Social Health Insurance Scheme for All Kenyans

Abstract

The health sector reforms that have hitherto taken place (including introduction of National Health Insurance Fund, free health services, cost-sharing, exemptions and waivers, etc) have all aimed largely at addressing affordability and access to health care services. Spending to promote access to health care is crucial, given also that Kenya is a signatory to the WHO Abuja Declaration. The latter requires member countries to spend at least 15 per cent of their national incomes (GDP) on health (Kenya spends 9 per cent). Many Kenyans therefore continue to have no access to or cannot afford to pay for their health care needs. It is due to the failures of the past programs, that the National Social Health Insurance Fund (NSHIF) was conceptualized for implementation, with a view to enabling more effective provision of health cover to all Kenyans, at both in- and out-patient service levels. In contrast to the private/commercial health insurance plans where premiums are actuary based (higher risk individuals pay more for their medical cover), a social health plan s contributions are based on members ability to pay but access to services depends on individuals health care needs, hence a socialized concept, with emphasis on community spirit of solidarity.