CS banks on NHIF reforms to drive universal coverage

Today, the global community dedicates the World Health Day to Universal Health Coverage (UHC) with a call on leaders to make health for all a reality.

“Universal health coverage is our number one goal,” says the World Health Organisation.

Kenya, the latest country to join the UHC movement through a six-month pilot phase, has embarked on a bold journey and set ambitious targets.

In 2012, all United Nations member states agreed to try and achieve universal health coverage by 2030 as part of the UN Sustainable Development Goals.

However, individual countries are free to set own rational targets, with Kenya planning to achieve 100 per cent UHC coverage by 2022.

This, President Uhuru Kenyatta says on his official website, will reach 51.6 million Kenyans by 2022; the year he leaves office.

But this is seen as too ambitious considering that the government is yet to make public UHC financing and operational mechanism.

“This may be a bit too ambitious considering the complexity of the work and cost involved,” says Gitahi Githinji, Amref Health Africa CEO and co-chairman of the global UHT committee.

Until days to the launch of the pilot in December, the government had planned for a contributory UHC scheme run through the National Hospital Insurance Fund (NHIF).

But in December, the President launched a free and non-contributory pilot known as AfyaCare for Kisumu, Nyeri, Isiolo and Machakos counties.

Health Cabinet Secretary Sicily Kariuki explained that this came after NHIF was assessed and found lacking in capacity to handle the UHC project.

This was mainly informed by accountability problems at NHIF, which have since led to some court action and studies showing high dropout rates among informal sector workers who had registered with NHIF.

A study by Kenya Medical Research Institute last year reported a drop-out rate of more than 70 per cent by informal sector contributors.

But Ms Kariuki, in a meeting in November with the Kenya Healthcare Federation, was categorical that the way to deliver UHC is through NHIF on a premium base.

The CS has since formed a taskforce to work on NHIF reforms and prepare the fund to take up leadership once UHC is rolled out nationally.

“The current free services being provided in the pilot are not sustainable. Pooled insurance is the way to go,” says Dr Rachel Kamau, the health executive in Nyeri County.