- The governor urged President Uhuru Kenyatta to look at the Bill and the various proposals they have made including others and refer it back to parliament for further review.
- EO and Board as the structures to manage this massive undertaking, and believes that it will not be effective or efficient.
Kisumu Governor Anyang' Nyong'o has made various proposals to the NHIF Bill including the establishment of an insurance bank to manage NHIF funds.
The governor urged President Uhuru Kenyatta to look at the Bill and the various proposals they have made and refer it back to parliament for further review.
“Although I am aware that the new Bill has passed through the Parliament and the Senate and is now awaiting the President’s signature, I wish to raise some critical issues which will contribute to the successful implementation of NHIF to the benefit of all Kenyans," he said.
According to Nyong'o the Bill proposes a CEO and Board as the structures to manage the massive undertaking, and he believes that it will not be effective or efficient.
He said by enrolling everyone above 18 years of age (over 25.36 million), the Fund will be well resourced and such resources should be handled by a professional institution that is accountable enough to manage them.
He further stated that even if there are 15 million contributors paying Sh6000 per year, the Fund will generate not less than Sh90 billion annually, which in their estimation, is sufficient on the lower side to finance UHC.
“Kenya must be bold and innovative and create a financial/insurance type Health funds management institution run by financiers (an insurance bank), under overall supervision of the Central Bank, Ministry of Health and Insurance Regulatory Authority," he noted.
The governor stated that the funds institution should do NHIF Revenue collection (from the government, employers and from the community) These processes must be fully developed and monitored.
It will also process claims payments to empaneled and contracted providers, invest NHIF Funds, provide low-interest loans for the development of health infrastructure in all parts of the country (clinics, hospitals, laboratories, etc).
“Provide grants to support difficult to reach and underprivileged areas to improve physical facilities, medical equipment and supplies and also invest in health human resources training and management”.
The governor spoke on the needs to have community participation and ownership in the structure and functioning of Universal Health Care.
He stated that the current structuring of NHIF has no community ownership or role component. It therefore cannot be able to effectively collect finances from members outside formal employment and will not properly finance the community health systems.
Nyong'o therefore proposed that primary healthcare financing be anchored on community health leadership structures and level 2 and 3 facilities.
He noted that the community health committees be remunerated and tasked with amongst other things enrolment of community members into the scheme and ensuring regular payments,all persons be linked to a community unit and to the a level 2 or 3 facility that serves them.
“Adequate funds and resources should be allocated to finance primary healthcare and community health services to be supervised by the county health leaderships," he said.
He recommended that structures must be established to implement the community component of health insurance.
In this regard, the Council of Governors should recommend how these structures can be established, given their experiences in establishing devolved units in the 47 Counties, said Nyong'o.
However on quality of care, the governor noted that to effectively achieve UHC, the country must have healthcare institutions which operate optimally and provide the much-needed quality of care.
The new NHIF Bill, he said must ensure that there is value for money to meet expectations of the population mandated by law to make payments for healthcare services.
In his recommended, Nyong'o stated that quality assurance and supervision functions should remain central for the successful implementation.
“An independent health inspectorate and Quality Assurance Department is needed to oversee this function. Already MOH has established the Kenya Health Professionals Oversight Authority (KHPOA) which could be further funded and supported to undertake these functions”.
The Governor also made proposals and recommendations on infrastructural development, private sector development and the need to have Board of Governance which oversees all the above.
He added that the Board should have representatives of the key stakeholders: MOH, Central Bank, KEBS, MPDB, Pharmacy and Poisons Board, and The Council of Governors.
“From the above, it is my prayer that the President should take a good look at the proposed NHIF Bill and noting the proposals we have made above, refer it back to the Parliament for further review to take into account these (and any other) suggestions made as part of Public Participation in the drafting of the new Bill”.
Once the Bill is updated, Nyong'o stated that an NHIF Implementation Strategy should be developed to highlight policy objectives in all the above areas and how they are to be achieved/implemented.