NHIF best placed to roll out free maternity services

The Jubilee Government has started on the right note by demonstrating strong political commitment to reduce inequalities in healthcare access. The policy to provide free maternity services is good given the high maternal mortality rate of 488 per 100,000 live births compared to the global average of 210 per 100,000 live births.

A high percentage of Kenyan women are still delivering at home which can turn out to be very costly in the event of obstetric complications. The new policy calls for financial commitment to the health delivery system. The question however is: Which is the best way to implement the policy?

Institutions are supposed to actualise government polices. After independence, the Government  pledged free health services in public facilities.  This was accomplished up to the mid 1980’s when fiscal constraints resulted in underfunding of the facilities.

Majority of government hospitals were converted into prescription centres where clinicians could diagnose sickness but patients were compelled to purchase medicine from private pharmacies.  The Government introduced cost sharing in 1989 to assuage the financing gap.Private health facilities have proliferated from this period.

Over the years, National Hospital Insurance Fund (NHIF) has executed public private partnerships with government, private and faith-based health facilities and has contracted over 1,200 of them to provide services to members and declared dependants.

NHIF’s Health benefit package includes comprehensive maternity package for normal and caesarian delivery.  Slightly over one million informal sector workers are accessing NHIF services and virtually everyone in the formal sector.

Studies all over the world are pointing to the fact that demand side financing embeds in the health system needed efficiencies. NHIF has come up with prospective provider payment system that stymies wastage and inefficiency. These include capitation payment system for outpatient care services and case payment system for inpatient maternity services.

Clinical governance system in place and close working relationship with contracted health providers guarantees quality services to the members. Financing to support maternity services need to be channeled through NHIF.

This will mesh well with the vision of Universal Health Coverage for all Kenyans. Those who are not members shall be enrolled and educated on how Social Health Insurance works. This shall work well in tandem with efforts to enroll everyone.  Whereas those able to contribute must do so, NHIF shall solicit contributions to support poor persons unable to make contributions to the Fund. Many countries like China and Mexico have in the recent past achieved Universal Health Coverage through partial and total insurance subsidies from general tax revenues for low income workers and the poor respectively.

I assure Kenyans that NHIF is the best vehicle to implement the Government policy on free maternity services and I’m sure many mothers who are NHIF covered can give testimonials on this. 

{Gitimu JN, General Manager, Operations & Marketing, NHIF}