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NHIF still crucial healthcare player

Thursday January 17 2019


A patient gets medical care at Randburg Community Hospital in Nyando, Kisumu. PHOTO | FILE | NATION MEDIA GROUP 

Of late, the National Hospital Insurance Fund (NHIF) has attracted negative publicity and harsh criticism owing to claims of corruption and misconduct against some of its senior executives and board members, among whom are battling related cases in court.

The latest twist in the NHIF saga erupted in the public domain just when the government was launching the pilot phase of the universal health coverage (UHC) programme.

Kenyans, rightly so, have every right to be angry at what transpired at the national health insurer.

They also have a right to demand that any money that may have been lost in fraudulent deals at NHIF be recovered from those implicated and that culprits face justice.

Since the matter is before the courts and a comment on them risks being treated as sub judice, I do not wish to delve into the merits and demerits of the cases.


However, it would be disastrous to throw out the NHIF baby with the bath water.

Truth be told, we cannot ignore or downplay the crucial role NHIF has played and continues to play in delivering affordable, accessible and quality healthcare services to millions of its members and their families in Kenya.

Walk into any hospital or health facility and you are sure to find a patient brandishing an NHIF card.

This demonstrates the amount of work done in creating public awareness of its role in enabling citizens to access quality and affordable health services.

With an estimated 7.5 million members and growing (not counting dependants), NHIF remains the biggest player in the delivery of affordable medical care to millions of households in the country.

From a social insurance perspective, the fund is one of the most critical actors in ensuring the health and well-being of individuals, households and communities in Kenya.


Take, for instance, some medical and surgical procedures that were previously considered far beyond the reach of the ordinary struggling mwananchi but are now being accessed in public and private hospitals with as little as Sh500 in monthly contributions to the fund.

Many Kenyans are being treated for life-threatening ailments such as HIV/Aids, cancer, tuberculosis and diabetes, thanks to NHIF.

How many Kenyans have been spared the agonising fate of dying simply because they could not afford basic treatment even in public hospitals?

How many families have been saved from total impoverishment by simply being enlisted with the fund and, therefore, not having to endure the financial hardship of selling their land and cattle to settle medical bills?


When we approach the matter this way, we begin to discover that, despite its myriad challenges, NHIF still has many positive attributes.

I am not saying that the fund is not grappling with issues that have undermined its ability to deliver on this nationally crucial mandate.

Rather, that we should address the issues without derailing reforms that have been carried out at NHIF over the years.

In other words, what NHIF needs is entrenching of reforms to shield it from recurrent governance crises that have continued to undermine its reputation as a reliable and competent institutional enabler of universal healthcare.

The government and other stakeholders should not be distracted by corruption allegations swirling around NHIF from building on the gains realised thus far to transform it into the prime provider of public health insurance in Kenya.


In addition, NHIF’s mandate in the pursuance of the UHC dream cannot be delegated or transferred to other government agencies, given the unique capabilities and competencies the public health insurance fund has acquired over time.

A better approach would be to eliminate inefficiencies and red tape at the institution while closing the loopholes that allow theft of public funds.

Expanding membership and educating the public on the benefits of health insurance will drive increased uptake of NHIF services, given its expansive footprint across the country.

NHIF is a recognisable brand and not too difficult to sell.


Besides, with health as a devolved function, and one of the pillars of the ‘Big Four Agenda’, the fund can partner with counties in making affordable health a reachable goal.

We should bear in mind that NHIF has been built, financed and transformed using taxpayer funds and, as such, efforts should now be directed at putting in place safeguards against malpractices such as corruption at the fund.

That way, we will be securing the country’s quest and aspiration for universal healthcare.

Mr Muriuki is a strategic communication consultant. [email protected]