MWAURA: Free medical care thanks to new social health insurance

It’s amazing how a well-thought-out plan can benefit so many people. This is the case with the Kenya Kwanza universal healthcare plan now being implemented, after the judiciary lifted the orders barring its implementation.

The Social Health Insurance Fund, is a stride towards achieving a more inclusive and accessible healthcare system. Notably, 54 percent of Kenyan hustlers will benefit from reduced NHIF contributions, resulting in greater affordability for essential healthcare services. Simultaneously, the act ensures fairness by introducing a modest 2.2 per cent upward adjustment for the remaining 46 per cent of the population, contributing to a more balanced distribution of healthcare financing responsibilities.

Previously, disparities existed with minimum wage earners allocating 5 percent of their salaries to mandatory medical contributions, while higher-income individuals, such as those earning a Sh1million salary, contributed Sh1,700, representing only 0.0017 per cent of their income. The recalibration of these contributions aligns with the broader goal of creating an equitable healthcare landscape, in which financial burdens are distributed more fairly across the population. This is indeed the true Hustler spirit.

The SHIF will also ensure that Levels 1, 2 and 3 hospitals are publicly funded offering free services to patients, in order to attain the Universal Health Coverage as per 'The Plan'. This will help so many Kenyans at the Bottom of the pyramid to access quality and affordable health care, and medical bills that burden families will be a thing of the past.

The SHIF Act establishes the Social Health Authority tasked with managing the Primary Health Care Fund for Levels 1, 2 and 3 hospitals, the Social Health Insurance Fund for Levels 4, 5 and 6 hospitals, and the Emergency, Chronic, and Critical Illness Fund for ailments requiring a lot of high cost care, e.g., cancer. These funds collectively aim to provide a comprehensive healthcare framework that meets the diverse needs of our population.

The Primary Health Care Fund, financed through the National Assembly allocations, in addition to grants, and donations, is dedicated to purchasing a spectrum of essential healthcare services. They include promotive, preventive, curative, rehabilitative, palliative, and referral services. Registration is mandatory for all Kenyan residents beginning March 1, 2024.

The Social Health Insurance Fund will pool funds to cover quality healthcare services for referrals from primary to higher-level facilities. Contributions to this fund are designated for indigents (can’t pay, won’t pay), vulnerable persons, and those under lawful custody, as appropriated by the National Assembly. Meanwhile, the Emergency, Chronic, and Critical Illness Fund manages chronic illnesses after Social Health Insurance benefits are depleted, also covering emergency treatments.

The Ministry of Health has also made significant strides in pursuit of a better healthcare environment as we promised in the BETA plan, key of them outlined below:

The number of health facilities have been increased from 13,841 to 14,532 representing a five per cent increase with the national hospital bed capacity increasing by 14.8 per cent to 109,020.

Also, 100,817 smartphones have also been delivered to Community Health Promoters in the subcounties across all the 47 counties to promote primary healthcare and to help in the tracking information concerning health in all households in Kenya.

The number of women covered under Linda Mama maternity programme increased to 638,541, a 30 per cent increase, underscoring our commitment to reproductive and maternal health.

It is encouraging the government is making significant efforts to ensure that as many Kenyans gain access to employment in the country and beyond.

For the last 16 months, the government has been able to increase job creation in the formal sector of the economy from 2.9 million to 3.1 million jobs, which is a 6.9 per cent growth in job creation. More jobs are on the way, as the government has entered into agreements for labour exchange with several foreign entities, including the recently advertised 2,500 positions for nurses to the Kingdom of Saudi Arabia. In the health sector, we have a workforce that is more than enough workforce for both domestic and export labour.

The government has really enhanced the National Social Security Fund savings from Sh1.4 billion to Sh6.5 billion, inculcating a savings culture representing a savings growth of more than 360 per cent. This is the highest since Independence. It will go a long way in cushioning our older parents when they retire and now the government is able to re-invest the monies in useful ventures that not only will help the pensioners, but also facilitate other national programmes, rather than getting expensive external financing.

In addition, it has raised the number of the social protection household beneficiaries from 1.2 million to 1.9 million under the Inua Jamii cash transfer programme. This programme is aimed at redistributing income to the grassroots to stimulate rural economies, enabling the aging and vulnerable populations to build their assets. More than 700,000 hustlers will now be able to get the monthly stipend of not less than Sh2, 000 to help cater for household needs.

The government also has managed to disperse the money through M-Pesa, saving the beneficiaries the hassles and costs of travelling long distances and queuing in banks to access their cash.

Further, the Kenya Kwanza administration has decentralised registration of persons with disabilities to be done by directors of health at the county level. This development saves the unregistered PWDs the agony of travelling all the way from their villages to Nairobi to seek verification and signing of their disability medical assessment reports by the National Director of Medical Services, paving way for their recognition.

The centralised system had in the past made quite a number of people with disabilities forego the registration, in effect, denying them benefits that come with recognition of one as a PWD. The low number of the PWDs captured by the National Council for Persons with Disabilities  is about 580,000 in the country, whereas the World Health Organization’s figure stands at slightly above 6 million PWDs. This is attributed to eligible PWDS shying away from registering over the long process but the uptake is now expected rise following decentralisation.

The process has further been shortened by the government’s move of on-boarding the disability registration service on the e-citizen platform as per the Presidential directive. This online registration system is aimed at collecting accurate socioeconomic data of PWDs right from the ward level. Eligible PWDs can now register themselves from the comfort of their homes as long as they have a smart phone and the signed health assessment reports backed by a national identity card or birth certificate and passport-size photo to be uploaded. The action saves the PWDs more time as they need not travel to county headquarters for the service. Already, 3,091 submissions have been made through the e-citizen platform by PWDs since activation of the service last month.

Cognizant of the possibility of reversing the gains Kenya has made in promoting disability inclusion, the government will in the next cycle of government’s performance contract, reinstate the disability mainstreaming performance indicator that had been retired from the performance contract of all ministries, departments and agencies

The Disability Support Allowance for Public Servants with disabilities has been revised by the Salaries and Remuneration Commission to include more types and categories of persons with disabilities such as those with low vision including albinism (drawing print nearer to the eye), two crutches, or walking frames. The government urges all employers within the public service to take note of this new development and for persons with disabilities who qualify, as enumerated above, to contact their employers for them to benefit from this very empowering development.

This and many more interventions are a clear demonstration that the Kenya Kwanza government is really delivering to Kenyans on its campaign pledges towards a better Kenya.

The writer is the government spokesperson 

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