Tharaka Nithi County has begun a major health insurance push aimed at enrolling more than 440,250 residents under TN-Care, its Universal Health Care programme.
The rollout is expected to start at Mumbuni Dispensary in Muthambi Sub-county, where the county will open registration and then extend the exercise across the region. Officials say the plan is designed to cover over 92,000 households and sharply increase National Hospital Insurance Fund (NHIF) membership.
At the moment, 36,894 people in the county are covered by NHIF. The county government wants to more than triple that figure through a two-year registration drive.
County Executive for Health Dr Gichuyia Nthuraku M’Riara said the programme is meant to reduce the burden of paying cash for treatment. He said elderly people and children under five already receive services without charges at the point of use, but urged more residents to take up insurance so they can access care when they fall ill.
The county says low NHIF uptake is linked to economic conditions in the area. Parts of Tharaka Nithi are agricultural because of their proximity to Mt Kenya, but large sections in the east and north are arid and semi-arid, where rain-fed farming performs poorly.
That has left some residents able to pay for treatment out of pocket while others cannot afford medical bills. County officials say the insurance drive is intended to ease that pressure and move more people into formal health cover.
The county also expects public sensitisation to play a major role in the campaign. Officials say the registration effort will be followed by an extensive mobilisation drive to encourage residents to sign up.
Dr Gichuyia said most illnesses reported in the county are preventable, making community-level health services important. He added that dispensaries and health centres are stocked with drugs and other supplies to provide free services.
The county says its facilities are prepared for a rise in patients once more residents are enrolled. It says general medical, surgical and paediatric services are already in place, including services that NHIF covers.
Outpatient cover already includes optical, orthopaedic, dental and physiotherapy services. Other services listed under the outpatient package include occupational therapy, maternal health, paediatrics and family planning.
Specialised care such as renal dialysis, x-ray services and laboratory tests will also be available under NHIF. The county says residents will be able to use their NHIF cards for tests including prostate-specific antigen (PSA) screening for prostate cancer.
The county renal unit has five beds and treats an average of four patients a day. Renal dialysis is fully paid for through NHIF, and the scheme is expected to work alongside other corporate insurers already accredited at county facilities.
Dr Gachuyia said other levels of service delivery have already been accredited as points where NHIF and other health insurers can pay for registered members of the community.
As part of the wider health plan, the Muthomi Njuki-led administration says it has already established 29 community health units across all 15 wards. During the 2018/2019 financial year, the county plans to expand that number to 100 and engage 1,000 community health volunteers.
The units are expected to help address the county’s top 10 diseases, which include upper respiratory tract infections, skin diseases, intestinal worms, arthritis, urinary tract infection, high blood pressure, pneumonia, diarrhoea, eye infections and malaria.
Tharaka Nithi has also benefited from the national government’s Managed Equipment Services project, which has delivered modern medical equipment to the county. The administration is now pursuing further upgrades at several facilities.
Among the planned projects is an upgrade of Chuka County Referral Hospital to a level five specialised health institution. The county says the move will reduce the costly practice of referring emergency cases outside Tharaka Nithi for higher-level treatment.
The county also plans to upgrade electrical power at the facility to meet the increased demand that will come with the expansion.
