Majority of pastoralists do not have formal financial tools like bank accounts: their currency is livestock. FILE PHOTO | NMG
Business Daily columnist
George Bodo’s piece last Friday about a law being crafted in Zimbabwe
aimed at supporting the use of livestock as financial collateral was
good news.
It highlighted a chronic problem relevant
to healthcare in many Kenyan rural households. Here are people with
alternative wealth, read livestock, but who are condemned to exclusion
from health insurance because vendors do not see them as potential
buyers.
Bodo’s article reminded me of a recent
discussion on healthcare financing with an economist at a health
innovative technology firm. The gist of our discussion was why a man who
owns 200 goats isn’t being reached by health insurers nor benefiting
from tech innovations around health insurance.
The
2017 Economic Survey and National Hospital Insurance Fund (NHIF) data
show that less than six million Kenyans have any form of health
insurance.
Across the hospital compound in Iltilal
village where I practice, my friend lives in a manyatta (Maasai hut) and
owns an intimidating number of cows and goats but still has no basic
NHIF cover.
Every time a family member falls sick some
are sold to finance hospital charges. Despite being “wealthier” than
most Kenyans, no insurer is thinking about him.
The
vast majority of those with health insurance are employed,
self-employed, are supported by donors or vulnerable family schemes.
My six years’ observation in Maasailand shows that vast swathes of such
populations have low NHIF membership despite accounting for 70 percent
of Kenya’s population.
Strangely though, these neglected folk have high ability to pay for such bills.
All it takes is some enlightenment and novel business model that seamlessly converts livestock into premiums.
Universal healthcare
A
second observation is that the majority here do not have formal
financial tools like bank accounts or mobile banking literacy: their
currency is livestock. With average homesteads owning 100 goats and
wealthier ones over 500 it is a ripe market for selling.
In
most of these houses, goats and cows are sold when someone falls ill
often to pay for bills tenfold what a decent insurance premium would
cost.
For donor and development organisations pushing
to get marginalised communities into the universal healthcare coverage
vehicle, it is time we started having discussions on how to surmount
this “payment modality” chasm which locks such communities out.
Donor
sponsored NHIF and development partners could support financial
intermediaries to take up livestock in lieu of health premiums as one
approach.
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