The problem with NHIF, and why it is being replaced with SHIF – CS Nakhumicha clarifies

Health Cabinet Secretary Wafula Nakhumicha has come out to address concerns and queries raised by Kenyans on why the government chose to phase out the longstanding National Health Insurance Fund (NHIF) and replace it with the new Social Health Insurance Fund (SHIF).

According to CS Nakhumicha, the NHIF system was plagued by a myriad fundamental flaws that made it an unviable medical cover option for Kenyans, hence the need for a switch.

The CS, who spoke during a townhall interview on Citizen TV on Wednesday night, said the NHIF model was primarily curated to take care of one after contracting an illness, hence the need for a system that prevents citizens from falling ill in the first place.

“The system that we have had (NHIF) predominantly has been curative in nature; that it waits for you to get sick then it treats you. What we’re moving to is preventive and promotive in nature; so that we try as much as possible to prevent citizens from getting sick,” she stated.

“We try as much as possible to promote good health amongst the citizens, and that is why we’re doing it with our Community Health Promoters; that they get into households and shift people’s thinking that you don’t have to wait until you’re sick, that if only you engaged in proper sanitation, there’s something that you’re going to avoid.”

CS Nakhumicha went ahead to also state that NHIF was only designed for salaried Kenyans who could afford to pay it, thereby overlooking unemployed citizens or those that do not have payslips at the end of the month.

She stated that the government deemed it fit to do away with this and institute a system that addresses the health concerns of all Kenyans – salaried or not.

“The problem with NHIF is that it has a structural problem; it was put in place largely to cater for people who are salaried. It was structured in a manner that you who has a payroll, you have a payslip that the end of every month there’s a deduction from your employer to remit to NHIF. And remember we only have about 2.5 million households on payroll, the rest are not,” said the health minister.

“So what we have done with SHIF is to ensure that, first of all, we’re able to identify every Kenyan. Secondly, that we’re able to know what is your level of earning/income. Thirdly, that then we’re able to ratio in terms of how much you’re able to pay towards your healthcare. And, forth, that we want to bring everyone in the fold; that those who have no ability to pay, including the vulnerable, but we have a huge number of people who are able to pay, then we put together resources so that we can take care of those who are not able to pay.”

Nakhumicha further stated that NHIF did not provide full coverage for treatment of some illnesses like Cancer, and would hence leave sick Kenyans with ballooning medical bills after running its course.

She also noted that NHIF did not cover illnesses obtained at birth, nor did it take care of general screenings, both of which the new system seeks to change.

“The other problem is that NHIF did not cover 100%. What we’re doing in the new law is that there are no limits; that means that your disease is covered from the beginning to the end,” said the CS.

“We have congenital conditions that are not covered by NHIF, even with private insurance. But we’re saying these are Kenyans and they did not choose to be born with certain illnesses, so now we have a package that will take care even of congenital conditions.”

Nakhumicha added: “NHIF also does not cover screening, where you’re not sick but you want to be checked whether you’re Okay or not. But under SHIF, we’re covering for screening and wellness, so that people can check themselves and ensure that they’re living well.”

Problems with NHIF as it is - Health CS Nakhumicha Wafula#JKLive @SamGituku pic.twitter.com/Fk6Q1ZGzBv— Citizen TV Kenya (@citizentvkenya) January 24, 2024