NHIF payments to be deducted from Mpesa — Kagwe

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Mutahi Kagwe was appointed into the Health docket almost two years ago. As he was settling into office, Covid-19 hit the country.

The CS has been Kenya’s face of the fight against Covid-19. He has vowed to continue working for the Jubilee administration, even as some Cabinet Secretaries quit to pursue elective positions.

Kagwe spoke to the Star Coast Region Chief Correspondent Charles Mghenyi on the sidelines of the Health Workforce Conference at Sarova Whitesands in Mombasa.

Waziri, many Kenyans are yet to understand Universal Health Care.

There is a misconception about what UHC is all about. UHC is not a concept of giving money to vulnerable people, but rather ensuring that all Kenyans have access to quality health services.

UHC is an encompassing idea, encompassing strategy, which touches on so many facets of healthcare that ultimately result in Kenyans being properly cared for in terms of health services.

What are these facets?

There are three aspects that we need to consider, that is affordable healthcare, access to health and the quality or the standard of the services.

Affordable health means no matter what happens, one can afford to go and get treated. Today, we noticed it for the first time at Coast General Hospital. At the Cathlab, we did the first ever stem cell in a government facility.

The cost was Sh400,000 and the patient was registered with NHIF. He walked in and walked out, having received the best treatment available anywhere in the world without paying anything. He walked in with sickness, and walked out better. That is affordable healthcare.

Access to health means that even if health services are free, are the services available? There is no point in telling people they can get free treatment and there are no hospitals or equipment.

That is why we have built hospitals in Nairobi and across the country. It is why we are equipping the hospitals with ICU facilities and why we have over 7,000 Covid-19 isolation centres.

The last facet of UHC is the standard of health services that we need to maintain in the country. It is not the brick and mortar facilities.

We need to ensure we have the best and the most qualified staff. Whether a doctor, clinical officer or nurses, we have to make sure those people are properly trained, both in quality and quantity.

Have we made strides in achieving UHC, are we close to hitting the 100 per cent rollout of this programme?

We have not achieved 100 per cent rollout of UHC. It is very unlikely that we will achieve it. The concept of achieving it should be such that we do not have a discussion on whether we have achieved or not.

We will only say we have achieved when it is pretty obvious that every Kenyan can get medical care as it is elsewhere in the world.

Waziri, is it mandatory for all Kenyans to be registered with the National Health Insurance Fund?

It is not mandatory, but it is mandatory for anybody who can afford it.

There are many ways of knowing you can afford it. If you are banking Sh20,000 per day from selling mitumba in Gikomba that does not mean you cannot pay Sh17 every day.

Why do you expect people to do a harambee for you when you get sick and you have a chance to pay Sh17 per day for your own and family health insurance? Surely,you can afford Sh17 per day.

What is the government doing to ensure more Kenyans contribute to NHIF?

We are in discussions with mobile money service providers like Safaricom, so that when you are doing your daily money transactions, they can deduct something from your transactions, if you allow them.

If you allow them to deduct Sh17 every day from your daily transaction, you wouldn’t even notice it. The money is submitted to NHIF and by the time you realise, your cover is in place.

That is the sort of thinking we must have and appreciate that taking care of one self is your responsibility.

Where are you with this plan?

We have done a lot of work with them, we are in the negotiation stage. In the next couple of days we will be announcing this particular scheme to the Kenyan public.

Because we have started this scheme, you will be hearing a lot of things happening, as we move on. It is a journey, we are journeying in the legislative area, healthcare and infrastructure

Do you have a target of how many people should be registered with NHIF by the end of the year?

We do have a target. Ideally, the government wants to get as many people as possible, if they can come out tomorrow, the better.

We want to cover everybody. We do not want that in two years people still get sick and cannot access UHC. Every year, we want to register at least a million people, who cannot pay for themselves.

Do we have enough personnel for UHC rollout?

Yes we have, as a matter of fact we are exporting personnel to other regions. Anyway, this is a mixed bag, because in some carders we have an excess and in some carders we do not have some specialists.

For instance, for esophagus cancer, we have very few specialists in Kenya. However, in clinical services, nursing we have so many who are even poached by other countries.

It is also good for our people to go and work out there. When people work overseas, they come back with a better outlook for how things are done.

What is the importance of having this Health Workforce Conference in Kenya?

To look at the health curriculum we have been using to train our people. This curriculum was put together so many years ago, and the world has moved on. Things have changed. 

When the drum beats change, the dancer’s steps have to adapt.  We are trying to change the steps because the world has moved on.

In India, you will find a battery of specialised doctors around you discussing your issue. Here, in Kenya, you will find that we have a bit of a possessive concept of treatment, where a patient is somehow owned by the physician.

We want to get away from that, the focus is on the end results. We are also here to address the issue of standards. When we talk about standards, we are not talking about training people in technical issues only, we are also talking about training them on non-clinical issues.

The care of the people, the empathy you must show a patient. This conference is a very successful one. I have no doubt that it is going to be of interest because this has not happened for so many years.

Finally, everyone is quitting government to pursue elective politics. We have not heard anything from you.

It is the right of every Kenyan to go and participate in the electoral process and vie for any seat, but to answer your question directly, no, I’m not resigning.

I have given a lot of thought to this issue. Therefore, I did not do so lightly. I was called to this government, just over two years ago by President Uhuru Kenyatta, to serve in this specific capacity.

For whatever reason, I happened to be there when Covid-19 hit us and it is still there. We are still grappling with this pandemic and in my thoughts, I do not feel it will be responsible on my part to abandon the course at this critical moment to go and run for an elective position.

As long as the situation is the way it is, as long as it is the President’s pleasure that I serve in this capacity, I don’t feel inclined to resign and do anything else. If I can stay behind and save the lives of five other Kenyans, it will be well thought I don’t resign.

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