By Reporter
Lack of national identity cards among many residents of Kilifi County is hampering membership registration under the Social Health Authority in the devolved unit, officials have said.
Officials at the Malindi Sub County Hospitals say many patients have had difficulties in accessing the services provided under the Universal Health Care (UHC) since they are unable to register with the new authority that replaced the National Health Insurance Fund (NHIF).
This was one of the reasons why only a paltry nine percent of the county’s 1,453,787 residents (as per the 2019 census) have been registered with SHA, the officials told journalists at the public health facility Thursday.
Other reasons cited were lack of mobile phones, lack of awareness and misinformation arising from negative publicity as well as former NHIF principal members who migrated to SHA but had not added their dependents into the new system.
Ms Getrude Mbeyu, the nursing officer in charge at the Malindi Sub County Hospital, said the hospital had started a programme of registering all patients admitted into the wards to help them benefit from the new health insurance, but the problem had been the lack of ID cards.
“When SHA came into force, all principal members under NHIF were mygrated into the new system but their dependents were not. It is the responsibility of the principal member to register the dependents, who must also have birth certificates for minors and national identity cards,” she said.
Ms Mbeyu said the hospital administration had stationed officers in all the wards to register patients so that they do not have to pay for the services, but noted that many of the patients do not have ID cards while other do not have mobile phones with which one is required to use to register.
She encouraged residents to acquire the important registration document in order to access the services under the new health insurer, which she said had more advantages both to the residents and public health facilities, than under the defunct NHIF.
Hospital administrator Said Ali said under SHA, government health facilities would get enhanced funds since the new authority was paying the same amounts of money to facilities of the same level, whether public or private, for similar services rendered.
“Under NHIF for example, level four hospitals were getting Sh5,000 per patient while private hospitals in the same level were paid Sh10,000 per normal delivery and Sh10,000 and Sh30,000 respectively for deliveries under cesarean section. Now, both private and public facilities will get Sh10,000 and Sh30,000 respectively for the services,” Mr. Ali said.
He said levels one to three health facilities used to get nothing from NHIF, but under SHA, each of them will get a capitation according to the number of patients it will serve, noting that this would help the facilities, most of them in the rural areas, to operate better.
CPA Baraka Ndilo, the Chief Accountant in charge of Malindi and Magarini Sub Counties praised the new health insurance system in the country, saying it had enabled poor and vulnerable people to access services.
“If people know that whatever they are contributing helps those who do not have anything to contribute because of poverty, they will not feel the pain of contributing to the fund,” he said.
He urged SHA to review the policy that one has to be served at level one to three facilities before going to facilities of higher level, so that those who contribute huge amounts can be seen directly in facilities in levels four and above.
This, he said, would help contributors to seek services at facilities of their preferences, saying many of them had opted to pay for services at private hospitals to preserve their egos.
Patients interviewed said the services they were receiving at the facility were good but asked SHA to improve the system, which they said were facing teething hiccups.
However, civil servants said they were no longer receiving the comprehensive care they used to get under NHIF despite the fact that SHA extended the same up to November 21, 2024.
The officers, who spoke on condition of anonymity, asked the Public Service Commission to contract a different insurer for the scheme or reinstate their medical allowances so they could look for alternatives privately.