Table 3. Summary of NHIF Benefit Package, Kenya Essential Package for Health and Top 10 Leading Causes of Mortality in Kenya .
NHIF National Scheme Benefit Package 41,42 | Kenya Essential Package for Health 2015 28 | Top 10 Causes of Mortality in Kenya in 2009 43 |
Inpatient benefits depend on category of hospitala • Consultation • Hospital daily charges • Nursing care • Prescribed diagnostic laboratory or other medically necessary services • Physician's, surgeon's, anaesthetist’s or physiotherapist's fees • Operating theatre charges • Specialist consultations or visits • Prescribed drugs/medications and dressings Maternity benefits • Consultation and treatment for both mother and child • Child birth including caesarean section deliveries • Family planning services Outpatient benefitsb • General consultation • Diagnostics and treatment of common ailments • Laboratory and investigation • Dental services • Prescribed drugs administration and dispensing • Management of chronic ailments (HIV/AIDS, diabetes, asthma, hypertension, cancer) • Health and wellness education/healthcare counselling such as Screening for conditions eg, cervical and prostate cancer • Treatment of sexually transmitted diseases • Radiology services • Family planning/midwifery/ante/post-natal services • Physiotherapy services • Referral for specialized services |
• Immunization • Child health • Screening for communicable conditions • Antenatal care • Prevention of mother to child HIV transmission • Integrated vector management • Good hygiene practices • HIV and STI prevention • Port health • Control and prevention of neglected tropical diseases • Community screening for non-communicable diseases • Institutional screening for non-communicable diseases • Workplace health and safety • Food quality and safety • Pre-hospital care |
• HIV/AIDS • Conditions arising during the perinatal period • Lower respiratory infections • Tuberculosis • Diarrhoeal diseases • Malaria • Cerebrovascular disease • Ischemic heart disease • Road traffic accidents • Violence |
Abbreviations: NHIF, National Hospital Insurance Fund; STI, Sexually transmitted infection.
a Category A: comprehensive cover for all diseases; Category B: comprehensive cover for all diseases though co-pay required for surgical procedures; Category C: per diem payment for each night of admission.
b The study was conducted before the introduction of outpatient benefits.