Membership in the National Hospital Insurance Fund

Post Date: 25 May 2018   |   Category: Health   |   Hits: 631

The National Health Insurance Scheme is a form of national health insurance established by the Government of Kenya under the National Hospital Insurance Act (1998) cap 255, with a goal of providing equitable access and financial coverage for basic health care services to Kenyan citizens.  

The significance of a National Health Insurance Scheme to a nation cannot be overemphasized, among the big four agenda by the Jubilee government, in pursuit of universal access to healthcare for all Kenyans, plans to increase the cover to ensure all Kenyans have access to affordable health insurance. To this end, the government intends to restructure the National Hospital Insurance Fund to eliminate corruption and bureaucracy; roll out a community health network across the country and raise the government’s budget allocation to health from 6% to 10%. 

Implementation of universal health coverage (UHC) is highly welcome and is hoped to cushion especially the low-income groups from high risks that arise from the shocks that they occasionally face during disease epidemics. 

The recent government statistics reveal a gap in terms of registered members of the national insurance cover.  As shown in the chart below, the membership is still low. In 2016/17 total membership was 6.8 million out of which 56% constitute membership from formal sector while 44% constitute membership from informal sector.  When these numbers are contrasted with employment in the formal and informal sector, it is shown that out of the total 16.8 million employees in 2016/17, informal employment constitutes, 83%, thus disclosing that a significant number of the Kenyans in informal sector do not have NHIF cover.

NHIF membership versus recorded employment

Source: KNBS | Economic Survey 2018

Number of the Week: 80%

  • Active members covered by national hospital insurance fund increased from 3.8 million in 2012/13 to 6.8 million in 2016/17
  • Over the same period active members in informal sector increased from 1.1 million to 2.9 million, representing a proportion of 29% and 44% respectively. This implies that NHIF coverage in informal sector is low but growing at a faster pace compared to the coverage in the formal sector. 
  • Total active NHIF membership as a share of total employment in 2016/17 constitutes 40% thus implying that two thirds of the employed Kenyans do not have NHIF cover. 
  • Out of the two thirds of the employed Kenyans who do not have NHIF cover, 80% are from the informal sector