ou have probably suffered high out-of-pockets health costs while seeking care or while admitted at a hospital or when fundraising for friends and relatives.

It shouldn’t be this way. Everyone everywhere should access the health services they need, of sufficient quality, when and where they need them, without suffering financial hardship.

A major barrier to universal health coverage is overreliance on direct payments at the time people need care. This is reflected in the fact that a third of total health expenses are out-of-pocket costs. Health costs are a major cause of poverty, with more than one million people impoverished annually by healthcare bills.

Ministry of Health estimates show that 16 per cent of sick Kenyans do not seek medical care due to financial constraints, while 38 per cent must sell their assets or borrow to finance their medical bills. There are also hundreds of patients who are inhumanely detained in hospitals over unpaid bills. Clearly, money is a big barrier to access to healthcare.

The government’s solution to this is universal health coverage as the means to reduce the financial burden of seeking healthcare, and the National Hospital Insurance Fund has been identified as the risk-pooling vehicle that will enable equitable access to basic health services.

To realise this objective, there are plans to review and amend the NHIF Act to align it with the universal health coverage agenda. First, to change it from a hospital fund to a health fund alongside other amendments that allow for different sources of pool funds.

Currently, the NHIF pool has about 16 million beneficiaries largely from the formal sector. In the government’s plans, a further 12 million beneficiaries from the informal sector will need to be recruited through own premium contributions.


The government has committed to pay for a further 1.5 million poor families through health insurance subsidy. Community health workers (CHWs) can play a huge role in the recruitment of new NHIF beneficiaries from the informal sector by visiting households, promoting NHIF, collecting household data and facilitating premium payments through mobile money technology.

Read more at Daily Nation