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NHIF bows to pressure, suspends proposed contracts for a month

They say beneficiaries of the medical cover will not know for certain what is covered and what is excluded

In Summary
  • The period for signing the new contracts was to lapse on December 31 with reports indicating that only less than 10 per cent of the hospitals had signed the new contracts.
  • They further said that the NHIF benefit package development process was not inclusive and transparent.
Kenya Pediatric Association chairman Lawrence Owino, KMPDU secretary general Davji Atellah and Rural Hospitals Association chairperson Brian Lishenga during a press briefing in Nairobi on December 30, 2021.
Kenya Pediatric Association chairman Lawrence Owino, KMPDU secretary general Davji Atellah and Rural Hospitals Association chairperson Brian Lishenga during a press briefing in Nairobi on December 30, 2021.
Image: MAGDALINE SAYA

The National Hospital Insurance Fund has extended the current service provider contracts for an additional one month after public outcry.

The NHIF in a letter dated December 30 said that the decision was arrived at to give healthcare providers more time to review their contracts before signing.

This comes as a sigh of relief to both the unions and Kenyans who would otherwise have suffered the brunt of the push and pull between NHIF and healthcare providers.

The period for signing the new contracts was to lapse on December 31, with reports indicating that only less than 10 per cent of the hospitals had signed the new contracts.

“Based on numerous requests by healthcare providers to be accorded more time to review the contracts," NHIF chief executive officer Peter Kamunyo said.

"The fund has resolved to extend your contract for a period of one month effective January 1 to January 2022.” 

Kenya Pediatric Association chairman Lawrence Owino, Kenya Medical Association president Onyino Were and KMPDU secretary general Davji Atellah during a press briefing in Nairobi on December 30, 2021.
Kenya Pediatric Association chairman Lawrence Owino, Kenya Medical Association president Onyino Were and KMPDU secretary general Davji Atellah during a press briefing in Nairobi on December 30, 2021.
Image: MAGDALINE SAYA

“The current re-contracting is expansive in breadth and complexity and the fund is committed to ensure that healthcare providers sign contracts that reflect the mutual interest of offering access to quality healthcare in Kenya,” Kamunyo added.

Health unions have been up in arms against what they have termed as retrogressive proposals.

The unions further asked the fund to shelve the new proposals to allow for further stakeholders involvement and public participation.

They said that the NHIF benefit package development process was not inclusive, transparent, nor did it use explicit evidence-based criteria, citing lack of clarity regarding the benefits included in the package.

As a result, they said that beneficiaries of the NHIF cover will not know for certain what is covered and what is excluded.

“A mutually agreed upon contract will ensure we achieve our UHC [Universal Health Coverage] aspirations to provide access to quality healthcare services without the devastating out of pocket expenditure to mwananchi," Kenya Medical Association president Onyino Were said.

“They are saying that we are going to do abdominal surgery when someone is involved in a road traffic accident they want to pay Sh24,000. That is not even enough to pay for the bed charges that NHIF normally reimburses the health institutions,” he said.

Kenya Pediatric Association chairman Lawrence Owino, Kenya Medical Association president Onyino Were and KMPDU secretary general Davji Atellah during a press briefing in Nairobi on December 30, 2021.
Kenya Pediatric Association chairman Lawrence Owino, Kenya Medical Association president Onyino Were and KMPDU secretary general Davji Atellah during a press briefing in Nairobi on December 30, 2021.
Image: MAGDALINE SAYA

According to the unions, the proposed benefit package has removed benefits that are currently being offered within the NHIF Supa Cover and are being enjoyed by millions of Kenyans within primary and secondary care services.

They said the new contract terms have omitted the cover for reproductive health services such as the removal of retained placenta and repair of cervical tears.

The omission, they said, risks reversing the gains the country has made in tackling the high maternal and perinatal morbidity and mortality cases.

“They have come up with rates that cannot ensure that Kenyans get the healthcare services that they need,” KMPDU secretary general Davji Atellah said.

“There are many services that have been left out and if NHIF is trying not to... involve stakeholders in discussion of these matters, then the UHC that we all want and we all envision will not be realised.”

They also said that the reduction of the number of dialysis sessions payable by the scheme is injurious to the health of the patients with chronic illnesses.

They said this will greatly affect the quality of healthcare to this group and ultimately increase the cost of treatment.

(edited by Amol Awuor)