NHIF system glitch leaves thousands of kidney patients stranded

The National Hospital Insurance Fund building in Nairobi. 

Photo credit: File | Nation Media Group

A glitch in the National Health Insurance Fund (NHIF) entered its second week Monday, dealing a blow to patients reliant on it for payments towards kidney dialysis.

The system hitch has caused a major backlog in the approval of dialysis sessions, inconveniencing thousands of patients with the life-threatening condition.

Patients fully reliant on NHIF have been forced to raise alternative cash to pay for dialysis or miss out on the treatment.

Jonathan Wala, chairman of the Kenya Renal Association, said that the NHIF has linked the situation to the initially planned switch to the new Social Health Insurance Fund (SHIF) on July 1. The shift to SHI has since been postponed to October 1, 2024, amid challenges with the digital platform designed to support contributions and registration into the scheme.

“Patients in need of dialysis in various hospitals have been forced to wait since there are a lot of claims that have not been approved because of the slow system. This is also causing a lot of confusion for both the healthcare providers and the patients,” he said.

“The challenges NHIF has created, the small transition time window, and the job security threat faced by employees makes this transition from NHIF to Social Health Authority (SHA) an even more precarious one,” Dr Wala added, noting that stand-alone dialysis centres are particularly affected by the issue as they have no other source of income apart from NHIF reimbursement. The stand-alone centres exclusively deal with renal ailment.

NHIF members are entitled to two dialysis sessions per week, each costing Sh9,500, bringing the total annual payment to an average of Sh960,000.

Healthcare providers have also reported technical problems with the main NHIF service portal, making it difficult to serve patients who now forced to pay cash for healthcare services. The system failure on the main NHIF portal was first reported on Friday.

The development puts NHIF in a difficult position at a time when it's been re-contracted to receive contributions from Kenyans until September.

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