April 2018 Dailynation;Details of the grand health scheme President Uhuru Kenyatta launched yesterday for secondary school students can be revealed.
If it is executed as planned, the NHIF cover will be a revolution in the education sector as well as the health sector.
A breakdown of the Sh4 billion-a-year cover, seen by the Saturday Nation, shows that all students in public secondary schools will be insured for treatment of all kinds of injuries and diseases including cancer and Aids.
Those who lose limbs inside school or during educational activities will also be entitled to prosthetic replacements at the insurer’s cost.
Students will also get their surgery costs footed, will be entitled to ambulances on land and on air and will qualify for reimbursement of costs incurred for treatment abroad.
Even male circumcision will be covered under its outpatient provisions, same as guaranteed access to vaccines against Rota virus and rabies.
President Uhuru Kenyatta yesterday said the students’ cover is a product of negotiations between the Education ministry and NHIF.
He ordered NHIF to ensure all learners are able to use it when schools reopen for the second term in May.
NHIF, he added, must also ensure that hospitals involved in the programme are as near to secondary schools as possible.
“The provider must ensure that students access medical services close to the schools. I’m gratified to hear that there are schools that have already started to enlist matrons and nurses to help provide first responder care,” he said at State House during the 2018 Kenya National Drama Festival State Concert.
The president praised the cover as a revolutionary intervention that will ensure students are in school most of the time.
“It is unique to the students since it covers an individual student, unlike the ordinary ones that cover an entire household,” he said.
NHIF chief executive Geoffrey Maina welcomed the launch saying the fund is ready for the task.
“The launch of the comprehensive NHIF medical scheme for secondary school children is called for because quite often, incidences like fires and accidents have elicited a public outcry and the immediate action is an appeal to the government to step in and offset the medical costs of treating the students, clearing medical bills as well as funeral expenses,” he said.
A parents’ representative yesterday welcomed the cover, terming it a welcome relief.
“It will go a long way in solving problems that parents have had for so many years,” said Mr Nicholas Maiyo, the Kenya National Parents Association chairman who was in a team the Education ministry consulted three weeks ago on the cover.
Mr Kahi Indimuli, the Kenya Secondary Schools Heads Association (Kessha) chairman, praised the product, describing it as “better than what the teachers may be getting with AON”.
But he said it should incorporate school sanatoriums and not just hospitals registered with NHIF.
“A student has to go to a facility outside the school to benefit. So we are saying, ‘how do the schools benefit in the same?’ Can the fund support sanatoriums?” Mr Indimuli posed.
In the cover, those like Virleah Wambui who spent 26 agonising days in hospital last year after sustaining burns in a dorm fire at Moi Girls High School will leave their families with an entitlement of Sh100,000 for funeral expenses.
There is also Sh500,000 in life cover to be paid to the family for any student’s death while in school or an educational function.
Virleah was in the intensive care unit for all those days incurring a hefty bill.
The bishops said that the conference should be an extension of the Uhuru-Raila truce.
Yesterday, Virleah — fondly known as Bubbles — was celebrated posthumously by family and friends at Nairobi’s Uhuru Gardens.
It would have been her 15th birthday had she survived the September 2, 2017 fire tragedy that claimed the lives of 10 Form One girls.
Her mother Maryanne Mwangi, who has been inconsolable ever since her loss, appeared determined to let bygones be bygones.
On matters relating to compensation, affected Moi Girls parents are awaiting the outcome of a case against a student who has been charged with arson.
Had the incoming policy been in place when the tragedy happened, by now the parents could have received compensation. Ms Mwangi said she had not received a coin from the government.
The document in our possession indicates that the government will pay Sh1,350 per year for every learner, with the number of secondary school students estimated at three million.
“The scheme does not have exclusions save for cosmetic/beauty treatment or surgeries,” it says.
Expenses that ordinarily make parents jittery like laboratory tests, X-ray services, prescription drugs, consultation fees and treatment of chronic illnesses will be covered.
“In-patient physiotherapy, hydrotherapy, chemotherapy and radiotherapy are also covered,” the document says.
“All treatment as prescribed by the attending clinician or doctor are covered, accidental reconstructive surgery is covered but cosmetic treatment in nature shall not be covered,” it adds.
TEETH AND EYES
Students will also be assured of treatment for problems pertaining to their teeth and eyes.
Those who will be admitted in hospitals will also enjoy full cover throughout their stay, provided they are in facilities that have a contract with NHIF.
“Bed entitlement for inpatient services shall be accessed in government healthcare providers, ward bed rooms in mission/faith-based healthcare providers and private hospitals,” the document says.
Even those who will be nursed from home will not have to pay for the services, thanks to the cover.
In fact, a student injured in any school-related event even outside their institution’s premises is covered.
“The scheme shall ensure portability of services even when students are on educational functions outside their school or during school closure,” it says.
A staffer at insurance firm Sanlam Kenya, who we cannot name as she had not been authorised to speak on behalf of her employer, described the cover as “very good”, saying that if the government delivers what it had promised, then Kenyan learners have healthy days ahead.
“No insurer in Kenya has such a cover for children under the age of 18. They are mostly included in their parents’ policies,” she said.
The Sanlam staffer noted that if parents were to personally pay for a cover with equal provisions, each student would have to pay at least Sh7,000 a month.
The Education ministry cover, the breakdown states, applies to all learners — whether their parents are remitting monies to NHIF or not.
“Members shall be registered and issued with biometric cards for identification and access service,” it says. “The waiting period for new members will be set as zero days. The cover commences immediately upon registration and payment of premium into the scheme.”
Mr Maiyo, the parents’ association chair, said one of the benefactors’ biggest burdens may be a thing of the past.
“Whenever a child was injured in school, we used to carry the burden. The first thing the principal does is to call the parent, maybe when the child gets injured in the field or is in a fire tragedy or any other accident. Normally, parents shoulder the medical bill,” said Mr Maiyo.
But the Kessha chair foresees problems. One of them is that medical facilities may unnecessarily admit students so as to get higher NHIF remittances.
Mr Indimuli noted that besides the cover provided, the ministry should equip school sanatoriums.
“If a school has a certain number of students, the fund can employ a nurse, or if the school has a thousand-plus, the fund can employ a clinical officer so that some of the cases can be managed within the school with good professionals,” he said.