Students benefit from state-funded Edu-Afya programme

Edu-Afya

National Hospital Insurance Fund official engaging school pupils on Edu-Afya at the Nairobi ASK show on 2019.

Photo credit: File | Nation Media Group

Mary Cherop is a Form Two student in a public secondary school in Uasin Gishu County. Cherop, 16, has been suffering from stem plant disease since birth.

Her parents are peasant farmers who cannot meet the cost of her treatment. In 2020, her condition got worse, and she was rushed to Moi Teaching and Referral Hospital for treatment.

 The family was not aware that she was covered as a secondary school student. Her parents were surprised to learn that the National Hospital Insurance Fund (NHIF) paid Sh420,000 for the initial treatment.

Two years later, Cherop was sent to India under the government-sponsored Edu Afya package. She was able to access Sh1.2 million as payment for the stem cell transplant to treat her sickle cell anaemia.

 Sickle cell anaemia

 A similar case is that of Gladys Moraa, a Form Three student at a secondary school in Kisii County. Moraa suffers from sickle cell anaemia. Her family, too, could also not afford her treatment. She had struggled through her primary education.

 With the Edu- Afya programme, Moraa, 17, was last year able to access Sh4.8 million for stem cell transplant for her treatment.

There are many other cases where students have benefitted from the Edu Afya package since its inception three years ago.

 Without the government-funded Edu Afya programme, Cherop, Moraa and many other students would not have afforded the treatment, maybe it would have been a sad tale for these future leaders.

 In April 2018, President Uhuru Kenyatta launched the Sh4.05 billion NHIF comprehensive medical cover to cater to students in public secondary schools.

Through the cover dubbed 'Edu- Afya', the government is paying a premium of Sh1,350 per student targeting three million students in public secondary schools to fulfil the Big Four Agenda – provision of affordable health care.

 Edu-Afya package was launched to enable students to access quality health services and thereby ease the burden from their parents and guardians, which has been done.

 Thus, the Ministry of Education signed a contract with NHIF to provide medical insurance for all public secondary schools for the duration of the study.

Treatment

Some of these students who are critically ill would not have afforded to get treatment with the huge cost of treatment but got a relief from the government-sponsored Edu Afya package.

The medical cover caters to any student in a public secondary school registered by NHIF through the National Education Management Information System (Nemis) database.

 Since its launch, Edu Afya has cushioned parents against the high cost of healthcare services, which gives the affected students a chance to stay in school.

EduAfya cover was launched to enable students to access quality healthcare services in proximity to the school and ease the burden from their parents and guardians.

 To ensure seamless access to services, NHIF has enhanced system integration to ensure bulk registration and exits of the registered students. The Nemis database has been integrated with the NHIF systems to ensure that once a learner is fully registered on Nemis, the NHIF system auto-registers the learner. This ensures that eligible students can access services upon registration on the Nemis database at the school.

Outpatient benefits

 Students have benefitted from standard inpatient and outpatient benefits packages that together account for over 80 per cent of the total medical claims for the scheme, followed by major Surgery at 9 per cent of the total utilisation in the current year.

 The scheme covers essential outpatient and inpatient medical treatment on a comprehensive basis within the country and overseas for the student members. In addition, the cover provides for road and air evacuation, dental, optical, specialised services, group personal accident, group life, and last expense cover.

 However, there is minimal awareness about Edu-Afya and what it can do for secondary school students across the country.

 What remains to be done is to ensure that all teachers, students and parents are fully aware of the Edu-Afya package which is critical to cushion parents from catastrophic medical bills, a critical issue for Kenya to attain universal healthcare coverage.

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