New NHIF reforms to suit the Universal Healthcare Coverage agenda

The number of patients seeking treatment under the National Health Insurance Fund (NHIF) has increased since the launch of the Universal Health Care programme, the latest report shows.

Speaking during the official receipt of a report on transformation and repositioning of the NHIF, Health Cabinet Secretary Sicily Kariuki said the rising number of patients demonstrated that there was an unmet need.

Kisumu, Nyeri, Machakos and Isiolo Counties recorded an increase in patients seeking health services from 20 per cent to 58 per cent.

“Poor Kenyans in the four counties, who were previously unable to access healthcare, are now able to access health services as part of the Big Four agenda,” said the CS.

According to Kariuki, NHIF needed to urgently address the sustainability of multiple schemes, some of which were making losses.

Scheme sustainability

James Wambugu, the chair of the panel responsible for producing an NHIF expert report presented to the CS, said there were 74 schemes under NHIF.

“Only 25 per cent of Kenyans have a prepaid insurance mechanism, while 75 per cent pay for their own health needs,” said Mr Wambugu.

He noted that the 75 per cent faced financial problems later on.

“Some will contribute only when they are sick, which means the majority would face financial strains such as failing to pay for health services,” he highlighted.

He said the panel was to review the regulatory framework with the aim of determining NHIF financial viability and addressing financial disputes.

Wambugu also noted that the new NHIF reforms proposed by the panel would address effective use of limited resources to offer adequate health services.

The reforms were generated from views from health professionals, the business community and ordinary Kenyans.