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Calls for efficiency and transparency in health services towards SHIF

Residents of Nyeri are calling for comprehensive reforms in the health sector ahead of the country’s transition to the Social Health Insurance Fund (SHIF).

While airing their views during a public participation forum on the draft Social Health Insurance Regulations 2024 Bill today, the majority of the speakers want the Government to ensure there is availability of essential drugs and quality health services under the new scheme.

A section of Nyeri residents who attended the forum. Photo by Samuel Maina

They also want the new scheme to focus more on funding medical needs for all people, devoid of discrimination, to enable those at the bottom of the economic ladder to access quality health care.

“While we welcome the rollout of the new Social Health Insurance Fund, let the scheme cater for the revival of our health care system, which is in a deplorable state. We want to get treated when we visit our health facilities, even as we pay into the new health insurance scheme. There is no need to replace the current National Health Insurance Fund if the problems we have been experiencing are to be replicated in the new one,” submitted Kabatha Wanjohi, who is chair of the Nyeri Disability Network.

Wanjohi has also urged the State to review a proposal meant to cater for funeral expenses, arguing that such money should be directed towards catering for critical medical needs such as drugs and screening for noncommunicable diseases.

“We need a scheme where both the rich and the poor will not be demarcated but where there is equality in providing health services at a health facility of one’s choice. We also wish to request that the Government ensure that those living with physical challenges are treated as equals when rolling out the new scheme. Finally, let the money that is being proposed to cater for the deceased be relocated to improve the provision of services in our health facilities,” he added.

A hearing-impaired person who identified herself as Susan requested the drafters of the new regulations to insert a clause that will cater for travel expenses for those seeking treatment abroad.

She argued that under the new insurance scheme, contributors who cannot access advanced treatment in the country should be catered for while flying out of the country since the majority of their families may not be in a position to foot such expenses.

Margaret Mwangi, a social worker for persons living with HIV/AIDS, called for the new scheme to cater for the cost of obtaining P3 forms for Gender Based Violence (GBV) victims, as the majority of them cannot afford the documents when seeking treatment.

She said that owing to the current hard economic times, the majority of GBV victims infected with HIV fear being ostracised any time they visit a health facility due to lack of P3 forms.

“I work with the key population, or those living with HIV. One of the challenges these people encounter, especially those who have been subjected to Gender Based Violence is lack of access to treatment due to lack of a P3 form. Most of these people cannot afford the documents that are sold at Sh400 and would rather buy food and take care of their children. My proposal is for the new insurance health fund to cater for such expenses in order for the victims of such vices to get assistance,” she said.

Reverend Bildad Wangondu, a prelate at the Mweiga Anglican Church, proposed the establishment of counselling services in all public health facilities to cater for the rising cases of mental health challenges.

The cleric argued that the majority of people struggling with mental health challenges cannot get help since most public health facilities lack such services.

“Mental health challenges are no longer new in this country, and it is time our health facilities get equipped adequately to deal with the new health scare. I am therefore proposing the new regulations to incorporate that our public hospitals be staffed with counselling psychologists and medics who can assist patients battling depression and other mental illnesses,” he stated.

Dr. Ruth Laibon-Masha, the CEO of the National Syndemic Diseases Control Council, assured the participants that their proposals will be considered when coming up with the final regulations expected to be operational late in March this year.

She also promised to escalate the challenges of accessing P3 forms for victims of GBV to the Ministry of Interior, under whose docket the matter falls.

Dr. Masha assured the public that the proposed SHIF scheme will be a game changer in the provision of quality services in the country as it will address all the challenges that have dogged the National Health Insurance Fund for years.

“Our sole responsibility is to ensure every proposal that has been given in this forum with regard to the Social Health Insurance Fund regulations is taken into consideration. A point of note is that the new health insurance fund will take care of each and every person who will be registered, regardless of his social or economic status,” she stated.

“The President (Dr. William Ruto) has helped put up a robust health scheme, which he hopes will bring to an end to the many fundraising meetings by the public in a bid to offset medical expenses for families stretched to the limit by the high cost of footing health bills for their loved ones,” she added.

Following the lifting of a court order suspending the implementation of the Social Health Insurance Act 2023 early this year, the Ministry of Health immediately kicked off countrywide public participation workshops to help come up with the regulations that will guide the implementation of the Act.

The Ministry is seeking views on the Social Health Insurance General Regulations 2024, which will provide for the implementation of the Primary healthcare fund, the Social health insurance fund, the Emergency chronic and critical illness fund, and the Social Health Insurance Dispute Resolution Tribulation Regulations 2024.

The new regulations have put deductions for salaried employees at 2.75 per cent per month, while unsalaried households will also pay 2.75 per cent of their income per year.

The capping will, however, take into account housing characteristics, access to basic services, household composition, and other socio-economic aspects of the households under review.

The minimum amount payable to the fund will be Sh300.

By Samuel Maina

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