Improving Health Care for Kenya’s Poor

NAIROBI, October 28, 2014 – While access to quality health care is a constitutional right, millions of Kenyans cannot afford to pay for health services at public or private clinics. Even with public health insurance available since 1966, only 20% of Kenyans have access to some sort of medical coverage. With the population at over 44 million and rising, it means as many as 35 million Kenyans are excluded from quality health care coverage. In addition, a quarter of total spending on health care comes from out-of-pocket expenses.

That is changing, thanks to a collaborative Health Insurance Subsidy Program (HISP), launched by the Kenyan government in April 2014. The program is supported by the World Bank Group (WBG)'s IFC and IDA, and other development partners including UKAid and the Gates Foundation-funded African Health Markets for Equity program.

The new program gives John Nzioka, a 78-year old widower, hope of access to better quality health care.

HISP is an initiative to extend financial risk protection to Kenya’s poorest by providing them with a health insurance subsidy, which covers both inpatient and outpatient care in public and private health facilities. The first phase of the program covers 125,000 Kenyans in 23,500 families, selected from a poverty list developed by the Ministry of Labour, Social Protection and Services, across the country’s 47 counties. These results were then validated at community level to ensure the program benefits the neediest.

“HISP is part of the World Bank Group’s Health in Africa Initiative’s support to the Kenyan Government’s priority agenda of achieving universal health coverage by expanding medical cover to the poorest and vulnerable,” said Cheikh Oumar Seydi, IFC’s regional director for East and Southern Africa. “Through HISP, beneficiaries have access to public as well as private facilities, and a quality improvement program guarantees that the poor will receive high quality care.”

The IFC’s Health in Africa Initiative (HIA) and the World Bank’s Health Sector Support Program lead the interventions in this integrated, innovative program, which is administered through the National Hospital Insurance Fund under the Ministry of Health. The IFC is providing technical support in the design, implementation and evaluation of the program, while the WBG is providing $20 million to support the implementation of the first phase.

HISP opens access of the most vulnerable to public health services and also to accredited private health sector facilities, which are often seen as out of reach for the poorest. The success of the pilot phase will enable the government and its partners to scale up the program to nine million poor and vulnerable Kenyans as part of the universal health care coverage.

“Every year, nearly one million Kenyans fall below the poverty line because of health care related expenditures and expanding health care access will reduce this burden,” said Diarietou Gaye, WBG country director for Kenya. “Our collaboration internally in the World Bank Group, and externally with the government and other partners, will enable health care interventions to contribute to ending poverty and increasing shared prosperity for all Kenyans.”