Better Health
Better Life
Operations
Benefit Package
In line with NHIF Strategic Plan 2018-22, the Fund has continued to review benefit packages to members. In 2016, new packages were introduced after the review of monthly contribution rates. The current benefit packages are: Outpatient; Inpatient; Maternity Package; Renal Dialysis; Kidney Transplant; Radiology Package( MRI&CT Scan); Oncology Package (Cancer treatment – chemotherapy & Radiotherapy); Rehabilitation, Drug and Substance Abuse Package; Foreign Treatment package; Chronic Diseases (diabetes & Hypertension); Specialized Lab Tests; and Surgical Package (Minor, Major & Specialist).
Declaration and Contracting of new Healthcare Providers.
In an effort to speed up the declaration and contracting process of new healthcare providers (hcp) into the NHIF system, the Board (in 2016) suspended pre-assessment audits and accreditation fees. The healthcare providers applying for declaration now only need to fill an application form, attach their hospital registration papers and licenses from relevant government bodies authorizing their operations.
Internal Restructuring for improved service delivery
Towards embracing a competitive business culture and practices, the Board put in place, in 2015, new organization structure comprising four directorates, two heads of department and six regional offices to ensure proper coordination of all NHIF service points spread across all the 47 counties. The reorganization has seen creation of divisions of Communications & Public Education, and Marketing and Customer Service to address the issues of corporate communications, customer service, the Fund’s corporate image and continuous public education on NHIF programmes.
Computerization and Decentralization
NHIF operations have been computerized and decentralized, enhancing efficiency in settling claims and effective management of membership database. The Fund also increased its service accessibility through the current networked 63 fully-fledged branches, 35 satellite offices and service points at most district hospitals countrywide. The branches function independently to offer services similar to any other office across the country.
Cost Containment
The Fund operates a zero-based budget allowing A-I-E Holders to spend within the planned budget. This has enabled administrative costs to be reduced and enhanced line A-I-E Holders accountability.
Member Database
The Fund has about 6.3 million principal members/ contributors as at December 2016. This translates to a coverage of about 25 Million beneficiaries taking an average family size of four people.
Service Accessibility
Expansion of NHIF service points to 98 and 45 Huduma Centres across the country has ensured service delivery closer to the people. The Fund has developed a policy to guide this important exercise into the future.
NHIF is committed to ensuring that the Corporate Social Responsibility Programme is an integral part of its basic strategy and plans. The target is to provide value addition to customers, employees’ welfare and community relations while supporting our environment. The Fund has a CSR (Corporate Social Responsibility) policy that outlines the organizations commitment to good business practices, which provide value to all strategic stakeholders.
CSR programmes generally focus on the broader issues such as combating diseases, alleviating poverty and hunger, education and sanitation. The Fund seeks to build a system of establishing and sustaining long-term partnerships with stakeholders by being responsive to the specific needs of these stakeholders.
Donations constitute initiatives, either by request or through national concerns that invite the organization to give by way of a grant to specific projects either in cash or kind. Whenever the Fund makes such donations, there is no expectation of material gain from that community or groups but NHIF will strive for corporate recognition, credibility and reputation.
These initiatives seek to develop partnership with the local communities in health, environment and social development activities, that contribute to long-term economic development of these communities and to partner with other organizations in supporting programmes that are related to our business
Company Profile:
National Health Insurance Fund (NHIF) – a state parastatal is established under NHIF Act No. 9 of 1998 with the mandate to provide medical insurance cover to all its members and their declared dependants.
SA8000 Standard:
Social Accountability 8000 (SA8000) is a global standard to improve human rights in the workplace. SA8000 is a certification standard, based on the core conventions of the International Labour Organization. The Fund is committing itself to embracing the best Human Resource practices through the certification of SA: 8000:2008. NHIF has included the requirements of the SA: 8000 as an integral part of its service delivery and therefore subscribes to its principles below that:
The Fund shall not engage in or support the use of child labour as defined by law.
- NHIF shall not engage in or support the use of forced labour.
- NHIF shall provide safe, healthy and humane working conditions for its personnel on a continuous basis.
- NHIF shall respect the rights of all personnel to form and join trade unions of their choice and to bargain collectively.
- NHIF shall not engage in or support discrimination.
- NHIF shall not engage in or support the use of corporal punishment, mental or physical coercion and verbal abuse.
- NHIF shall comply with applicable laws and industry on working hours.
- NHIF shall ensure that wages paid for a standard month shall meet the industry or legal minimum standards.
- NHIF shall define clear policy on SA: 8000, appoint both a management and worker representatives, hold management review meetings, ensure that suppliers/subcontractors/sub suppliers commit to the SA in their contractual agreements, and maintain appropriate records to demonstrate conformance of the standard.
In line with Section 9.13 and 9.14 of the SA 8000 policy manual, the Fund shall regularly communicate with all interested stakeholders and keep them informed about the SA: 8000 standard through this website. Any report of non conformance identified against the organization’s policy and/or the requirements of the SA: 8000 standard can also be sent through email at hresource@nhif.or.ke.
NHIF is committed to Responsible Social Health Insurance Initiative and Accountability.
