President Uhuru Kenyatta recently ordered the Education ministry to ensure that all secondary school students are enrolled to the National Hospital Insurance Fund (NHIF) scheme in the 2018 financial year.
Details on how this will work out and where the funds will come from are scant, but the assumption is that the government has money to meet the needs of the 2,354,786 students in high school as per the Treasury’s 2015/16 FY statistics.
Assuming that each student will cost the government Sh5,000 per year, about Sh12 billion is needed.
The move is commendable as we make strides towards achieving universal healthcare as part of the Jubilee agenda. The chosen group however is peculiar and arouses both suspicion and disappointment in some quarters.
Our health system has glaring staff shortages, more so in informal urban and rural areas. In one case I met six medical staff covering a 1,200 square kilometre area overseeing five health facilities and serving 20,000 residents.
Under-staffing and shortage of facilities have imposed on us the need for Community Health Volunteers (CHVs).
With the average distance covered to and from a health facility being 20km, it is impossible for six medical staff to work without using CHVs. As such they form an important cogwheel in the primary health gear. These foot soldiers cover vast terrains helping medics deliver health services. They are crucial linkages with communities.
Almost all are also not paid, receiving occasional stipends from non-profits working in the health sector.
Depending on the region, a community health unit covers from 25 to 40 homesteads with each CHV overseeing about 35 homesteads.
They deliver health information, give First Aid as well as other health interventions including promoting healthy lifestyles.
What makes their circumstance sad though is that when they, or their family members, fall ill most cannot afford the health services they help deliver.
For the group any small token of appreciation, including State paid NHIF cover, would go a long way to show recognition of their efforts even as counties work out how to remunerate them.
Offering the cover to high school students and not acknowledging CHVs is downright improper.
The selection of beneficiaries lacks merit and adds salt to the wounds of hard working CHVs.
Unless otherwise explained, we see this move as a political calculation angling for 2022 when this cohort will be eligible voters for the very first time.
Health advocates must fight to include CHVs as beneficiaries of the free NHIF cover.