In this interactive series, we invite readers to send in questions to select public figures. This week, Geoffrey Mwangi, the chief executive officer of the National Hospital Insurance Fund, responds to your questions.
Why must we select health facilities for outpatient services yet I might get sick when I am not near the selected facility? Does it mean I would have to go back to my base to get the outpatient cover even if I had travelled?
As members you select facilities to ensure each one of you has access to quality healthcare. If your dependants are located separately from you then they can also choose facilities which are closest to them. Should you get sick while on travel, you can access services at any of our accredited facilities? All you need to do is notify the facility and the rest shall be taken care of. The model of outpatient provision we are using requires one to select their provider of choice and this will guarantee sustainability among other advantages.
What happened to the raft of measures that were proposed by NHIF top leadership and the Departmental Committee on Health to amend the NHIF Act that could have seen members’ contributions pegged on the basic salary and not the current one that is pegged on the total income?
Andrew Maranga Ratemo, Malindi
Thank you Ratemo for keeping up with the health affairs in our country. There has been a progressive move towards implementing the proposed measures. However, as you know, some of the proposed measures require change in legislation which takes time. We look forward into transforming the Fund to a Social Health Insurer to reduce the financial burden faced by our members as soon as possible. Kindly note as well that our level of contributions levied are still low compared to the health needs of the members.
What have been the major challenges at NHIF as you continue to serve your clients?
Francis Njuguna, Kibichoi
Challenges are inevitable. They inform us of areas of improvement and the need for innovative ideas. Some of the challenges we have faced as we continue to serve our valued members include lack of adequate infrastructure to provide specialised services in far flung areas. You will have noticed that we recently introduced evacuation services to ease some of these burdens. Our other challenge is the enrolment of the informal sector into the scheme. While the numbers continue to grow, it has been quite slow. We shall endeavour to continuously educate and inform the sector on importance of health insurance not just to safeguard their health but also their incomes.
During this year’s Labour Day celebrations, Cotu Secretary General Francis Atwoli, in the presence of President Uhuru Kenyatta, said you are the right person to head NHIF. When did you join NHIF and what difference have you made there that makes you the right person?
It is always an honour and humbling when one’s abilities as a leader are commended. I joined the Fund over 20 years ago. Since then, I have witnessed the institution transform into what it is today. The difference I make at NHIF is ensuring that our vision comes to life and lives are transformed for the better. Each and every day I lead a team of staff who are passionate about their work to ensure we are a world-class social health insurer. My focus right now is ensuring each member and their dependants have access to a variety of quality essential healthcare services. Once that aspect is achieved for all, I will truly know that I fulfilled my vision for this worthy institution.
First, let me thank you for improving and expanding the Fund’s services. However, I wish to request you to increase the health care facilities in Nairobi’s Eastlands — including Kamulu, Ruai, Kayole. Some of us spend more on fare than the value of the drugs and treatment we get.
Murage, our mission at NHIF is to ensure all our members have access to quality health care that does not dent your pockets in any way. Your sentiments have been noted and we are currently looking into these areas to make access possible. Kindly be on the lookout.
I am a NHIF member (reference number withheld) and I have tried to obtain a bill/receipt from Pumwani Maternity Hospital without success after my wife delivered there. Could you help?
George M. Wahome, Nairobi
Congratulations on the safe delivery and to the new addition to your family Wahome. We are glad to be at your service. At NHIF we cater for maternity costs at accredited facilities, the bill notwithstanding. We also have arrangements with facilities to ensure that you are receipted for services offered. We urge you to kindly get in-touch with our Eastleigh Branch Office on 020 8055788 for further assistance.
How does one switch as a member from formal employee contributor to informal employment contributor? When a member switches, do benefits from NHIF change?
Brodas E. Lidembu, Kitale
We value you as our member and are more than glad that you have considered retaining NHIF as your health insurer of choice. For a switch to the informal sector, kindly contact our customer care through toll-free number 0800 720 601 at your convenience and you will be promptly served. Alternatively, you can visit one of our branches for similar service. In addition, at NHIF we believe in equity, the same benefits you access while in the formal sector are the same you have access to after the switch.
In my area hospital there is no neurosurgeon and my treatment, having suffered a stroke, needs the attention of one. Whenever I visit a neurosurgeon he sends me to laboratories which are private and I pay hefty fees on the tests. Last time I visited them it cost me Sh18,000. How do I get the refund on such costs? As for medicines prescribed by my consultant I have no problem except that my pharmacy is now refusing to give me the medicines with explanations that they have not been paid. Who should pay them?
Adrine Mercy Mukima, Murang’a
It is disheartening to hear of your current situation. We at NHIF purpose to ensure our members have access to quality healthcare services including medicines and laboratory services at facilities near you and through a less burdening process. Could you kindly get in touch with us through our toll free line 0800 720 601 as soon as possible. I wish you quick recovery and look forward to serving you.
While officiating at an event in Kaimosi, the President is said to have directed NHIF to increase capitation rate forthwith to the Jumuia Friends Hospital, Kaimosi. Sir, can this be considered a political directive to your institution or this is an ordinary occurrence in the running of NHIF?
Komen Moris, Eldoret
Komen Moris, Eldoret
Thanks Morris for the inquiry. It is quite ordinary for stakeholders to request an increase in the capitation and rebate rates and that includes Jumuia Friends Hospital Kaimosi. We at NHIF, have a financing model that ensures equitable reimbursement to facilities based on the services they can provide to our members. And yes, we are looking into reimbursing the Jumuia Kaimosi Hospital equitably and fairly.
NHIF is a vital institution but one which does not inspire public confidence because of alleged irregularities including payment of ghost clinics, unprocedural selection of clinics and creation of an unapproved unit at the NHIF. What efforts are being put in place to create transparency and accountability?
Amos Washisino, Nairobi
Our values at NHIF are transparency and accountability for all our actions to stakeholders and that includes you. We continuously improve our communication channels including email ([email protected] and [email protected]), drop-off boxes and telephone contacts (toll free 0800 720 601) for reports on any malpractices. I would also like to inform you for all the reported cases, none has been left untouched and necessary actions including tightening policies have been taken to prevent recurrence of the same.
For some months now, Kenyans have continued to become vulnerable due to the increasing cost of living. Many of those in the informal sector could even be most affected. Sir, how has this situation impacted on NHIF contributions especially from those who voluntarily make their monthly contributions through mobile money transfers? How have you mitigated against this unfortunate situation?
Indeed, it is true that the cost of living has been on the rise. While we may not meet our targeted contributions at 100 per cent from the informal sector, we have seen an increase in contributions. Our beneficiaries tell their stories which has seen more members retaining their membership and also other new entrants into the scheme. Another strategy that we have put in place is the NHIF wallet app. The app allows you to deposit small sums of money daily and once it gets to the required Sh500 you can pay up your monthly contribution. NHIF has you covered.
What happened to the Clinix saga?
I would like to inform you the Clinix case is currently under investigation. It is in order that we give our judicial system time to determine the case. Once the ruling has been done all stakeholders shall be informed.