Effectiveness of Public Health Insurance in the Treatment of COVID-19 during the First Year of the Pandemic in Kenya

Abstract

Since 2004, the Government of Kenya has used the public health insurance as a strategic tool to implement Universal Health Care, seeking to lower inequality in access to health care. To date, the fund covers only 16% of the population. Public health insurance has an enhanced scheme that covers those in formal employment, with beneficiaries paying up to US$15 per month, while the super cover for those in the informal sector pays US$4. Worth noting is that 83% of Kenya's workforce is in the informal sector, the majority of whom cannot afford this premium. While the cost of treatment for COVID-19 was estimated at US$18 to US$599 per day, at the onset of the pandemic, the public health insurance announced that it would not cover COVID-19 treatment for all its beneficiaries. As the Pandemic progressed, the Fund limited treatment to health facilities designated by the Ministry of Health, thereby excluding private hospitals, which were better equipped and had greater capacity to treat COVID-19. The objectives of this study were to assess the affordability and accessibility of public health insurance as a tool of primary health care scheme in Kenya; to determine the effectiveness of public health insurance coverage in the treatment of COVID 19 during the first year of the pandemic; and to establish mechanisms that can inform comprehensive future responses to pandemics and epidemics. The study employed a qualitative research method. Specifically, the desktop research method was used to collect data. The study showed that although public health insurance is a form of social protection, it was ineffective in treating COVID-19, especially for those in the informal sector. Further, the Fund remained unaffordable and inaccessible to the majority of Kenyans.