We, the undersigned civil society organizations, and community-based organizations working on HIV, TB, sexual and reproductive health and rights, minority non-discrimination, with key and affected populations and on health and human rights in Kenya, state as follows:
Our attention has been drawn to a recent exposé aired by NTV on 18th June 2023 which revealed that several private hospitals in Nairobi and Meru Counties were involved in a complex syndicate collaborating with dishonest National Health Insurance Fund (NHIF) personnel to unlawfully exploit unsuspecting citizens and misappropriate healthcare funds. The expose reported inflation of medical care bills, gratuitous administration of medical care and ineligible administration of medicine to patients who were tricked into accepting healthcare services from officers of the medical facilities in Nairobi and Meru Counties. The information revealed through the exposé raises the need for urgent action, including holding those involved to account and undertaking reform in the way NHIF operates.
Corruption in the health sector diverts resources, causes inequitable access, compromises healthcare quality, and weakens health systems. It creates disparities that make healthcare unaffordable. To protect the right to health, it is vital to address corruption through transparency, accountability, and anti- corruption measures that ensure equal access to quality healthcare services. As a public institution, NHIF plays a critical role in facilitating access to healthcare services for Kenyans. Consequently, any implication of corruption within NHIF is both unacceptable and highly worrisome. Corruption undermines the trust of citizens in government and is especially detrimental in a contributory scheme such as NHIF. Currently, NHIF has enrolled only 20% of Kenyans, leaving out the bulk of 80 % majority of whom are exposed to catastrophic out of pocket expenditures to access health services. Corruption within NHIF impacts negatively on the enjoyment of the right to health as enshrined in the Constitution of Kenya and to the achievement of Universal Health Coverage (UHC) in Kenya.
We also take note of the fact that the Cabinet Secretary for Health and the chair of the Council of Governors have recently signed an intergovernmental agreement to streamline the health sector. It is reported that one of the first actions of this agreement is said to be the roll out of effective Universal Health Coverage (UHC) in all 47 Counties in Kenya with the aim to transform NHIF into a Social Health Insurance Fund (SIF). We are concerned whether such an endeavor will be successful if the current trend of corruption at NHIF continues. It will be important for the Ministry of Health and Council of Governors to make this agreement public.
The health sector in Kenya is due for a revamp thus efforts must be made to hold those accountable for corruption and to implement strong systems of transparency and oversight to prevent corruption. It is crucial that the government and relevant authorities prioritize investigation and prosecution of people involved in the current scandal contrary to past practice of culpable individuals not being held accountable.
Action must be taken to protect public funds from waste and pilferage, and to ensure that such funds are utilized to facilitate access to health care.
We therefore call upon the following authorities as follows:
- Ethics and Anti- Corruption Commission to thoroughly investigate the allegations of corruption within the National Health Insurance Fund and take appropriate action against the perpetrators.
- Kenya Medical Practitioners and Dentists Board to conduct investigations on the facilities and staff involved in the scheme and to take disciplinary measures on institutions and medical practitioners found culpable of professional misconduct.
- Kenya Pharmacy and Poisons Board to investigate the unauthorized administration of medicines by the institutions accused of misconduct and to provide a public report of the findings for public scrutiny.
- Office of the Directorate of Public Prosecutions to direct investigation and guide the conduct of criminal investigations into the individuals involved in the embezzlement scheme and to institute and undertake criminal proceedings against any person alleged to have participated in the embezzlement scheme before a court of law.
- Office of the Auditor General to investigate whether NHIF is effectively and lawfully using public money raised for access to quality healthcare services.
- Ministry of Health to, in line with the provisions of the Access to Information, issue a copy of the intergovernmental agreement to streamline the health sector signed by the CS for Health, Nakhumicha S. Wafula and Chair Council of Governors, H.E Anne Waiguru.
We applaud the media for the excellent investigative journalism and for exposing this scandal.
We urge the above institutions to ensure transparency and accountability in the conduct of investigations in this case and to ensure prosecution of those found culpable.
Endorsed by the following organizations:
- Kenya Legal and Ethical Issues Network on HIV and AIDS (KELIN)
- NivalishePad Initiative
- Men For Positive Living Support (MOPLS) CBO
- Network for Adolescents and Youth of Africa (NAYA)
- Picture Youth Group Organization
- Centre for the Study of Adolescence
- Youth Empowerment Movement Kenya, YEM Kenya
- Nelson Mandela TB HIV Information CBO, Kisumu Kenya
Youth Alive! Kenya
