Page 44 - KMD 2022-23 EDITION

it very important that the health professionals deducted Sh40,800 a year while a single payer
should be accountable to them. Moreover, the earning Sh100,000 will contribute Sh20,400. The
centralized system that preceded devolution was two families will get the same benefits. This is
associated with very inequitable distribution of highly inequitable. We have proposed to change
health professionals because they could influence the contribution to family/household, rather than
their posting to favourable locations. Many of the individual, as is the case with private insurance. If
historically marginalised counties did not have a the Sh150 billion out-of-pocket payments were
single specialist. Both positions have merit. converted into contributions to NHIF, each Kenyan
would have to contribute Sh3,000 a year, or
Sh12,000 for each of the 12million households.
In fact, county governments acknowledge that
they do not have the resources to sponsor doctors To raise Sh200 billion required to cover both the
for further education, or money to pay both the secondary and tertiary pillars works out to an
doctor on study leave and the replacement. They average of Sh4,000 a person which totals Sh16,000
also acknowledge that the County Health Services a household. Our preliminary analysis shows that
need specialists. We, in Kenya Kwanza, believe a progressive contribution system can achieve
that this conundrum is solvable. What it requires the Sh200 billion requirement with contributions
is goodwill and honest mediators. We will be that ranging from Sh300 to Sh3,000 a household a
honest mediator. We pledge to work together month (Sh3,600 to Sh36,000 a year).
with the health workers and county governments
to find a solution within the first 100 days of our 9. Practical Challenges of Enrolling
administration. Self-employed Kenyans in NHIF
We recognise that even though enrolment to
NHIF is now mandatory by law, there are practical
6. Make Community Health System Better
Resources challenges of enrolling self-employed Kenyans
Community health is the bedrock of preventive who are the majority. A number of initiatives will
healthcare. Doctors estimate that 70 per cent of be deployed to make enrolment easier for self-
cases seen in our hospitals are preventable. It is employment Kenyans, including:
estimated that Sh1 invested in community health • Leveraging on the proposed Primary
has a return of Sh9 saved in curative health costs. Healthcare Funds as platforms for community-
based group schemes;
Kenya Kwanza is committed to ensuring that our • Leverage on the Hustler Fund and farmer
primary healthcare has, at the very bottom, a well- organisation initiative to set up occupational
resourced community health system. Consequently, schemes for trades such as, boda boda and
the Kenya Kwanza national government will market women saccos;
contribute to the stipends paid to community • Affordable and flexible premium financing
health workers by county governments on a schemes such as, contributions financed
matching basis. quarterly in advance, while contributors repay
the loans weekly or other interval aligned with
their income streams.
7. A State-of-the-Art Integrated Information
Management System
We will leverage on information technology to drive 10. NHIF Must Enjoy the Confidence of all its
responsiveness, efficiency, seamlessness between Stakeholders
providers, transparency and fraud prevention. Insurance is a business built entirely on trust. For
We will procure, as soon as practically possible, the NHIF to fulfill the mandate of the social health
a state-of-the-art health integrated information insurer we need, it must enjoy the confidence of
management system that will enable every Kenyan all its stakeholders, in particular contributors and
to own and control access to their health records health service providers that it serves directly. We
and provide them with all the information they recognise that at present, the NHIF falls considerably
need to access health services on their phones. short. Kenya Kwanza is committed to implementing
the reforms required so as to build this trust as
recommended by stakeholders.
8. Progressive NHIF Contribution System
We are aware of a new contribution structure
gazetted by the (former) Treasury Cabinet Secretary. Consideration will be given to unbundling the NHIF
People earning Sh100, 000 will contribute 1.7 per along the lines of the pension fund system. This
cent amounting to Sh1,700. Under this structure, would entail separation of the Fund management,
a couple earning a combined Sh200,000 will be claims, administration and regulatory functions.

42 Kenya Medical Directory