Plans to reform health financing in Kenya underway


NAIROBI, Kenya, Mar 2 – Plans to reform health financing in Kenya and steer the country towards realising Universal Health Coverage are currently underway. The changes are expected to facilitate the provision of social health insurance for all Kenyans and protect them from poverty.

Recent studies indicate that 2.4 million Kenyans are at risk of impoverishment due to catastrophic health expenses. At the moment, 26.6 percent of total health expenditure in Kenya is out of pocket. The country’s health insurance coverage stands at 20 percent with the large informal sector population not enrolled in prepaid health schemes.

The total insurance coverage in Kenya as at 2013 was 17 percent. Only 2.9 percent of the poorest have some form of cover compared to 41.5 percent of the richest having some form of cover.

Among the proposals made is a call to register the residences and incomes of those in the informal sector; co-funding between the National and County governments; matching employer-employee contributions; cross subsidization of health services costs between Counties and also supporting the role of private healthcare providers.

Speaking in Nairobi on Thursday, Health Principal Secretary Dr. Nicholas Muraguri said that there was an urgent need to revamp the country’s public and private insurance providers. He mentioned the need to strengthen accountability mechanisms; lower the administrative costs incurred with running health insurance in Kenya as well as tightening the regulatory framework for both public and private insurance providers.

“We cannot talk about shared prosperity and equity without health and I believe that we are moving in the right direction. There is a working draft that we need to finish because it promotes and enhances our accountability in addition to promoting the dreams and desires of our Constitution. This document will shape and guide our health system,” he said.

Treasury Principal Secretary Dr. Kamau Thugge underscored the importance of protecting Kenyans from financial risks associated with the escalating costs of healthcare. He also pointed out that it was necessary to understand and critically analyse the factors that could affect the transition to Universal Health Coverage.

On his part Seme Member of National Assembly Dr. James Nyikal singled out the need to set up a strong legal framework that would guide Universal Health Coverage. He explained that this would steer the implementation phase and bring clarity. He also said that it was important to have a third-party agency that will be tasked with settling claims.

These discussions follow a Universal Health Coverage study tour to Japan, Estonia and Germany. Japan has a population of 120 million people with out of pocket expenditure standing at 14.4 percent according to a 2010 report. Germany has a population of 80 million with out of pocket expenses (co-payment for drugs and medical supplies) standing at 10 percent. Estonia on the other hand has a population of 1.3 million. Out of pocket expenses stand at 22 percent (co-payment for drugs and dental services).