The Kenya Network of Cancer organizations (KENCO) and Non-Communicable Diseases Alliance of Kenya (NCDAK) held a joint press briefing on the proposed National Health Insurance Regulation (NHIF). The press brief came at a time when raft of changes is being implemented at the fund with the aim of offering better services to patients who are in dire need of insurance to cushion them against the heavy out-of-pocket expenditure.
It is to be noted that adoption of some of the proposals in the Draft Regulations to the NHIF Act 9 of 1998 (amended in 2021) will reverse the gains Kenya is realizing towards attaining Universal Health Coverage and further threaten to increase pain and likelihood of pre-mature death of people living with NCDs and other chronic conditions in Kenya. Additionally, some of the regulation, as note in the press statement, compromise the fundamental freedom and right to life as espoused in the Kenyan constitution and other regional/international legal documents.
I am glad to have been a part of this important event. As members of the NCD Alliance of Kenya, the presser was an opportunity to petition the health insurer to consider scrapping off some of the regulations that appear to be retrogressive or even draconian, to say the least. For instance, the proposed regulation seeks to introduce a penalty of 20000 for any person who doesn’t register with the fund. This has strongly been opposed in the statement as it creates a punitive atmosphere rather than giving patients an opportunity to seek healthcare without coercion and undue threat. Further, the proposal by the new regulations suggesting that beneficiaries of NHIF with chronic illness shall only access treatment for their conditions from public health care providers only has also been opposed strongly due to a myriad of reasons. Some of the reasons cited by the statement include;
- Public Hospitals in Kenya are generally not adequately equipped and do not have the capacity to be the sole provider of healthcare to the rapidly increasing number of people living with NCDs. NCD patients are often compelled to seek such services in faith based or private hospitals.
- Some of the services and entire range of medicines and therapies required for chronic illness listed in the first schedule are not readily available in public health facilities. These facilities have limited access points for services like chemotherapy and radiotherapy, including pet scan, and are supplemented by faith based and private facilities that facilitate timely access to diagnosis and treatment which is critical for patients with NCDs. Thus, it would be limiting and unfair to require patients to seek these services only in public health facilities.
- Where the services are available, public health facilities still face supply chain challenges with frequent stock out of medicines and commodities; machine breakdowns and human resource constraints including strikes. Frequent breakdown of the radiotherapy and brachytherapy machines at Kenyatta National Hospital (KNH) in the recent past has forced cancer patients to either stop treatment or seek services from private health facilities.
- Faith Based Health Facilities are not profit driven, offer quality services and play a major role in supplementing health services available in the public health facilities. These are the only facilities that are available and accessible in certain regions in then country. A blanket limitation to public health facilities will compromise care to healthcare for patients who seek services from these facilities.
The statement is voluminous. It covers other concerns around claims and benefits, contributions among other proposals.
In my capacity as the Secretary of the Caucus of Patients Led Organization under NCDAK, I weighed into this discussion about NHIF proposed regulation. In a short interview by Royal Media Servers local TV Station (Ramogi TV), I urged NHIF to listen to our concerns and ensure they are incorporated. The concerns we raised are weighty and require urgent attention. My only hope is that the issues raised will be looked at keenly so as to come up with regulations that will not hurt NCDs patients.