More pain for kidney patients as NHIF funding stalemate persists

Kennedy Anjejo, a resident of Kajulu, Kisumu County, is a worried man. He is a renal patient who has been undergoing dialysis for more than four years now. 

However, with the recent stalemate between the National Health Insurance Fund (NHIF) and hospitals, his health is at stake. The Kenya Renal Association (KRA) has raised concerns over the ongoing crisis occasioned by NHIF in failing to disburse funds owed to dialysis centres.

“Dialysis is a matter of life and death. We do the process twice per week. If you miss the dialysis, your life is at risk,” said Mr Anjejo, who has since relocated to Nairobi.

“The main job of the  kidneys is to  filter blood. But for us we have to depend on an external system to cleanse the system. This has forced me to be away from work for some time. As a patient, your schedule and work has to change so you can attend to your health.”

Mr Anjejo noted that about 217 health facilities that offer dialysis are mostly clustered in urban centres, with 65 per cent being private facilities.

“I am anaemic. I am using blood boosters, which come with a lot of cost implications. I also use hypertension drugs, depending on how I wake up in a day,” he said.  

Philip Okuku, a retired teacher, is appealing to NHIF to release pending bills owed to dialysis hospitals under the consortium.

“When we get support through NHIF, it is God-sent. Already, facilities are threatening to stop giving us services. The government needs to address this matter as soon as possible,” said Mr Okuku, 52. 

He added: “The best would be for us to go for dialysis at least three times per week, but we cannot afford an extra session. I have seen patients who missed sessions of dialysis and ended up dying.”

In a statement signed by Kenya Renal Association Chairman Jonathan Wala, the federation decried NHIF’s reluctance to disburse the funds, noting that daily operational expenses incurred by dialysis units rely heavily on funds owed by the insurance fund.

Mr Wala added that NHIF’s unwillingness to release the funds is significantly harming the dialysis centres and jeopardising their ability to provide uninterrupted healthcare to patients requiring dialysis.

“With daily running costs, any delay or failure by NHIF to release funds that are owed to dialysis units is a death blow to these units and puts a serious threat to offering seamless and continuous care to these patients, all of whom are contributors to NHIF,” Mr Wala said.

He added: “For these patients, missing even a week’s session of dialysis may cause serious deterioration in their health and even result in avoidable death. Already, several dialysis units have closed down due to severely restricted cash flow and inability to pay suppliers.”

While noting that the Rural Hospitals Association of Kenya has declared that its member hospitals will ask patients (NHIF contributors) to cover their medical expenses out-of-pocket from January 4, 2024, Mr Wala opined that other hospitals will likely follow suit in order to stay afloat.

He anticipated a scenario where the lives of more than 5,000 dialysis patients in Kenya will be at risk. 

“In a week’s time, they will have to transfer to already crowded and poorly resourced government facilities to access dialysis,” said Mr Wala.

“We estimate that at most, these government-run dialysis units can cover 1,500 of these patients.”

The official  subsequently advised dialysis patients to begin making necessary financial and logistical arrangements needed to ensure they continue smoothly with two dialysis sessions per week.

“Dialysis patients should prepare to make direct payments for sessions. They should also identify government facilities with dialysis units and book for sessions there in case this crisis is not resolved,” Mr Wala said.

He similarly urged Health Cabinet Secretary  Susan Nakhumicha to personally intervene and address the issue of pending bills owed to the dialysis centres.

“The challenges NHIF has created, the small transition time window given, and the job security threat faced by NHIF employees makes this transition from NHIF to the Social Health Authority an even more precarious one. It needs all hands on deck and we ask that the CS takes immediate action,” said Mr Wala.  

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