Discussion Paper No. DP060/2004 : Social Health Insurance Scheme for all Kenyans: Opportunities and sustainability potential.

nje ru Enos Njeru RAPMN8 18/02/20. "Discussion Paper No. DP060/2004 : Social Health Insurance Scheme for all Kenyans: Opportunities and sustainability potential.". ISBN 9966-948-18-x.; 2004.


Health is a basic need for all, regardless of race, nationality, social class, age,
sex, etc. In Kenya, just like in many other developing countries, the health
situation has been deteriorating in spite of the government having since
independence directed her efforts tow;rrds tackling the twin problems of
affordability and access to health care services. Beyond this, the policy position
is also clear on the need to address equity and sustainability of quality health
care delivery. The health sector reforms that have hitherto taken place (including
introduction ofNHIF, free health services, cost-sharing, exemptions and waivers,
etc.) are all largely aimed at addressing affordability and access to health care
services, especially among the poor. The latter often find themselves in poverty
traps that deny them access to social services, consequent upon which they
benefit least from health, education, food security, knowledge and information
services and other basic human rights components.
This negates the policy endeavors relating to promoting poverty reduction through
economic growth, access to minimum quality health care by removing barriers
arising from social differentiation and concomitant stratification on basis of
gender, social class, knowledge and limited or even zero participation of the
underprivileged in prioritization and provision ofthe national service infrastructure.
Past policy priorities and measures have not been effective in addressing these
concerns, which relate positively to health care access potential for all. Spending
to promote access to health care is crucial, given also that Kenya is a signatory
to the WHO Abuja Declaration (25th April 2000). The latter requires member
countries to spend at least 15 per cent of their national incomes (aDP) on
health (Kenya spends 9 per cent).
The high cost of health care limits access to the services for many Kenyans,
given that 56 per cent of the population lives below the poverty line (on less
than one dollar a day) among whom 30 per cent live in absolute poverty. The
Second Report on Poverty in Kenya reveals that 40 per cent of the poor did not
seek medical care when they fell sick, mainly due to inability to meet the cost of
medical care, while 2.5 per cent were constrained by distance to a health facility.
Unaffordability, therefore, remains a key challenge facing the poor against
access to health care. Many Kenyans therefore continue to either have no
access to or cannot afford to pay for their health care needs. It is due to the
failures of the past programs, that the National Social Health Insurance Fund
(NSHIF) was conceptualized for implementation, with a view to providing a

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