Why it is important for your domestic worker to have a medical cover

To date, Jane Wangui is grateful to her former employer for signing her up for medical cover. She tells Gardy Chacha why

“My medical cover came in handy when I needed surgery to deliver my baby,” Jane says.

The mere thought that she could have been forced to foot the bill on her own sends shivers down her spine. “I don’t know what I would have done if I was not covered,” she says. “I would have had to beg for help — and I am not even sure if I would have got any.”

In 2016, Jane was working for Kanyeki as a house help and she was pregnant. “I did not worry much about the pregnancy because I knew I would give birth normally,” she says.

Things would, however, take a different turn when D-day arrived. “I was taken to hospital but it would take until the following day at 5am when actual labour set in,” Jane recalls.

Nurses kept checking on her to monitor the progression of her labour but by 10am, her cervix had hardly dilated yet she was in so much pain.

“A doctor came and performed further checks and advised that I go into the theatre. He said the path for the baby was not opening up fast enough,” she explains.

Jane panicked. “Why was I going into surgery? Where will I get the money to pay for the surgery?” Jane’s mind was running wild. For a good reason though.

In 2012, before being signed on NHIF – Kenya’s national health insurer, Jane recalls she was gravely ill. She had suffered an ectopic pregnancy. “I was operated on at Kenyatta National Hospital (KNH),” she says. She was in the wards for approximately two weeks – recuperating.

But upon getting better, she still could not leave the hospital because she was unable to pay the bill. “I was moved to a room where patients who cannot pay their bills wait as their families raise the funds needed,” she says.

She spent close to two months there as her family struggled to raise funds. Friends and family contributed. Even one well-wisher — who wrote a cheque of Sh48,000 — chipped in.

“I don’t know the amount of money the hospital needed but I know it was well over Sh100,000,” she says.

Coming from a poor background, Jane says such amounts of money are too hefty hence the trepidation she was feeling when the doctor recommended that she undergoes surgery to deliver. She then asked how much money the hospital will need from her and how she would pay.

“That is when I was asked for my NHIF card. I didn’t know exactly to what extent the card would cater for the bill but I was happy to know that I wouldn’t need to pay everything by myself,” she says. The surgery that Jane keeps referring to is Caesarean Section (CS). Dr John Ong’ech, the head of reproductive health at Kenyatta National Hospital, says a CS is often crucial in saving the life of a mother or the unborn child or both.

“We only resort to CS when we believe there is a good chance normal birth will be impossible and deadly,” he says. Jane did undergo the CS and was able to hold her baby in her arms. The total bill was Sh35, 000 — which NHIF paid. She also needed to pay for medication she would need to take post birth.

“My employer paid Sh3,500 for me — which I believe was for medicine and a few extra things,” she says. When Jane started to work for Kanyeki in 2010 she knew little about NHIF. “I had heard the word but I didn’t know what it was,” she says.

It is only when her boss registered her and she started using the card that she understood what it was and how it would improve her life. Kanyeki, as a rule of thumb, wants all her house helps to have a medical cover. She does not even deduct the monthly premiums from their salaries. To her, medical cover for the nanny is not just beneficial for the employee but also for her as an employer.

“I pay the premiums as an added benefit for working for me. I don’t want to find myself in a situation where payment was skipped,” she says. Paying the premium herself, she says, is a way of making sure that the cover is active in case of an emergency.

“But the nannies should register with NHIF directly for sustainability in case they change jobs. It may also be wiser to train them about remitting the premiums via mobile money so that they can take responsibility,” she says. This, however, is the ideal situation. It is possible for the nanny to use money for premiums on an entirely different thing.

“I pay for my girls’ NHIF because I often find myself paying hospital bills in had not budgeted for, including those of my nannies’ children,” she says. Kanyeki is particularly happy that Jane was able to attend pre-natal and antenatal clinics with ease.

“I was very delighted,” Kanyeki says. There were other times Jane visited a hospital and was treated and the bill covered by NHIF. However, the time she delivered via the CS stands out. “It has stuck with me for a long time,” Jane says.

According to Kanyeki, a house help is an employee just like any other. They deserve safety nets like a medical cover. Some employers, however, easily lose patience with their employees when they fall sick.

Trizzer Kimani, founder of Nani Employee Leasing, a provider of Human Resource Management services for clients who need nannies, says that some employers lose their humanity when nannies fall sick.

“It is not unheard of, really: an employee will fire the nanny the day she gets sick and cannot work,” she says. “It is a very inhumane way to handle an employee.”

Employers, she says, sometimes fear cost ramifications of a finance-intensive treatment: because the nanny is likely not paid a lot of money to be able to pay hospital bills on their own. “When the nanny is unable to pay hospital bills then the employer has to or risk grievous harm to the nanny — which is also not an ideal situation,” Trizzer reckons.

Hence the go-to solution for many a nanny employer, she says, is to fire them and get a ‘healthy’ one as replacement.

Placing a nanny on medical cover, Trizzer says, would therefore bring down the turnover and allow nannies to continue working after prompt and successful treatment.

Jane no longer works for Kanyeki but she is deeply grateful to her. Now a housewife, she says she can’t afford monthly subscription due to economic difficulties.

She however wants to resume paying the premiums “because I know how helpful medical cover has been to me.”