Universal healthcare will secure all Kenyans

Bomet Governor Hillary Barchok(center) being shown by officials from NHIF the process of recruiting one into the health cover during the launch of UHC program at the county offices on August 4, 2021. [Gilbert Kimutai, Standard]

Doubting Thomas in the Bible played a key role in asking for evidence-based proof. Skepticism about the success of any project is normal, and we welcome it in the journey towards Universal Health Coverage (UHC).

UHC means all Kenyans have access to quality health services without financial hardship. The government adopted UHC as one of the Big Four Agenda, with an aspiration that by 2022, all citizens access these services.

It resonates with the 2010 Constitution, which provides a legal framework for the right-based approach to health. The success of UHC requires every Kenyan resident be enrolled as a beneficiary under the National Health Insurance Fund (NHIF) by ensuring those who can afford to pay do so while the government takes responsibility for those who can’t.

The government has taken the first step by sponsoring one million indigent households shared proportionately as per the poverty index in the 47 counties. Leonard Ndege from Kisii County, is among the one million indigents identified
in the first phase of UHC scale up.

He gave his testimonial during the Kisii County national UHC launch, following a directive of by President Uhuru Kenyatta to all counties. Leonard didn’t follow the skeptics who shied away from the UHC scale-up biometric registration exercise in 2021. He no longer uses his income towards healthcare as the government supports his family of twelve.

Ali Baarmi of Malindi shared a similar story in Mombasa. NHIF catered for his hip replacement surgery and accompanying treatment when he got an accident in 2017. Such stories and lessons learned informed the move to a more sustainable health insurance model while still focusing on strengthening health systems.

To ensure efficiency and equity in coverage, the government decided to scale up UHC on output financing model nested on NHIF.

In 2018, the government appointed a Health Financing Reforms Expert Panel (HEFREP) to develop NHIF’s reforms to transform and position it as a strategic purchaser of healthcare services.

The reforms recommended a legal framework within which NHIF operates to align its processes to UHC. The NHIF Act 1998 was, therefore, amended and became law in 2022. Some of the new aspects introduced is change of name to the National Health Insurance Fund. This amendment gives provision for access by allowing NHIF to focus on holistic spectrum of health as opposed to curative aspect alone. It also allows NHIF to work with a wide network of healthcare professionals therefore giving more options to members.

The Act requires all Kenyans to register as members. The spirit of UHC is to ensure everyone is insured and transfers medical risks to the Fund leaving their resources to cater for other needs.

Other reforms include digital transformation through biometric registration and identification of beneficiaries for ease of access and mitigation of fraud. A vibrant real-time health information system is critical in determining the progress of universal coverage.

The move to a paperless electronic claim management system provides a reliable system for payment of claims, monitoring the
utilisation of services and analysing health conditions that help in decision making. A journey starts with the first step and UHC has taken baby steps in Kenya and it’s working.

The writer is the National Health Insurance Fund (NHIF) CEO