Nyong’o opposed to NHIF cash being managed by board, chief executive

Anyang' Nyong'o

Council of Governors Health Committee Chairman Prof. Anyang` Nyong`o (left) and the Council of Governors Chairperson Martin Wambora. Nyong'o proposes creation of an insurance bank to manage the NHIF.

Photo credit: Bonface Bogita | Nation Media Group

Kisumu Governor Anyang Nyong’o has called for amendments to be made to the National Hospital Insurance Fund (NHIF) Bill before it is assented to by President Uhuru Kenya.

Prof Nyong’o is opposed to plans to have the NHIF managed by a chief executive officer and board, saying the proposal would make running of the fund inefficient.

The county chief instead proposed the creation of an insurance bank to manage the NHIF.

The government-backed NHIF (Amendment) Bill will see all adults compelled to pay Sh500 monthly or Sh6,000 annually in a remodelled Universal Health Coverage (UHC) scheme for outpatient and inpatient services, including maternity, dialysis, cancer treatment and surgery.

“Overall, the NHIF funds should contribute to development of the private sector in a strategic way. Funds can be made available as low-interest loans to the private sector,” said Prof Nyong’o.

“By enrolling everyone above 18 years of age, the Fund will be well resourced. Such resources should be handled by an institution that is professional and accountable enough to manage them,” the governor said.

He argued that even with 15 million contributors paying Sh6,000 annually, the fund will generate about Sh90 billion per year, which is inadequate to finance UHC.

“Kenya must be bold, innovative and create a financial/insurance type health funds management institution run by financiers, under overall supervision of the central bank, Ministry of Health and Insurance Regulatory Authority,” said Prof Nyong’o.

In his proposal, Governor Nyong’o said the NHIF funds should be used to provide low-interest loans for the development of health infrastructure in all parts of the country.

“They should develop tools for this by learning from what our banks are doing. There are many institutions which can help this fund to operationalise this objective,” he said.

The Bill proposes significant changes to the administration and implementation of the scheme.

These changes come in the wake of reforms that started two years ago aimed at reposition the NHIF into a strategic purchaser, focusing on use of information to allocate resources to priority areas to improve service delivery.

One of the proposed amendments is having the private insurer incur the first charge for beneficiaries with other health insurance plans. The fund should also provide grants to support and improve physical facilities, medical equipment and supplies in rural and remote parts of the country.

“There needs to be community participation and ownership in the structure and functioning of universal healthcare. The current structuring of NHIF has no community ownership or role component,” the governor said.

Prof Nyong’o added that primary healthcare financing should be anchored on community health leadership structures and level 2 and 3 facilities.

“Adequate funds and resources should be allocated to finance primary healthcare and community health services to be supervised by the county health leadership,” he said.

He proposed that structures be established to implement the community component of health insurance.

 “In this regard, the Council of Governors should recommend how these structures can be established, given the experiences of establishing devolved units in the 47 counties,” said Prof Nyong’o.