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By Benta Moige, Zaina Kombo, and Lavendar Namdiero 

National Hospital Insurance Fund (NHIF) has come a long way since its inception in 1966. Over the years, it has grown to become the main provider of health insurance in Kenya. In 2023, NHIF is at the centre of an important policy debate as the Kenya Kwanza administration seeks to strengthen the financial revenue to expand the range and quality of public health services to more Kenyans. 

Currently, NHIF has over 15.4 million registered members. However, about 48 per cent of the registered members were dormant by January 2023 due to the tough economic times.1 One of the main challenges facing NHIF is inadequate funding. This has led to delays in provider payments and a shortage of funds for critical operations. Additionally, NHIF has faced challenges in curbing fraud and abuse, which has led to the loss of resources.  

NHIF is primarily financed by employees in the formal sector, who are also the main beneficiaries of the scheme.2 While the government provides subsidies to the Hospital Insurance Fund, the details of the contributions, regularity and appropriation of the subsidies are unclear. The nature of the citizen’s contributory scheme is key to the government’s intention to realise universal health coverage. 

On the other hand, NHIF has several opportunities to improve its operations. The organisation can improve its digitisation efforts to streamline its processes and reduce costs. NHIF can also invest in partnerships with public and private sector organisations to enhance its services and ensure better access to healthcare for its members. 

In conclusion, NHIF faces challenges and opportunities in providing health insurance to Kenyans. By addressing these challenges and embracing its opportunities, the state agency can improve its services and remain a critical enabler of public healthcare. 

 

A joint piece by Benta Moige ( Lead Country Researcher), Zaina Kombo (human rights lawyer and the Inequalities and Discrimination Campaign Manager) and Lavender Namdiero (Senior Campaigner Inequalities and Discrimination)at Amnesty International Kenya. They write in their own capacity. Email: [email protected], [email protected], [email protected] 

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