The State owned National Health Insurance Fund (NHIF) has set aside a half a billion Kenya Shillings towards cardiac surgeries, with members posed get up to Shs 1.5 million cover for heart operations.
NHIF Chief Executive Officer Geoffrey Mwangi said: “Cardiac surgery needs among Kenyan citizens currently outweigh the country’s national healthcare capacity, with lengthy processing times and procedures too costly to refer every case overseas.”
The NHIF national cardiac program, launched last year, was initiated to save the lives of cardiac patients with “sick hearts” and speed up interventions for patients who have been waiting for treatment for a number of years due to lack of funds. The cardiac coverage is also meant to provide lower-risk cardiac interventions locally while improving on the timeliness and access of safe and ethical cardiac care for Kenyans.
“The NHIF fully finances the program which is delivered through local partner hospitals. The cardiac care program is implemented by NHIF with the intent to alleviate the suffering experienced by the patients during the long wait for surgery within Kenya,” NHIF says.
In a statement, NHIF says 262 patients have benefited form the program 179 being open-heart surgeries while 83 patients are interventional procedures.
“The Cardiac health benefit package informed by NHIF’s goal of reducing backlog of heart condition patients was analyzed after numerous requests on financing such heart conditions were made by clients. The cover is to carter for patient pre-assessment, treatment, and post-treatment care for up to six months after a cardiac procedure done by the healthcare provider,” the CEO added.
NHIF says it is “collaborating with several local hospitals to handle cardiac cases according to each facility’s available manpower and equipment to support the program. These hospitals include Kenyatta National Hospital, Coast Provincial General Hospital, Mater Hospital, The Karen Hospital, The Nairobi Hospital, Nairobi West Hospital, Tenwek Mission Hospital, Eldoret Hospital, The Gertrude’s Children Hospital, and M.P Shah Hospital.”
The NHIF cardiac care insurance program will be implemented in collaboration with the global health partner, A&K global health with intent to alleviate sufferings experienced by heart condition patients during their long wait to get surgical interventions.
The national health insurer is also looking at ways to help address the low insurance coverage and uptake while coming up with tailor made products to enable it provide holistic care for its members Mr. Mwangi said.
Kenyan health Insurance uptake remains one of the lowest by international standards, with less than 20 percent of Kenyans having health insurance cover. About 88.4 per cent are covered by NHIF while private insurers cover 9.4 per cent.
The national health fund established in 1966 provides health insurance coverage to members in three tiers. The first tier gives a comprehensive coverage at state hospitals. The Second arrangement offers limited co-coverage provided at selected range of private facilities. All salaried employees are required to have a compulsory cover with NHIF.
The national insurance fund accepts anyone with a minimum wage of Sh.1000 per month to register as its member. Premium payment to the fund was again simplified through a partnership with Safaricom which now allows members to pay their premiums through the mobile money platform-Mpesa.