Nakhumicha speaks on UHC roll-out and ongoing reforms

Health CS Susan Nakhumicha addressing staff of NHIF during a meeting on the New Social Health Authority (SHA) in a town hall to provide an update on the new authority on November 27, 2023. [Bonifaçe Okendo, Standard]

Previously, there were plans to rebrand NHIF to the National Social Health Insurance Fund. However, the government is now aiming for a complete overhaul of the NHIF.

The CS responds to questions by Health reporter Mercy Kahenda;

Health is one of the five pillars of Kenya Kwanza's Bottom-Up Economic Transformation Agenda. One year down the line, how have Kenyans benefited?

The Kenya Kwanza government is committed to providing inclusive, effective and accessible health care to all. It has implemented crucial reforms in the sector. Consequently, President William Ruto recently assented to four crucial Bills, which are expected to anchor the implementation of Universal Health Coverage (UHC).

Through BETA, all people will have access to quality health services when and where they need them without financial hardship. This is to be achieved by focusing on four main pillars of UHC namely health financing, health commodities security, human resources for health and integrated health information technology.

Digitisation will provide integrated and interoperable health information ecosystem to drive patient-centric services, prevent fraud, improve responsiveness, efficiency and sharing of health data. This system will provide interconnectivity in the health sector (private and public) unlocking efficiency.

On human resources, the ministry met stakeholders that included the Ministry of Labour and Social Protection, the Ministry of Public Service, Performance and Delivery Management, Kenya Health Human Resource Advisory Council and the health workers' unions and committed to work together through the Kericho Declaration signed in the presence of the Head of Public service on October 18.

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The advisory council will also establish a formula for sharing post-graduate training responsibility between the two levels of governments, and a post-training redeployment mechanism, where necessary.

Its other roles include the development of a framework for sharing of health specialists across counties and between the levels of government, expand access to quality health services, and streamlining internship to improve relevance and quality.

You've been vibrant in spearheading the UHC programme, when are we expected to have its full enrolment?

UHC is already rolling out. The President flagged off 100,000 community health promoters (CHPs) who were trained, equipped and deployed as frontline players in the delivery of preventive and promotive health care. They are the veins of UHC.

At least Sh3 billion has been allocated annually for stipends to the 100,000 CHPs. The CHPs have registered more than 1.25million households using the e-CHIS. Moreover, 29,000 CHPs are using e-CHIS for routine household visits.

Have all counties recruited promoters? Why did you pick Meru as a pilot county?

The 100,000 are distributed is all the counties. Additionally, there are 10,000 community health assistants/extension workers recruited and trained

Meru was picked because all their CHPs are fully kitted, with gadgets commissioned by the governor. The county government of Meru is also a pioneer as it had allocated funds and paid their CHPs on time.

Are these CHPs government employees, and if so do they have contracts?

CHPs are not government employees; they complement the already existing health workers in the community. The national and county governments have collaborated to pay them a monthly stipend.

Corruption from top to bottom has hampered provision of efficient services. What are you doing about it?

We have a commitment to expose and deal with all corrupt staff at all institutions affiliated to the Ministry of Health.

Kenyans are curious about the newly proposed medical scheme -the Social Health Authority (SHA). What's the main difference between SHA and NHIF? And how will the court case challenging the implementation of the Social Health Insurance Act impact its implementation?

The National Health Insurance Fund (NHIF) has been repealed. The public health insurer, which is the primary implementer of the Universal Health Coverage (UHC), will now be replaced by three funds namely; Primary Healthcare Fund; Social Health Insurance Fund; and Emergency, Chronic and Critical Illness Fund. The move follows the approval of four crucial Bills aimed at accelerating the attainment of affordable and quality universal health coverage.This ambitious plan will help the government reshape the insurance aspect of the NHIF, ultimately running it separately from its previous structure. The new funds, each designed to address specific facets of healthcare financing and delivery, signify a significant shift in the government’s approach to ensuring universal access to quality medical services.

Previously, there were plans to rebrand NHIF to the National Social Health Insurance Fund. However, the government is now aiming for a complete overhaul of the NHIF.

The decision by NHIF to cut down on some services it previously offered was considered a double-edged sword that eroded gains it had made in winning over customers.

Complaints with the outpatient capitation care in particular had seen many physician-staffed facilities pull out, leaving less than three per cent offering doctor consultations in the OPD. The Government will refine and repackage incentives to attract more healthcare providers.

With the current changes in laws, are Kenyans still expected to remit monthly fees to NHIF?

President William Ruto announced changes to NHIF contributions to increase access to affordable health care. Currently, Kenyans are still remitting their dues to NHIF before full enrolment to SHA.