football arena are mere politicians and
not football man, they always act politically and not on the reality of football.it is important to be
39
noted that, the loop and huge different between politics and football therefore football must be
under footballers and not politicians52.
4.2.2.2 Weak economy of most clubs,
The study reveals that, there is sixteen Clubs participating in men Premium league and twenty
clubs participating in Championship competitions, also there is ten clubs in Women Premium
league. Out of all these clubs only few of them have good economic standard compared to the
level of Tanzania competitions. The study reveals that there are some clubs in Championships
competitions cannot afford even paying Transportation, meals and accommodations to their
players. One of the TFF officers cited the example of Gwambina football Club which writing a
letter to remove themselves from competitions to TFF and competition board after failure to
attend in three consecutive matches due to economic reasons. Monil Patel remarked that,
Many football clubs, are community sponsored clubs. Consequently, many of

these clubs are among the poorest and perform the worst year in and year out.
The reasons for this are simple: poor funding and lack of organization. With
minimal funding from the government, these clubs do not have any money for the
players or for investing in a physiotherapist and a sports clinic. When the
government is supposed to give money for the players, facilities, etc., the money
gets lost somewhere in process, and these players suffer53.
Therefore, the study reveals that, in our Country most of Championships clubs have weak
economy to the extent that if authority begun to enforce health insurance clause, Competitions
may remain in almost three up to four teams not only Championship but also even in Premium
league only team until now which their players are covered under health insurance are these
teams with the huge economic status including clubs like Yanga, Azam and Simba. One among
of the officer of the Club from championship explains that, we cannot we know the value of
health insurance, as it reduces cost in health services and also it insures access of health to the
52
Lagat, J; “Interview with Jeroen Deen, one of the leading sports physiotherapists in the world, A View from
Kenya.” (Last modified February 16, 2015). http://www.runblogrun.com/2015/02/interview-with-jeroen-deen-
one-of-leading-sports- physiotherapists-in-the-world-a-view-from-kenya-by.html retrieved at 06/01/2023.
53
40
players at all but the problem with most of our clubs is weak economy to the extent that there is
time club cannot afford even paying for transportation of the players.
It revealed in literature that, many clubs with private sponsors get a decent sum of money that
can be given to the players, invested in good coaches and facilities, and used for developing
facilities and personnel. The government is not expected to fund these high altitude training
camps- they are all privately owned and run but if Tanzanian’s biggest ambassadors and
successors are footballers, why would more money not be spent on them? More specifically, why
more money would not be spent on the developmental aspect of running, such as the training
promotions54.
4.2.2.3 Low level of education and knowledge among the players.
The study reveals that more than 80% percent of the professional players know nothing about the
legal aspects those governing football competitions. Most of the players think that the laws are
for the officers and they have no duty to know it, this made too difficult for them to complain
about different legal matter that club vested with the duty to provide for them. The side of TFF
and TPLB in general explained that, it is their duty to ensure laws governing competitions
available and well accessible to the footballers; therefore they insert all laws in TFF website and
for international laws are available in the website of CAF and FIFA. Literatures show that, many
footballers lack even a basic education, and this ends up hurting them in the long run. This has a
major effect because many footballers some with potential to play in Europe get injured, but do
not know who will take care of their medical bills55
Also the study identified that, professional footballers lacks persons with the legal professions to
whom they can advise about the legal procedures. One of the footballers said that, even my
manager knows nothing about law, my father and my mother are my adviser to everything in my
carrier and second is my manager both know nothing about law, we only meet a lawyer when we
have family problems and my last day to meet with lawyer it is two years ago and it was in the
54
players/-/1102/2151258/-/m9sqsx/-/index.html accessed at 12,October 2022
55
Osoro, R; “Kenyan footballers suffering thanks to lack of basic education.”(June 7, 2014)
http://www.futaa.com/blog/kenyan-footballers-suffering-thanks-to-lack-of-basic-education
41
contractual period. The study reveals that, in the football industry there is adequate of lawyer to
help them to fulfill their right and obligations stipulated within the Laws governing football
industry.
4.2.2.4. Poverty of most of the Professional footballer families.
The study reveals that football is employment like other employments, professional footballers
are paid salaries and bonus also they entered contracts with their employees. Therefore, most of
the players fears to report the incidence in the authority for fear to lose their employments. It was
Remarked from Some players that, my family is very poor, I am the first one to possess one
million shillings in cash in my family, all family matters are on my hands, how did I begun to
sue for my club because it did not give me health insurance while I receive my salaries, it is not
that health is not so more important but what makes most of player silent on it is the value of
employment over health insurance, we remain silent to secure our employments more over.
Literature shows that, most of footballers come from poor families; therefore they become the
backbone of their families hence it become difficult for them to complain against their clubs 56.
4.2.3. Negative effects of failure to enforce health insurance to footballers.
Respondent had different views, their views based on the major aspects which are Economic
effects and the effect on the performance and carrier of footballers.
4.2.3.1. End of player’s career,
The study reveals that, there is some critical evidence on this facts, since respondents managed to
identify different players who until now from the injured day, it is more than three years they did
not recovered well to the extent that they are not fit for playing again. This also become the
reasons for many of professional players lost their employment since they cannot perform
fundamental part of their contracts as they employed to play and they cannot play for the reason
of long time injury.
56
players/-/1102/2151258/-/m9sqsx/-/index.html accessed at 12, October 2022.
42
Other Respondents from side of footballers said that, we see other players in Europe once they
injured it does not matter what kind of injury, but they believe they will be back in the pitch
again, but here in Tanzania, it is difficult since players have no access of health services since
clubs use out of pockets payments to pay for health care and there is situation clubs left their
duty of doing so or when there are some injuries requires huge amount of money ,it become
difficult for them to finance for it, hence it remain financing pain killers to footballers and not
treatments so as to enable them back to the pitch again. The evidence from literature shows that,
there is vast number of players whose carrier end after failure to access health care due to cost,
Japheth waweru from Leopards Fc mentioned as the example of the player57.
4.2.3.2. Ineffective and low performance of the players,
The study reveals that, lack of health insurance to the players lead to death of talents of the
players since, talent need to be practiced with spirit and courage so as to develop it. Therefore,
lack of health insurance increase fears to the player while they are in the pitch to the extent he
cannot deliver all what he has by fear an injury. One respondent stated that, there is time we
failed to play at the highest level by fear injuries, as you know football is very dangerous play it
is just like half death half live game, he mentioned example of player who died in the pitch.
Literature observes that, playing without having insurance reduce confidence and fighting spirit
to the players, since they believe that once they injured, clubs may have no mercy on them 58.
4.2.3.3. Increases expenditure to both clubs and players,
The study reveals that, clubs incur huge cost to finance health services to the players by using out
of pockets payments when they injured. One of the officer of football club explained that, we
learn a lot from the event of our player, it cost a lot of money to make sure that he reaches even
in this stage we know that still we have the burden to deal with the health of our player as we
agreed in his contract but next season we will make sure that our players, all employees in our
club including ball boys are covered with Health insurance. Also another officer from big club in
Tanzania said that, we always suffer with the increase of cost when it comes the matter of health
57
Osoro,R; “Kenyan footballers suffering thanks to lack of basic education.”(June 7, 2014)
http://www.futaa.com/blog/kenyan-footballers-suffering-thanks-to-lack-of-basic-education
58
43
services, yes we employed doctors but they are here to assist with first aid other matters in case
of injury players are taken to hospital, now we are in negotiations with National Health Insurance
we expect from few days’ letter we will reach to the agreements.
There is time players ask for the amount of money to the club for treatment and are given a lot of
procedures to follow to the extent they decide to use their money for treatment. The study reveals
that not only expenditure but also this method makes difficult for player to get money for
treatment, as it was remarked from respondent above, the procedures may even take one or more
than a day up to it accomplishments, this create hard and difficult situations for the players to
access health care at the time59.
4.2.3.4. Death to the footballers,

The study reveals that, in there is number of footballer’s die due to failure to access health care
due to lack of health insurance. When Respondents answer the question, one of the doctor said
that, few days back there is player died for a such reason, he was always used pain killers and
other medicine for the reasons that, his family cannot afford to finance health care and more over
his football club is among of these clubs with low income to the extent that, it become difficult
for them to invest in the health of one player at all.
4.4 Conclusion.
Therefore, this chapter has made a detailed and critical analysis on the findings on the challenges
facing effective enforcement of health insurance to professional footballers in Tanzania, the
research has also analyzed the legal and institutional framework achievements in care of health
footballers.
59
Makongoro, I and Saddick, S; “Bima za wachezaji fupa gumu kwa klabu’(Mwanasport ,Tanzania,Sept 29 2021)
https://www.mwanasport.co.tz/ms/kolamu-3566986. Accessed at 20 october2022
44
CHAPTER FIVE
CONCLUSION AND RECOMMENDATION
5.0. Introduction
This chapter gives a conclusion in relation to the findings of the research and recommends
doable and practicable approaches needed to reduce and eventually remove the Challenges
facing the health insurance to footballers in Tanzania.
5.1. Conclusion
There are several Regulations in Tanzania which have been enacted to curb the problem Health
insurance to the footballers. The problem is not only dealt by local laws but also international
instruments, all of these aim at curbing the same problem, unfortunately, this has not been
realized because there is massive increase death and permanent incapacitation.
This study has reviewed a Football Industry in Tanzania; the overall objective of the study is to
generate information and well-grounded views which can persuade the government to take the
necessary steps to solve the problems of health insurance to footballers. Thus in specific terms
the study has evaluate the challenges facing effective enforcement of the laws governing Health
insurance to footballers in Tanzania, the scale and impact of Lack of health insurance to the
footballers and assessment on the mode Used by clubs to finance health care to players.
From the findings, it is clear that problem of health insurance dominates and therefore is a
serious problem in Tanzania which requires immediate remedial measures, The study reveals
that challenging the enforcement of the health clause includes; Weak economy of most of
participants clubs, Low level of knowledge among the players concerning the legal aspect
governing football matters, Poverty of most of the Professional footballer families, In adequate
of lawyers in the football industries and poor administrative system. More over the study reveals
that, the effects of failure to enforce health insurance to footballers includes; It may lead to end
of player’s career, it increases expenditure to both clubs and players, it may to death since is the
obstacle to access of health care to the footballers.
45
5.2 Recommendations.
This section presents recommendations which aims at advising on what should be done as per
the law to curb the problem of counterfeit foods and drugs. The followings things are
recommended.
5.2.1. Provision of education to both footballers and clubs toward the value of health
insurance.
TPBL and TFF as the authority vested with the power should organization of seminars and
workshops to address the important aspects to the footballers at whole and not only having
several meeting with the leaders of the clubs. This will enable footballers to be able adhere with
the duty of know the laws governing their field. It is my constructive view that, in every season
there should even a single seminar involving all stake holders of the footballers, that is to say,
Advocates since they play part in their contracts, Club doctors, Players, Officers of different
sponsors, health insurance representative as to mention few of them. This may give out
awareness based on different aspect in the football field
5.2.2. Creation of good environments to welcome investors in the football field.
Honestly speaking, we have Azam Company, GSM Company, Sport pesa, Barrick, Mbet Pari
Match and other Investors in our league brought huge changes in economic aspect in most clubs.
Therefore it is my considered view that, among of the way of inviting investors is through tax
relief and exceptions and promotions through mass Medias.it is my opinion that to attract more
investors in the football arena, government may offer relief to all company or organization which
will opt to invest in any football club this will encourage more company to invest therein and
hence will enable clubs to be economically stable. Also as it was done by the President Samia
Suluhu Hassan in Royal Tour, government through it ministry governing football may invites
even the largest football clubs like Manchester United, Real Madrid, Barcelona or even the
famous and greatest players like Christian Ronaldo, Lionel Messi or any other as deemed fit to
cover the sphere so as to give the World attention toward our League.
46
5.2.3. Easily accessibility of the laws governing football industry in Tanzania.
Being it the case TFF and TPLB have to ensure accessibility and easily availability of the laws
and Regulations governing football in Tanzania Honestly speaking, the law governing football in
Tanzania become like a gold stone, it is too difficult to find them; most of them are still in hard
copy only. Even in the TFF website, they did not found at all. This has the great effects since it
requires a lot of time in finding hard copy of the law, example Regulation governing Premium
League found in Hard Copy this made difficult even for player to find them..
5.3. Conclusion.
Therefore, this chapter has stipulated the conclusion and recommendations on the challenges
facing effective enforcement of health insurance to professional footballers in Tanzania, the
research has also analyzed the some ways and mechanisms that would help to cure problems
which made the to be ineffective.
47
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Mwakisiki, E.M; Introduction to Insurance Law in Tanzania theory and Practice, (Compiled
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James A and Mooney G; Social health insurance to each according to his needs; from each
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10’2022
McGovern, P; Globalization or internationalization? Foreign footballers in the English league.
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Moffitt. R.A and Eric P. S; Health Care Coverage for Children Who Are on and off Welfare. The
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Patel, M; "Sports and Exercise Medicine for Athletes and Footballers: The Case of Kenya"
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activities of patients with arthritis compared to controls. (1987) V.14 Journal of
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sports- physiotherapists-in-the-world-a-view-from-kenya-by.html retrieved at
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Mutiso, Vincent, “Knee Injuries in Elite League Football during One Season in Kenya:
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Osoro, R; “Kenyan footballers suffering thanks to lack of basic education.”(June 7, 2014)
http://www.futaa.com/blog/kenyan-footballers-suffering-thanks-to-lack-of-basic-
education. Accessed at 12, October 2022
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Nation.(Kenya, January 18, 2014). http://www.nation.co.ke/sports/football/Kenyan-
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GAZATTE
Makongoro I and Sadick S; Bima za wachezaji fupa gumu kwa klabu,(Mwanaspoti , (Dar es
salaam,Tanzania, Wednesday September 2021,);at p.12
https://www.mwanasporti.co.tz/ms/kolamu-3566986. Accessed at, 3 Oct, 2022.
50
APENDEX I.
Questionnaire (English Version)
Questionnaire Number……………
Name of club/ office ……………………
Date ………..Month……….Year……………..
SECTION A:
1. Sex (a) Male [ ] (b) Female [ ]
2. What is the level of education you attained? (a) None [ ] (b) Primary education [ ] (c)
Secondary education [ ] (d) Certificate/ College (Diploma) [ ] (f) University level [ ]
3. What is your occupation? (a) Footballer [ ] (b) club doctor [ ] (c) TFF officer [ ] (d) Club
officer [ ]
SECTION B:
4. Do you know anything about Health insurance?
5. Do you know the laws governing football competitions in Tanzania?
6. What is the position of the laws governing football competitions in Health insurance for
footballers in Tanzania?
7. Is it important for footballers to be covered under health insurance?
8. What is the challenges facing the enforcement process of the health insurance clause to
footballers?
9. In your view, what should be done to ensure health insurance clause

enforced? ...........................…………………………………………………………………………
……………………………………………………………………………………………
THANK YOU FOR YOUR PARTICIPATION!
51
APPENDIX II
Dodoso (Kiswahili)
Namba ya dodoso……………
Jina la Timu / ofisi ……………………
Tarehe/ mwezi /mwaka …………………..
SEHEMU A:
1. Jinsia (a) Mme [ ] (b) Mke [ ]
2. Kiwango cha elimu ya mshiriki? (a) hajasoma[ ] (b) elimu ya msingi [ ] (c) elimu ya sekondari
[ ] (d) elimu ya ufundi [ ] (e) Chuo (Stashahada) [ ] (f) Elimu ya juu[ ]
3. Kazi? (a) Mchezaji wa mpira wa miguu [ ] (b) Daktari wa timu [ ] (c) Kiongozi wa shirikisho [
] (d) Kiongozi wa Klabu [ ]
SEHEMU B:
4.Unafaham nini kuhusu Bima ya Afya?
5.Unazifaham sharia zinazo ongoza mashindano ya mpira wa miguu Tanzania
6.Niipi nafasi ya sharia za mashindano ya mpira a miguu katika kusimamia bima za afya kwa
wachezaji Tanzania?
7.Je kuna umuhim wowote kwa wachezaji mkuunganishwa katika mfumo wa bima ya Afya?
8.Ni changamoto zipi zinazo pelekea kutokua na utekelezwaji wa kifungu cha sharia ya bima ya
afya kwa wachezaji?
9. Nini kifanyike ili kuondo changamoto ya sharia ya bima ya afya kwa wachezaji
kutotekelezwa? .................................................................................................................................
AHSANTE KWA USHIRIKIANO WAKO.
52

HEALTH INSURANCE TO PROFESSIONAL FOOTBALLERS IN TANZANIA by Kiswgaer JR

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MZUMBE UNIVERSITY

HEALTH INSURANCE TO PROFFESSIONAL FOOTBALLERS IN

NAME: YUSUPH H. KISWAGA

REG. NO: 1236009/T.20.

SUPERVISOR: MR; SEM A. MNZAVA

A COMPULSORY MINI-DISSERTATION SUBMITTED IN PARTIAL

© Yusuph Hamisi Kiswaga,

In regard to that, I would like to express my special thanks and prayer to my

CHAN African Championship Competitions

FIFA Federal International Football Association

TFF Tanzania Football Federation

TPLB Tanzania Premium League Board

DECLARATION AND CERTIFICATION............................................................................iii

The researcher recommendations towards this problem are; creation of good

Key Words; Professional footballers, Health insurance, Out of pockets, injuries,

Tanzania Premium League (NBC Premium League) Competition Regulation

In Tanzania, Football is regulated by Federal International Football Association (FIFA)

1.2 Statement of problem

1.3 Objective of the study

1.3.1 General objective of the study

1.3.2 Specific objectives

iii. To examine negative implications of failure to enforce health insurance to professional

1.4 Research questions

ii.Why health insurance to professional footballers is not enforced in Tanzania?

1.6 Research Methodology.

1.6.1 Research Design

1.6.3 Sample size and Sampling Technique.

1.6.4 Source of data.

1.6.5.3 Documentary review.

1.7. Ethical consideration.

1.8. Literature review.

2.1. Professional footballer

According to McGovern, Professional footballer is person under a labor intensive industry in

2.2. Out of pockets payments.

2.3. Health insurance.

2.1. International legal frame work.

4.1. General results of the research

4.2 Results in relation to research questions.

4.2.1 Value of health insurance toward access of health care.

4.2.1.2. Is the key against cost in health services.

4.2.2. Challenges facing enforcement of provisions of health insurance to footballers in

4.2.2.1. Weak administration system in the football arena.

4.2.2.2 Weak economy of most clubs,

Many football clubs, are community sponsored clubs. Consequently, many of

4.2.2.3 Low level of education and knowledge among the players.

4.2.2.4. Poverty of most of the Professional footballer families.

4.2.3. Negative effects of failure to enforce health insurance to footballers.

4.2.3.1. End of player’s career,

4.2.3.2. Ineffective and low performance of the players,

4.2.3.3. Increases expenditure to both clubs and players,

4.2.3.4. Death to the footballers,

5.2.2. Creation of good environments to welcome investors in the football field.

9. In your view, what should be done to ensure health insurance clause

THANK YOU FOR YOUR PARTICIPATION!

Jina la Timu / ofisi ……………………

Tarehe/ mwezi /mwaka …………………..

4.Unafaham nini kuhusu Bima ya Afya?

5.Unazifaham sharia zinazo ongoza mashindano ya mpira wa miguu Tanzania

AHSANTE KWA USHIRIKIANO WAKO.

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