NHIF’s legal mandate to extend health insurance coverage in Kenya and achieve a universal health coverage system

Abstract

An analysis of NHIF’s history reveals efforts by Kenya to extend health insurance coverage to all Kenyan citizens. However, upon further investigation, it becomes apparent that the NHIF encountered barriers, such as socio-demographic factors and knowledge gaps, while striving on this journey. A doctrinal research method identifies deficiencies in adequacy, affordability, accessibility, and availability in NHIF’s operations. Furthermore, administrative inefficiencies, inadequate communication between the NHIF and its beneficiaries, and a lack of accountability further exacerbated challenges, eroding trust in NHIF’s capabilities and deepening disparities among benefit members. An exploration into the insights from South Korea experience recommends multifaceted reforms across policy, legal, and institutional domains. Policy reforms were found to be vital to enhance awareness campaigns aimed at addressing knowledge gaps. Additionally, financial support programs to assist marginalized and indigent groups would be invaluable. Legal reforms advocating for accountability measures and antidiscrimination legislation were also deemed essential, to address transparency and accountability concerns, and discrimination cases against privately insured individuals in comparison to their cash paying counterparts. Finally, essential institutional reforms in community engagement and supply chain management are crucial to raise awareness of benefit packages and ensure consistency in the drug supply chain within the community. In conclusion, sustained efforts are necessary to achieve universal health coverage in Kenya. Collaborative attempts can overcome barriers and ensure equitable, affordable, and quality healthcare for all citizens.