Convert NHIF to social insurance, Amref CEO Githinji Gitahi suggests

by Amref Health Africa

Approximately 1.5 million Kenyans are impoverished by health care bills every year, says Amref Health Africa CEO Dr Githinji Gitahi. This is as Kenya grapples with the implementation of Universal Health Coverage (UHC).

“An average Kenyan in a rural community will work to five to jobs to make a living. In such kind of a family, if one person gets sick the entire income structure collapses,” said Dr Gitahi on Tuesday during a Vybes Radio morning show.

Dr Gitahi said about three out of ten people do not seek healthcare because they are afraid of the expenses. Despite the shocking statistics, he believes Kenya should not be struggling to make healthcare affordable.  

“Ideally, in a civilised society, nobody should ever worry about where the money comes from when they are sick and that is what universal health coverage is all about,” he said.

Dr Gitahi blamed the unaffordability of health care to the commercialisation of the National Hospital Insurance Fund.

What ails NHIF?
“The problem with our NHIF is that it has focused on the private sector. It has started to participate in commercial schemes where it is competing with other private insurance companies,” he said.

According to the proposed NHIF regulations, one is supposed to pay up-front for a year’s cover in the three-month waiting period (Sh 2,000 monthly) during which health services are unavailable to them.

Many have said that the cost is too high since most Kenyans live on a dollar a day.  

Dr Gitahi believes Kenya can afford UHC by converting NHIF into social insurance that covers the poor through mandatory contributions by taxing workers.  

This, he says can be done if the government “takes our taxes, identifies the poor and gives all of them NHIF cards using our taxes”.

Dr Gitahi says this approach has worked in Ghana and Rwanda where it has seen almost 90 per cent of the people access affordable healthcare.

According to Dr Gitahi, UHC is not as expensive as people think. He opines that the government can afford NHIF cover for more than 40 per cent of the population with less than Sh30 billion.  

“It is not about excellence or having the same quality you have in a private hospital. It is about outcome such that when a mother is pregnant you can have a healthy mother and baby at the end of the delivery,” he said

Dr Gitahi says NHIF should stop channelling funds to private hospitals but make payments to public health facilities in order to improve them.  

Article first published on

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