World Bank wants more private clinics under NHIF

The National Hospital Insurance fund building in Nairobi.

The National Hospital Insurance fund building in Nairobi in this photo taken on March 27, 2022. 

Photo credit: Lucy Wanjiru | Nation Media Group

What you need to know:

  • Moved aimed to curb out-of-pocket (OOP) expenditures that are pushing more households into poverty each year.
  • OOP expenditures continue to make up a significant proportion of the total health spending and drive about 1 million individuals into poverty each year.
  • A recent study estimated that about 1 million to 1.1 million Kenyans fall into poverty each year because of costs related to healthcare

The World Bank has urged Kenya to enrol more private hospitals into the National Hospital Insurance Fund (NHIF) scheme and cover medicines to curb out-of-pocket (OOP) expenditures that are pushing more households into poverty each year.

The Bretton Woods institution said despite the government’s efforts to improve financial protection from healthcare use, OOP expenditures continue to make up a significant proportion of the total health spending and drive about 1 million individuals into poverty each year.

“Although Kenya has removed user fees for public facilities, public hospitals still operate under the cost-sharing policy, and all levels of private health- care facilities are still paid for through OOP payments,” the World Bank said in a new policy paper.

“To further reduce OOP expenditures in Kenya, it is critical to address the role of the private sector, such as through the inclusion of more health facilities under the NHIF arrangement and coverage of pharmaceuticals” it added.

The multilateral lender said a recent study estimated that about 1 million to 1.1 million Kenyans fall into poverty each year because of costs related to healthcare, which mainly hurt households from disadvantaged socioeconomic backgrounds.

Chronic conditions

The elderly and people affected by chronic conditions are the worst hit by the OOP expenditure that has continued to rise over the years despite increased budgets by the State for healthcare.

“This is a concerning trend, as paying at the point of care for services or drugs creates financial barriers and exposes households to catastrophic health spending,”  the World Bank said.

“A large proportion of the sick population continues to lack healthcare due to the financial barriers, despite the implementation of financial protection policies, such as the Linda Mama, health insurance for the poor and elderly, free primary healthcare, and government efforts to increase prepayments through the NHIF,”  it added.

The lender said that although the State recently announced more subsidised insurance for vulnerable groups, enrolment into the NHIF scheme has been slow, hence significant additional public resources will need to be injected to markedly increase the share of the population insured and provide needed subsidies.

“Moreover, the unavailability of drugs at public health facilities continues to be a driver of OOP. Therefore, efforts to expand health insurance enrollment need to be accompanied with efforts to provide essential drugs at no costs to the poorest”  it said.

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