When the world around you crumbles in seconds: Chronic illness, disability in old age and
yet no funds to purchase insurance
On a Thursday afternoon amidst the heavy rains in Emorijoi village ( Narok ), we drive
towards the homestead of Mr Tirop. The heavy rains and the slippery murram roads make it
difficult for us to travel faster thus journey that usually takes 30 minutes drive during dry
weather today takes almost one and a half hour.
As we make our way to the compound, we are warmly received by the family. Mr. Tirop
aged 90 years and his late wife Rael had lived together for the last 68 years. His wife was
blind and lived with diabetes – a chronic condition that required her to seek health care on a
monthly basis. The elderly couple had been enrolled under the government’s ‘‘Inua Jamii
program’’. The program provides cash transfers to help uplift the lives of poor and vulnerable
citizens of Kenya through disbursement of regular and reliable bi-monthly cash. Mr. Tirop
and his wife used the funds they received to purchase food and subscribe for their NHIF
cover.
As the effects of COVID 19 pandemic became significant in Kenya, the Inua Jamii program
erratically disbursed funds to the elderly hence most of them like Tirop defaulted their
monthly insurance subscriptions. With no stable income Mr. Tirop could not afford to pay
for NHIF hence his cover was suspended which meant that he could only access health care
by paying out of pocket. This financial hardships was even severe when the wife was
admitted in hospital and the family had to sell some of their livestock to cater for hospital
bills. Unfortunately, despite receiving treatment Rael passed away.
Mr. Tirop is among the many elderly villagers who face challenges in accessing health care .
With no feasible source of income they have to pay out of pocket when seeking health care –
a great financial burden that very few can manage hence they resort to staying at home with
the hopes that they miraculously get healed. These catastrophic out of pocket payments are
more severe for the poorest households and in the rural areas due to costly and frequent
outpatient health services. The elderly and those with chronic conditions suffer more
financial hardships as they regularly visit health facilities for health care..
Despite NHIF & government making numerous reforms to protect the citizens against
financial risks associated with illness and healthcare seeking behaviour, evidence shows that
Kenya still lags behind. In Kenya, unemployed families have to part with at least KShs.
500/= per month as premiums for subscription for monthly National hospital insurance fund.
Even though the subscription rates look affordable, the situation on the ground paints a grim
picture. Most households in Kisaruni community live on less than a dollar per day hence
such families are left with the tough choice of either paying for health insurance premiums or
purchasing food. More efforts and different strategies are needed to protect the most
vulnerable population groups from the high costs of seeking health care.
Kisaruni community action organization(kcbao.org) is working with communities to
empower them to subscribe to NHIF as a sustainable way of seeking health care. We are
using a mix of innovative strategies to hence the financial capacity of community members to
pay for the monthly premiums. Today we paid the insurance premiums for Mr . Tirop’s NHIF
coverage as a way of ensuring that he is able to access health care for the next 8 months.
As we hand over to Tirop the NHIF card that has 8 months premium subscription he joyously
acknowledges. “This is the best gift I have received for a long time. I feel lucky that I will be
able to easily access health services in the nearest facilities. The days I have had to spend
sleepless nights because of joint pains and other minor ailments are surely going to be over.”
As we drive from the homestead, we are overwhelmed by the gratifying experience of
witnessing how only KShs. 500 per month (though little but not easily affordable) can have
so much positive implications in an individuals life.
As we hand over to Tirop the NHIF card that has 8 months premium subscription he joyously
acknowledges. “This is the best gift I have received for a long time. I feel lucky that I will be
able to easily access health services in the nearest facilities. The days I have had to spend
sleepless nights because of joint pains and other minor ailments are surely going to be over.”
As we drive from the homestead, we are overwhelmed by the gratifying experience of
witnessing how only KShs. 500 per month (though little but not easily affordable) can have
so much positive implications in an individuals life.
