Health cover for all Kenyan residents close to reality after successful dry run

Friday November 13 2020
Patient in surgery.

A team of doctors conduct surgery on a patient at ACK Mt Kenya Hospital in Kirinyaga County, central Kenya, on January 20, 2019. Kenya’s plan for Universal Health Coverage (UHC) is moving closer to realisation. PHOTO | FILE | NMG


Kenya’s plan for Universal Health Coverage (UHC) is moving closer to realisation with the enrolment of 43 counties following a successful two-year piloting in Kisumu, Isiolo, Machakos and Nyeri counties.

The country, which has been lagging behind its East African counterparts in providing basic health services, last week launched biometric registration for Universal Health Coverage scheme beneficiaries to be under the National Hospital Insurance Fund (NHIF) —the government-run medical insurance service that oversaw the piloting of the scheme.

The pilot counties were chosen for the prevalence of communicable and non-communicable diseases, high population density, high maternal mortality, and high incidence of road traffic injuries. About $3.9 million was spent in the two years of piloting.


To expand affordable healthcare coverage, at the launch of the expanded rollout, President Uhuru Kenyatta promised to push for policies that will increase cooperation between the NHIF and private insurance providers to achieve 100 percent coverage in 2022, up from 56 percent when the scheme was launched in 2018.

“We have articulated for implementation, specific policy measures in such plans as our National Vision 2030 and the Kenya Health Policy 2014-2030 and the “Big Four” Agenda,” said President Kenyatta during the official launch of scheme in Mombasa on October 30.


Even then, President Kenyatta acknowledged the dreams to have all persons resident in Kenya have access to the essential health services is faced with challenges among them corruption and acknowledged the many challenges in achieving that.

“I urge the NHIF to ensure that the funds committed to its custody, are utilised prudently with utmost transparency and accountability.”

In getting this programme here, Kenya started by waiving all beneficiaries’ fees in lower level facilities, introduced several government-sponsored insurance programmes for the elderly, vulnerable children, people living with severe disability, pregnant women, and secondary school learners, among others.

According to government statistics, the piloting in four counties saw an increase in the use of health services, with over 1.6 million additional hospital visits made in 12 months.

Key achievements of this phase include the establishment of an additional 208 community health units, staffed by 7,700 community health volunteers who attended over two million clients, many of whom were served in their homes rather than having to travel to the health centre.

In scaling up the implementation of the UHC, Kenya will focus on five major pillars among them scaling up of reforms at NHIF to ensure the country has a national social health insurer that is able to responsively meet the needs of Kenyans by strategically purchasing services for their health and wellbeing.


The government also intends to establish a mandatory UHC scheme for all persons resident in Kenya. Under the third pillar of implementing UHC, the government will push for the adoption of the Essential Health Benefits Package. This will enable Kenyans to gain access to an essential set of health services at Ksh6,000 ($60) per household per annum — outpatient and inpatient services, communicable and non-communicable disease management, maternity, dialysis, radiology, mental health, minor and major surgery among others.

The government will also provide insurance cover to initially one million households who are vulnerable and unable to meet even low cost premiums.

The last pillar will involve the biometric registration of the identified poor households to ensure that beneficiaries are, identified when they seek services at the health care facility and at NHIF branches, countrywide.

If the UHC is fully implemented, Kenya will join Uganda, Tanzania and Rwanda in ensuring all its citizens get access to affordable health services.

Rwanda has the highest enrolment in health insurance in sub-Saharan Africa. The implementation of health insurance schemes is guided by the National Health Insurance Policy of Rwanda.

Tanzania’s 4th Health Sector Strategic Plan (2015-2020) provides for a new health financing strategy aimed at helping the country achieve UHC, by addressing this complex and fractured health insurance market.