Efficient NHIF key to making Universal Health Care a reality

In Summary

• The Fund’s sole access to the media or information sharing is the Board Chair, CEO or in limited cases the PR Manager, who are all based in Nairobi.

• First,individuals need to have access to information about the content and scope of the right to health.

NHIF headquarters in Nairobi.
NHIF headquarters in Nairobi.
Image: FILE

Provision of universal access to health and related planned access to the same remain a major commitment of the government and forms big part of the Big Four agenda. 

And the main vehicle expected to play this role is the National Health Insurance Fund (NHIF), which is a public body created under the State Corporations through an Act of Parliament.  What is the public perception about the NHIF in terms of service delivery to Kenyans and has the body re-engineered itself from the former self through meaningful reforms to attract the much-needed additional membership.

Is the fund run in a manner that is transparent and is Board and management of the Fund not alienated from Kenyans.  The Fund is offering a wide range of health related services to Kenyans, but getting to know them or qualify for them is problematic. The Fund must be integrated into national services and structures which leads national government coordination to ensure there is public education on the services. The processes of approving health facilities and or approving services for members seeking health under the scheme must be done more transparently and in a structured and predictably manner.

Kenya is a member of the UN family, thus is bound by requirements of the various conventions and covenants that the country is a signatory to.  The treaties boldly recognize the connection between the right to health and the right to information. The World Health Organization (WHO) first enunciated the right to the highest attainable standards of health in its constitution in 1946, identifying health information systems as one of the six essential building blockswhich together make a comprehensive health system.

WHO notes that a well-functioning health information system ensures that the production, analysis, dissemination and use of reliable and timely information on health determinants, health system performance and health system status.

Currently, the Fund’s sole access to the media or information sharing is the Board Chair, CEO or in limited cases the PR Manager, who are all based in Nairobi or the website. Note that the bulk of members are in the counties, where information demand is high, the lack or the practice of referring all questions to the head office frustrates journalists. There seems no structuredmechanism, which allows it to continuously and regularly disclose to the public its operations and financial status-   and Fund’s lack of pro active disclosure of informationis hurting its efforts to attract more members or even convincing to enroll.

The UN special rapporteur on the right to the highest attainable standards of physical and mental health has summarized the important of access to information and transparencyas essential features of an effective health system in his report to the seventh session of the human rights council in 2008. He stated:

Access to health care information is an essential feature as an effective healthy system, as well as the right to the highestattainable standard of health. Health information enables individual and communities to promote their own health, participate effectively, claim quality services, monitor progressive realization, expose corruption, hold those responsible to account and so on. The requirement of transparency applies to all those working in health-related, including states, international al organization, public private partnership, business enterprises and civil society organizations.

First,individuals need to have access to information about the content and scope of the right to health itself in order to be able to assess whether their rights are being respected or not and, if not, to claim their rights. Thus, the right to health requires human rights education, especially awareness raising measures on the right to health itself.

Second, individuals need to have access to reliable and accurate health information, including about risks to general public health. Public accessed information about both dangers from within the health care system such as risks from drugs and procedures and external risks such as from the environment is therefore essential for ensuring the right of individual to take measures to protect themselves.

Third, access to information is essential for individuals and groups, as well as human rights monitors to be able to scrutinize the state’s implementation of its obligations on the right to health. Transparency is an essential characteristic of any effective health care system. Access to information also empowers individuals to be able to participate effectively in political decisions taken at community, national and international levels.

For society to monitor if the state is developing appropriate policies to promote access to health, it is necessary for individuals to have access to information about the development and implementation of public health policies. It is also important for the state to provide information about the specific content of such policies, so as to analyses how budgetary commitments are delivered. Provided such health related information is made available, individuals and groups are made available, individuals and groups are able to participate more effectively in democratic health-related decision-making at the community, national and international levels. Hunt and backman point out.

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