By Pauline Achieng’ Tom @pauline_tom
The National Insurance Fund (NHIF) announced that it is going to cut renal dialysis payments from the current Sh9,500 to Sh6,000, the move has caused an uproar among patients and doctors and hospitals.
According to NHIF, dialysis is currently its single largest medical insurance claim with an increased payout of 41 per cent since 2019, with a payout of Sh1 million every year per patient.
Over 4 million Kenyans suffer from chronic kidney disease (CKD), the once considered a lifestyle disease now affects low- and middle-income families, this has seen the government invest in dialysis units totalling 210 units by 2020 across the country to handle the increasing demand for the service.
According to Professor Seth McLigeyo, Consultant Nephrologist, dialysis is extremely important for chronic kidney disease patients as it increases their chance of survival and quality of life. “Since the kidneys of a CKD patient cannot function properly dialysis is used to mechanically remove the waste material and excess fluid from the bloodstream, no dialysis usually leads to kidney failure and death,” he said.
Currently, 10,000 chronic kidney disease patients suffer from end-stage renal failure but only 10 per cent of them are on dialysis, this is despite coverage of the cost of dialysis, many patients still cannot afford the incurred costs needed for dialysis this, in turn, has put a lot of patients at risk of mortality.
Most kidney patients solely depend on NHIF to cater for their dialysis and can barely afford the additional cost that comes with the procedure, this move by NHIF will see many patients suffer and increase the mortality rate associated with chronic kidney disease.
The Kenya Association of Private Hospitals has threatened to stop offering dialysis services by its members, this will adversely affect the dialysis services since there are more dialysis units are in private hospitals compared to public hospitals.
“If private hospitals stop offering dialysis the number of patients who can access these services will significantly reduce and at the same time a huge burden will be placed on the few public centres thus inadvertently overloading them,” warned Prof Mcligeyo.
The NHIF also seeks to increase the number of dialysis from two times a week to three times a week to match with international standards, the difference of which is to be covered by the patient this coupled with other costs such as those of filters and immunity boosters are incurred by the patient, this raises a lot of concern as the fear is that many patients will opt out of dialysis thus decreasing the gains made by the renal sector.
Through their president, John Gikonyo, The Renal Patients Society of Kenya termed the move by NHIF as alarming urging for further consultations in the future with stakeholders before decisions are made. “NHIF needs to embrace public participation and also involve stakeholders in this decision, as well as all the future changes and amendments they have committed to providing to their members.”
Lamenting further on the Funds increment in dialysis sessions from two to three a week saying, “these changes do not result in any dialysis cost-saving for NHIF and we are at a loss for what gain are they being affected.”
Mr Gikonyo further insisted on the need for further consultation while also lobbying the fund to increase the transplant package from Sh500,000 to Sh800,000 to include pre-transplant evaluations and post-transplant medications. The Renal Patients Society of Kenya insisted that they were grateful for the current package but hope more can be done to improve the quality of life for renal patients in the country.