Medical Technologies
Confronted with the increasing prevalence of NCDs the government in 2015 introduced the Sh38 billion Managed Equipment Services (MES) project.

This has seen all major public hospitals in the country increase their capacity to screen and treat disease such as cancer, high blood pressure and kidney problems at county level. However in the public sector only Kenyatta National Hospital offers comprehensive cancercare – radiology, chemotherapy and surgery.

Other public hospital offering some cancer care include Moi Teaching and Referral Hospital, Eldoret, Coast General Teaching and Referral Hospital, Jaramogi Oginga Odinga Teaching and Referral Hospital, while all county referral hospitals offer limited cancer care services.

The bulk of cancer care, however, is provided by private hospitals mostly based in Nairobi. In 2011 the Aga Khan University Hospital made history in the region with the opening of an ultra-modern Sh4.5 billion heart and cancer management centre in Nairobi. The centre which also offer specialized fellowship training and research in heart diseases and cancer is the only such private facility in East Africa.

In 2018 the hospital became the first and only facility in the region to install a Positron Emission Tomography (PET) CT scanner. The technology, from General Electric Healthcare, has revolutionalized cancer diagnosis and treatment in the region.

“This will enable doctors to identify health threats at the cell-level thus giving them the best view and time of treatment for complex diseases such as cancer, heart diseases, brain and other central nervous system problems,” said Shawn Bolouki, Chief Executive Officer at Aga Khan University Hospital of the Sh600 million technology. Other facilities offering cancer treatment and care are: AIC Kijabe Mission Hospital, Mater Misericordiae Hospital, Cancer Care Kenya at MP Shah Hospital, Nairobi Hospital, Nairobi Women’s Hospital, Texas Cancer Centre and Tenwek Mission Hospital.

Due to an aging population and increased chronic diseases the Kenya Hospice and Palliative Care Association (KEHPCA) was registered in 2007. Since then the number of palliative care providers in Kenya have grown from seven to fifty-one, reaching an estimated total of 30,000 patients each year.

Satellite Clinics
In the ended decade, Kenya has seen a huge growth in the number of top and middle-tier private hospitals opening satellite outpatient clinics away from the mother institutions. Previously, apart from Aga Khan Hospital which has had a long presence in Nairobi, Mombasa, and Kisumu, most of the other major private hospitals had been centralized in Nairobi. However, this has changed with most opening satellite clinics in the outskirts of Nairobi as well as other towns in Kenya.

Distances to hospitals has been established as a critical factor in how patients seek health care – the further the hospital the most likely some people may fail to seek care when sick. Leading hospitals which have opened various satellite facilities include Mater Hospital, Nairobi Hospital, Nairobi Women Hospital, The Aga Khan, Gertrude’s Children’s Hospital, Metropolitan Hospital, Avenue Healthcare, Karen Hospital among others.

The satellite units offer high quality laboratory, physiotherapy, imaging and consultancy services to patients who may not have had the opportunity to reach the main hospital, says Betty Gikonyo, CEO at Karen Hospital.

The health sector is allocated about six percent of the national budget against a recommended 15 percent. Healthcare is mainly funded by households through out-of-pocket payments at 32 percent, government contribution at 31 percent, donors contribution at 26 per cent and insurance at 13 per cent. The high out of pocket payment has been blamed for a low utilization of health care, inequity, and household poverty.

To address these issues several health financing initiatives have been introduced in the sector since the National Hospital Insurance Fund (NHIF) was established in 1966. The NHIF has been reformed to lead in the delivery of Universal Health Coverage (UHC) launched by President Uhuru Kenyatta in 2018. The goal of Universal Health Coverage is to provide everyone with affordable access to health services.

Established in 1966 to cover the formal sector, NHIF has grown to include the informal sector, civil servants, the disciplined forces and recently indigent populations and maternal care. Currently, about 20 percent of Kenyans have some type of health insurance which is significant growth from about 10 percent in 2003. Of those insured almost 90 percent or 8.8 million Kenyans are covered by the NHIF according to the Kenya Household Health Expenditure and Utilisation Survey 2018. In the 2017/18 period the national insurer paid out a record Sh37.2 billion in medical claims.

Private Health Insurance
The private health insurance market in Kenya has grown significantly over the last 25 years. According to the Insurance Regulatory Authority, there are 29 medical insurance providers and 11 insurance companies offering health insurance products. Approximately 1.5 million Kenyans are covered by private health insurance, up from 600,000 in 2009.

The latest available data shows the gross premium revenue more than quadrupling from Sh 9 billion in 2011 to over Sh 38 billion in 2016. The largest health insurance is Jubilee Insurance Company with an estimated market share of 26 percent, followed by AAR Insurance at 17 percent and UAP with 14 percent. Some other private firms offering health insurance include: Heritage Insurance Company, APA Insurance, CIC Health Insurance, Madison Insurance, Resolution Insurance, Pacis Insurance Company, Kenindia Assurance Company, Britam Insurance Company, and Pan Africa Life among others.

Launched in 2016 by FinTech and payments administrator CarePay, in partnership with Safaricom, PharmAccess and UAP Insurance, M-TIBA has possibly been the most revolutionary health financing facility in Kenya in the last 25 years.

It has a network of 500 participating health care providers and enrolled more than one million Kenyans. M-TIBA enables subscribers to save, send, receive and pay for medical treatment through their phone. It also enables friends and family to send funds to loved ones exclusively for health expenditures and provides a secure channel for subsidies or vouchers from donors. M-TIBA funds are earmarked for use at participating clinics, which protects them from other uses and improves access to health financing.

Last modified on Sunday, 08 March 2020

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