NAIROBI, Kenya, Apr 28 – The Kenya Medical Association (KMA) has opposed effecting new charges for National Hospital Insurance Fund contributions and the commencement of the new scheme until consultations are held to resolve underlying issues.
Issues the association wants ironed out include how decisions concerning the health care providers were arrived at, and how a choice was made on the disbursement of funds to the providers.
KMA national chairman Elli Nyaim Opot and the chairman of KMA’s Eldoret division Lukoye Atwoli told journalists in Nairobi that the new scheme ought to start after all stakeholders are satisfied with all the issues.
“KMA strongly condemns the opaque manner in which the comprehensive cover for civil servants and other contributors was made. The issues in question include the possibility of conflict of interest on the part of the NHIF board, management team and the allocated providers,” Opot said in resolutions read out after the association’s Annual General Meeting.
“The providers were initially selected by NHIF and allocated to the contributors, disbursements of funds were also done to the providers without known criteria and we are asking that these issues be looked into,” added Atwoli.
The Central Organisation of Trade Unions COTU and the Kenya Medical Practitioners Pharmacists and Dentists Union have also raised questions over the capacity of NHIF to handle such a large scheme that also offers outpatient cover.
The new rates expected to be effected in May will see those earning over Sh100,000 remit Sh2,000 a month while those earning less than Sh6,000 will contribute Sh150 monthly.
In March, the NHIF manager in charge of Planning and Strategy, Chacha Marwa told Capital FM News that guidelines on how contributors ought to choose their providers will be made before the commencement of the new rates in May.
Opot challenged the government to hasten the enactment a laws providing for health tax on income instead of the government leaving the responsibility to individual contributors.
The newly elected chairman insisted that doctors must be involved in the drafting of legislation and revising existing laws to align them to the new constitution.
“Doctors of Kenya will not accept governance structures in the health sector that relegates the doctor to the status of a mere observer in a field where they are expected to major policy drivers,” he insisted saying that the association will lobby to ensure that national and county health administrators are experienced doctors.
Issues causing discomfort for the association in the draft Bill include the definition of healthcare providers, over emphasis by the Bill on reproductive health and the qualifications of members of the proposed Health Services Authority.
Other measures that the medical association want addressed is the immediate implementation of the Mutava Musyimi taskforce report that was handed over to the Ministries of Health in February and the inclusion of the association in the drafting of the new Health Bill.
The taskforce recommended that to should set up the Kenya National Ambulance Services within each county and a central coordinating office at the national level within the next two years.
The taskforce further asked the government to fill in existing vacancies to ease staff shortages in health facilities noting that Sh19.75 billion was required to recruit additional staff in the next financial year.
It noted that the country still had a severe shortage of health workers with 16 doctors and 153 nurses per 100,000 people.
This is compared to the World Health Organisation recommended minimum of 100 doctors and 356 nurses per 100,000 people.