The recently released guidelines by the National Hospital Insurance Fund (NHIF) on 7th January 2020 provide a bleak picture into the future that envisioned Universal Healthcare Coverage (UHC) in Kenya. One of the changes is the reduction of the waiting period for new members from the current 60 day period to 90 days. There is also a mandatory 1 year upfront payment. For those defaulting on the payments, the changes provide for a penalty of 50% of each monthly contribution paid late for up to 11 months. Where the contributor has defaulted for 12 months, they will be required to start payments afresh and will only be eligible to benefits after 90 days from the date of resumption of payment. They will also pay a 1 year upfront payment. The rationale behind these changes is to marshal the efforts of NHIF towards the achievement of sustainable UHC and to enhance member retention. But is this really so?
Article 43(1) of the Constitution of Kenya 2010 provides that every person has the right to the highest attainable standard of health that includes the right to healthcare services. This is reiterated in the African Charter for Human and People’s Rights under Article 16.
The right to health is crucial to the realization of other fundamental rights and freedoms envisaged by the Constitution. Without it, one cannot be able to fully to enjoy their right to live fully. This right has four key elements that determine whether it can be enjoyed to the fullest. These are availability, accessibility, acceptability and quality. Availability connotes the present functioning public health and healthcare facilities for the use by the public. Accessibility takes different forms; the main ones being non-discrimination, physical accessibility and economic accessibility. Acceptability is with regard to being respectful of culture, minorities, peoples and communities. Quality relates to the scientific and medical appropriateness of the labour, equipment and drugs in the facility.
However, this is not the case as we know it. Almost daily, there are cries and complaints regarding the shortage of drugs in hospitals, shortage of beds in wards leading to even more deadlier cross-infections, lack of proper equipment to either detect or control certain diseases, long lines and wanting customer service to patients seeking assistance in healthcare facilities.