The National Health Insurance Fund (NHIF) is the social health insurance provider mandated to cover all Kenyans against the risk of impoverishing or catastrophic health spending. It is the vehicle of choice for Kenya to achieve Universal Health Coverage as envisioned in the constitution.
Upon this backdrop, the Centre for Enhanced Democracy and Good Governance, in partnership with International Budget Partnership Kenya, carried out a study to provide insights on the level of information provided on NHIF at the county level.
Summary of findings:
- The findings show that not all eligible public health facilities in Baringo County claim funds under the Linda Mama Scheme. Baringo County Government is yet to put in place administrative measures for the coordinated and harmonized implementation of the Linda Mama Scheme across all eligible facilities. The scheme’s performance has relied heavily on individual service providers’ efforts.
- There are gaps in financial reporting from the facility to the County. Generally, budget and facility level documents reviewed lacked details of actual revenue received broken down by revenue by source in comparison with the claims made and justifications for not achieving claim targets.
- Disbursement delays from NHIF to the facility have negatively impacted service delivery. For levels 2 and 3, the delay occurs only from NHIF to the facility. For level 4 and level 5 health facilities, delays occur at two levels, i.e., from NHIF to the Facility Revenue Account (which has to forward the funds to the County Revenue Fund Account) and from the County Revenue Fund Account to the Facility Operations Account. These delays have led facilities into debts: depletion of drugs and critical supplies, low motivation of staff remunerated at the facility level due to delays in payment of wages and withdrawal of services by this cadre of staff.