Student NHIF cover underused, report shows

Form One students at St Peter's Mumias Boys study biology on January 17, 2019. PHOTO | FILE | NATION MEDIA GROUP 

In Summary

• The report says only 640,745 students have used the scheme since April last year when it came into effect, out of a learner population of about 2.7 million.
• Some 607,738 have been treated as outpatients, 30,995 as inpatients while two sought medical care overseas.
• The ministry negotiated an annual premium of Sh1,350 per student and paid about Sh2.5 billion to cover 2,785 students from May to December last year.

   

By KARIUKI WAIHENYA
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The most common ailments afflicting secondary school students are dental, eye and complications linked to drugs and substance abuse, a government report shows.

The report, prepared by the National Hospital Insurance Fund (NHIF) and the Education ministry, also cites tumours and surgeries resulting from injuries.

OVERSEAS

The government launched the Edu Afya comprehensive medical scheme for all public secondary students last year, covering all students captured under the National Education Management Information System (Nemis) and registered with NHIF.

The report says only 640,745 students have used the scheme since April last year when it came into effect, out of a learner population of about 2.7 million. Some 607,738 have been treated as outpatients, 30,995 as inpatients while two sought medical care overseas. The ministry negotiated an annual premium of Sh1,350 per student and paid about Sh2.5 billion to cover 2,785 students from May to December last year.

According to the report, likely to be tabled at the ongoing Kenya Secondary School Heads Association meeting in Mombasa, Bungoma County leads with the highest number of claims at 58,678 at a cost of Sh89.7 million. It is followed by Kakamega with 45,124 claims worth Sh107 million, Kisumu with 31,252 at Sh82 million and Siaya with 31,398 at Sh74 million.

Other leading counties are Nandi (26,684 claims), Homa Bay (25,587) Kericho (25,336), Migori (22,329) and Laikipia (20,826).

Counties with the lowest number of claims are West Pokot (four per cent), Mombasa (five) Tana River (seven), West Pokot (two), Makueni (four), Nyandarua (four), Machakos (two) and Bomet (six).

Hospitals with the highest number of claims are Royo Out Patient Services in Kakamega with Sh65.5 million, Kory GFamily Hospital in Kimilili with Sh30 million, Moi Teaching and Referral (Sh29 million), Siloam-Kericho (Sh29 million) and Sori Lakeside Nursing Home, Migori (Sh21 million).

AWARENESS

“The main challenge faced by the scheme is low awareness by the parents and the school principals,” the report says, adding that the lowest usage rate was during the school holidays “which should not be the case”.

NHIF is expected to make a presentation on the scheme during the school heads’ meeting hoping to push up awareness.

The scheme covers outpatient consultation, diagnostic laboratory and radiology services, prescribed drugs and dressings, chronic, pre-existing conditions and day-care specialised surgery.

Inpatient services include hospital accommodation charges, pre-hospitalisation diagnostic services, doctor’s fees, medication and internal surgical appliances, diagnostic services, rehabilitative services, operating theatre services and radiological diagnostics.

The scheme also covers dental, optical, emergency services and overseas treatment where required services are not available in Kenya or upon the recommendation of a doctor.