1. Patients in a typical health facility

2. Demand for healthcare
OVERCROWDED FACILITIES

4. The Financing gap
‘The Kenya government financing of health care
stands at about 50 percent of acceptable
minimum health services.
Households’ contribution (out of pocket private
expenses) (at 43 percent) exceeds the
government (at 30 percent) contribution to
the total health care financing.
On recurrent health care cost, government
finances 50 percent, private sources
(insurance and out of pocket) 42 percent,
while donors, NGOs, mission hospitals and
other institutions contribute six
percent(source Dr. Wahome Gakuru ),

5. Perceptions of private health
insurance
For profit and commercially motivated
Too many exclusions and limitations
Services meant for upper class and middle
class leading to cost escalation
Targeted at those in employment
Concept not understood by the population
at large

6. Health Shocks
Health shocks, defined as unpredictable
illnesses that diminish health status.
Households facing health shocks are
often affected by both the payments
for medical treatment and the income
loss from an inability to work

8. Effects of Health
Shocks Out-of-pocket payments
for outpatient services
or drugs, particularly
among people with
chronic conditions,
could amount to a great
deal of money and may
be even more
detrimental to patients
and their families
Outpatient
over the long-term; they
differ from out-of-pocket
payments for
inpatient care, which can
involve large sums of
money in a short period
of time.
Inpatient expenses may
also correspond to more
unpredictable forms of
illness that patients may
be poorly equipped to
deal with

9. Coping with out-of-pocket health payments:
empirical evidence from 15 African countries
(Adam Leivea & Ke Xub)
• Research indicates that in most African countries,
around 30% of all households financed out-of-pocket
health expenditure by borrowing and selling assets
• About 50% of the households with a hospitalization in
the previous year did so across countries, while the
figure was less than 40% among those whose health
services did not include hospitalization..
• The utilization rate of inpatient services of any
household member within the previous year was
between 10% and 20% in most countries.
• Monthly out-of-pocket payments on outpatient and
inpatient services varied widely by country; however,
out-of-pocket payments for inpatient care were
greater than for outpatient or routine services

10. Suggestions
Become the primary source of risk pooling for
large segments of the population as our
middle class grows
Complement the NHIF by providing what it
does not cover such as dental and other
outpatient services or other identified gaps
such as access to specialists and elective
surgery
The government to provide increased
oversight through policies, incentives and
regulations to protect the public and
providers