NHIF on the spot as 3,000 small hospitals miss out from its list

The National Health Insurance Fund building in Nairobi.

File | Nation Media Group

By  Verah Okeyo

Nation Media Group

What you need to know:

• The hospitals, which constitute 94 per cent of all health facilities in Kenya, serve the poorest.
• Dr Victor Gioko, the assistant vice-chairman of KAPH, told the Nation that the lack of accreditation is injuring both patients and owners of the hospitals.

The National Health Insurance Fund (NHIF) has not accredited more than 3,000 lower level hospitals in the last three years despite being given the green light by the medical council and the Ministry of Health.
The hospitals, which constitute 94 per cent of all health facilities in Kenya, serve the poorest.

The most affected hospitals are the ones run by Catholic and protestant churches, facilities that have served the marginalised in areas with little government presence such as arid and semi-arid counties.
In a letter to Health Cabinet Secretary Mutahi Kagwe, officials of the Kenya Associations of Private Hospitals (KAPH), the Rural Private Hospitals Associations and Christian Health Association of Kenya demanded fairness in the process of NHIF accreditation.

Private insurers

Dr Victor Gioko, the assistant vice-chairman of KAPH, told the Nation that the lack of accreditation is injuring both patients and owners of the hospitals.

“Patients in rural areas and informal settlements are sometimes unable to pay Sh3,000 for very crucial care. So when they pay their premiums for NHIF, it is only fair that they are able to get medical services in the hospitals near them,” he said.
Dr Gioko added that even private insurers do not accept to accredit their facilities without NHIF, a move that also impoverishes hospital owners and healthcare workers who depend on them for a livelihood.
In the NHIF reforms that were initiated by former Health CS Sicily Kariuki, a new agency — the Kenya Health Professionals Oversight Authority — was created and mandated to inspect facilities and determine the services they can offer.

Accreditation

The feedback would then be given to Attorney-General, who would gazette the facilities to be accredited by NHIF.  In the gazette notice dated February 4, 2019, 9,064 hospitals were given greenlight for accreditation. But the Nation has since learnt that a majority of the facilities that succeeded in getting the right to serve patients were government hospitals and those of level four and above.
When contacted, NHIF head of registration and compliance Robert Otom said: “This is not correct. All hospitals recognised by NHIF are offering services to members in accordance with the contracts they have signed with the insurer. Unless it is those facilities that want to offer services they have not contracted for.”
vokeyo@ke.nationmedia.com