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STRIDES TOWARDS UNIVERSAL HEALTH COVERAGE
Mrs. Hannah W. Muriithi, EBS
Chairperson – Board of
Directors
It is my great pleasure to present
to you the ?nancial report for the
year 2017/2018. Once again, NHIF
has demonstrated its commitment
to deliver accessible & affordable
health care to all Kenyans. As you
Strategic Transformation Towards Universal Health Coverage In Kenya
The National Hospital
Insurance Fund (NHIF) has
continued to implement social
health strategies with a view
to achieving Universal Health
Coverage (UHC) for the bene?t
of all Kenyans. Subsequently,
the Fund has over the last three members while delivering on
years developed and rolled
out new bene?t packages as
a means towards expanding
access to both the employed
and self-employed sectors.
At the same time the Fund
has stepped up its member
recruitment and public
education drives across the
country with a view of covering
many families thus cushioning
them against catastrophic
health care expenditure.
These among many other
strategies, continue to bear
positive impact with many
Kenyans responding well with
increased product uptake.
To enhance the national
coverage and meet the
demand for health insurance
products, NHIF has adopted
a transformational agenda
through:
x Continuous assessment
of bene?ts to stay ahead of
customer needs and demands
x Sustained reforms and
realignment of NHIF strategy
to improve efficiency
x Enhanced strategic
stakeholder alliances and
partnerships for collaborative
advantage
x Adoption of innovative
technology and process
improvement to enhance
the Fund’s performance and
capacity.
íIùA??
26| SACCO Star Magazine
FOR ALL KENYANS
STATEMENT FROM THE CHAIRPERSON STATEMENT FROM THE CHIEF EXECUTIVE OFFICER
will all recall, this ?nancial year was has been extremely cautious to *HRRUH\*0ZDQJL As an institution, we remain
marked by a long electioneering ensure that decisions that are made Chief Executive Officer extremely dedicated to walk the
period and poor weather conditions. adhere to the letter and the spirit Nation towards Universal Health
These factors made our economy to of our Constitution. In this regard The end of the 2017/2018 ?nancial Coverage. To this end, a number
take a downward trajectory thereby more efforts have been put in place year gives us yet another opportunity of initiatives were undertaken in
moving from a growth rate of 5.9 per to ensure that all Kenyans and in to re?ect on the gains that we have the 2017/2018 ?nancial year. These
cent in 2016 to a growth rate 0f 4.9 in particular those that ?nd themselves been able to attain as an organization include accreditation of all public
2017. In spite of these challenges, the in vulnerable circumstances are able as well as to refocus on the future health facilities, putting more
organization remained focused in to access quality healthcare services. in line with our mandate to provide resources in the ongoing biometric
its mandate and was able to register accessible, affordable, sustainable registration as well as refocusing
good performance in member I am ?nally happy to report that equitable and quality social health our energies in protecting the poor
registration, revenue collection and the board has continued to support insurance to all Kenyans. under the vulnerable and the Older
in payment of bene?ts. productive engagements with key Persons and Persons with Severe
stakeholders in the health sector in Disabilities Programs (OP&PWD).
It is worth noting that the view of our noble responsibility to
government instituted economic deliver universal health coverage to In addition, NHIF continues to
recovery measures under the ‘Big all Kenyans. In the last ?nancial year, ensure safe delivery of mothers
Four’ plan that was centered on NHIF embarked on strengthening through Linda Mama Program and
achieving critical milestones in relations with County governments providing health insurance to the
manufacturing, universal healthcare, in a bid to harness collective secondary school students through
affordable housing and food energies in health care delivery. the Edu-afya program.
security. All these areas are closely Indeed, these initiatives bore fruits
related to health care business and when 21 County governments signed I wish to register my appreciation
so achieving superb results in them for a comprehensive medical scheme to all stakeholders who have played
does equally translate to the Fund’s with NHIF. different roles, keeping us focused
success. on our mandate. Let us all join hands
As a board, we shall continue to and make a ?rm resolve to continue
In keeping with the provisions of engage with all key stakeholders to play our individual and collective
the Kenyan Constitution 2010; that both from the public and the private responsibilities towards building a
guarantees the highest attainable sector to steer the organization healthy Kenya.
standard of health as a basic right towards achievement of Universal
for every person, the NHIF board Health Coverage.
NHIF recognizes the (Ksh. 30,000), postnatal care, is covered at a maximum of OíøgA???OiK?ARKAIditn?A?KA??eAígLeùí?A?AIAULl?CíùgíeAl?
importance of collaborations Manual Vacuum Aspiration KES 18,000 per week (?ve
and public engagement with all (MVA)and Family planning sessions) up to a maximum Period 2017/2018 2016/2017 Growth
partners and stakeholders and of 20 sessions per family per Unaudited Audited
thus has forged partnerships ?? $híeEIe? JA?OEùAl? ?? Basic year. Chemotherapy Basic
across the country towards x-rays and Ultrasound are level at KES 25,000 per cycle Healthcare Benefit Amount ( Kes) Amount ( Kes) %
increasing value to the covered under the general capped at 6 cycles per family Package
outpatient and inpatient care per ?nancial year and Complex
the core mandate. while MRI and CT scans level up to KES 150,000 per 1. Inpatient Services 14,695,395,233 12,048,865,574 22%
are available in designated cycle capped at 4 cycles per
HIGHLIGHTS OF NHIF contracted facilities (see list family per ?nancial year. 2. Outpatient Services 7,512,551,228 5,075,532,866 48%
in www.nhif.or.ke) under a
MEDICAL INSURANCE referral system with a pre- ?? hA?eAIùr? ?AlùnA?
authorization from NHIF services- Kenya Red Cross (E
BENEFITS under policy terms and Plus) is contracted to provide 3. Surgeries (Major
The Fund has continued conditions. Road Ambulance rescue and and Minor)
to expand its offerings in emergency services. This 3,622,114,046 2,091,611,416 73%
terms of healthcare bene?t ?? ?ne? íIþ? EAeíøEgELíLEiI? bene?t is available to members
packages to all its members. services at accredited round the clock (24/7) and is
The NHIF Supacover is a rehabilitation centers at a accessible through dedicated 4. Renal Dialysis 1,763,415,726 1,247,216,500 41%
maximum of one treatment toll free number 1199 or 0700
comprehensive and affordable session a year up to a maximum 395395. 5. Maternity Services 1,533,079,255 1,628,589,332 -6%
health insurance scheme that of Ksh. 60,000.
offers the following to the x :OA?lAíl? L?AíLhAIL for
NHIF members: x Renal Dialysis: - this is treatment not available locally 6. Free Maternity 1,488,460,969 28,172,808 -
covered per family; applicable up to a maximum of Ksh. (Linda mama)
x Outpatient services: for inpatient and outpatient 500,000 subject to approval by
- Consultation, laboratory care for pre-dialysis, intra the Ministry of Health.
investigations, daycare dialysis & dialysis care. Renal 7. Cancer treatment 1,367,193,712 1,232,149,150 11%
dialysis offered at a maximum To enjoy the above bene?ts,
procedures, drugs & of KES 9,500 per session twice the formal sector members’ 8. Optical (Managed
dispensation, health weekly. monthly contribution is Schemes)
education, wellness and between Kes. 150 to Kes.1,700 738,440,079 158,747,955 365%
x Kidney transplant: - based on an individual’s pay
counseling, physiotherapy Applicable for both local and scale and a standard ?gure 9. Dental (Managed
services, immunization / overseas treatment: - pre- of Kes 500 monthly for the Schemes)
vaccines as per KEPI schedule. transplant, Intra-transplant, informal sector/self-employed 559,545,537 373,651,683 50%
immediate post-transplant contributors.
x Inpatient Services inpatient care and hospital
-including bed charges, stay for the donor. In this case, The expanded bene?ts 10. Specialized
nursing care, consultation, the applicable amount on package currently offered has Surgeries 548,059,958 274,110,673 100%
the donor’s card shall apply. increased health care access
prescribed drugs/medication, This is limited to a package for NHIF members and at the
laboratory services, surgery, payment of KES 500,000 same time boosted the health
physiotherapy, specialist care providers’ ability to 11. MRI 434,031,838 651,582,821 -33%
x Jn?eEùíg? CíùgíeA;- provide more effective care to
consultation and treatment. Major, minor and specialised both NHIF members and the 12. CT-Scan 285,069,617 311,512,561 -8%
Inpatient payment rates are surgeries packages to a Kenyan citizen.
100% in category A & B health maximum of Ksh 500,000.
care facilities. In high cost Limits are subject to the level Table 1 below illustrates the 13. Kidney Transplant 64,796,889 21,709,305 198%
of hospitals and the procedure utilization of the NHIF bene?ts
private hospitals, category C, being conducted. packages;- 14. Rehabilitation for
the in patient payment are up Drugs & Substance
to a maximum of KES 4,000 x :Iùigierg
Abuse 54,386,371 32,472,977 67%
O?AíLhAIL? - Radiotherapy
per day.
x Maternity Services-
including prenatal care,
child delivery – normal (Ksh.
10,000) and caesarean section