3.4 Million Students Without Medical Coverage as NHIF Ends Ksh.4.5 Billion EduAfya School Insurance Scheme
The National Health Insurance Fund (NHIF) has terminated the Ksh.4.5 billion EduAfya school insurance scheme, leaving over 3.4 million students without medical coverage.
For the past four years, the EduAfya program has provided full medical insurance coverage to students enrolled in public secondary schools that are registered with the National Educational Management Information System (NEMIS).
According to the most recent medical plan report, 606,893 students out of 2.7 million covered sought medical attention in 2019.
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The ruling now puts parents and educators in a difficult position regarding the potential impact on student’ well-being.
The Kenya Secondary School Heads Association (KSSHA) has urged the government to secure the continuation of the program, which ended on December 31, 2023.
The action, according to KSSHA Chairman Indimuli Kahi, is unwise. “The EduAfya program should not be discarded…we need to look at it and ensure that the benefits that were realized with NHIEF are not lost,” Indimuli stated.
Secondary school principals, according to Indimuli, have also proposed a slew of adjustments to the plan. Some of the recommendations include lowering the Ksh.1,600 premium paid every student per year, which is deemed excessive.
“The figure of Ksh.1,600 being taken per child, we felt it was a little bit too high, because the school was left with nothing to be able to manage certain illness…for example payment of school nurses, taking children to hospital was an extra cost,” he went on to say.
The Universal Health Bill, which went into force two months ago, has created a fog of uncertainty. The medical scheme is not included in the new organization that will replace the fund as a result of the reforms.
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“The idea of having a collective pool was very noble and should not be forgotten because we look at schools that have large numbers…for schools that do not have the numbers, it becomes a challenge for them,” Indimuli said.
Susan Nakhumicha, Cabinet Secretary for Health, has revealed why the EduAfya Medical Scheme will be phased out once the Social Health Insurance Act, 2023, goes into effect.
The Sh4.6 billion earmarked to the plan will now be transferred to the Primary Healthcare Fund, where learners will be covered alongside their households, according to the CS.
Following an order from former President Uhuru Kenyatta, the EduAfya Medical Scheme went into effect in May 2018, and it included students in public secondary schools across the country.
It was made possible by the Ministry of Education’s Free Day Secondary Education program, which covered premiums for over 3.4 million students. The government spent Sh9.5 billion on the initiative between 2019 and 2022.
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The National Health Insurance Fund (NHIF) informed Parliament on November 30, 2023, that the program would die naturally after NHIF is replaced by a new fund.
NHIF Chief Executive Officer Elijah Wachira told the National Assembly Petitions Committee that by December 31, 2023, NHIF would terminate all service provider contracts under EduAfya.
He stated that schools would have to find another health insurer because NHIF would no longer exist.
Following the adoption of the Social Health Insurance Act in 2023, the NHIF will be replaced by three health funds.
The Primary Healthcare Fund, the Social Health Insurance Fund, and the Emergency, Chronic, and Critical Illness Fund are the three.
However, the court stayed the execution of the Social Health Insurance Act of 2023, the Primary Health Care Act of 2023, and the Digital Health Act of 2023 until a case hearing on February 7, 2024.
Justice Chacha Mwita expressed satisfaction that Joseph Aura’s appeal raises crucial constitutional and legal issues that necessitate immediate and careful examination.
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Nakhumicha affirmed that upon resolving the court issue and implementing the Acts, the ministry will give priority to establishing the Social Health Authority, tasked with managing the three health funds.
The stalling of the execution of the three health Acts is currently a heated topic, with President William Ruto accusing the Judiciary of working with cartels to thwart changes in the health sector.
In February, a citizen petitioned the National Assembly to intervene in the Edu-Afya Medical Scheme’s poor execution in public secondary schools.
In a statement to the House, Speaker Moses Wetang’ula declared that the petitioner, Joyce Cherono, asserted that the system had not yet been optimized. The government paid a price of Sh1,350 per student for the coverage.
They aimed to reach three million students in public secondary schools in order to complete the Big Four Agenda’s provision of inexpensive health care.
The petitioner requested that the House direct the relevant ministries to conduct an urgent review of the scheme’s implementation structure to ensure that it serves all public secondary students equitably.
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Cherono hoped that the House would persuade the government to support the development of clinics within public secondary schools, as well as to commence the hiring and deployment of qualified, registered, and licensed medical workers.
Between 2019 and 2022, the NHIF got Sh9.5 billion from the government under the EduAfya program.
Outpatient and inpatient care, day surgical services, local road ambulance, and emergency air rescue services are all part of the program.
The National Parents Association head, Silas Obuhatsa, warned on Tuesday that ending such a program could harm the most vulnerable pupils.
Obuhatsa stated that the medical system has been a pillar for students suffering long-term diseases and that failure to extend it could jeopardize their education and lives.
“There will be a big problem, remember this is a programme that was aimed at providing preventive, curative and managing chronic diseases, so what will become of the beneficiaries?” Obuhatsa inquired.
It is yet unknown whether the lack of medical coverage would have an impact on student achievement or contribute to increasing absenteeism.
Although Principals believe that providing medical care is a great goal, they question its finance strategy.
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3.4 Million Students Without Medical Coverage as NHIF Ends Ksh.4.5 Billion EduAfya School Insurance Scheme
