KENYA— After the government failed to renew the EduAfya comprehensive medical insurance for millions of students enrolled in public secondary schools through the National Educational Management Information System (NEMIS), a cloud of uncertainty now hangs over their health.
EduAfya comprehensive medical insurance scheme was launched in May 2018 by former President Uhuru Kenyatta with an aim of providing preventive, curative, and management services for chronic diseases among students.
This cover was adopted and is evaluated on an annual basis by the Education Ministry and the National Hospital Insurance Fund (NHIF), with the contract terminating on December 31, 2023.
This information became public after NHIF issued a letter in December 2023 warning hospitals that it would not compensate them for services performed under the secondary school medical program beyond the contract’s expiration date of December 31.
The ministry negotiated an annual premium of Sh1,350 per student for the Edu Afya coverage, which covered the detection of previously undiscovered and thus untreated chronic diseases that cause pupils to skip school on a regular basis.
Outpatient and inpatient care, day surgical services, a local road ambulance, and emergency air rescue are all part of the program.
Between 2019 and 2022, NHIF received Sh9.5 billion from the government as part of the EduAfya medical initiative.
Since its inception in the form of a presidential directive, the program has resulted in a rise in health budgetary allocations of Sh4 billion per year, based on a premium of Sh1,350 per student per year.
To get medical care, a student was required to present an NHIF membership card or a letter written and signed by the school principal or a recognized official if the student had not yet received a membership card.
However, school administrators believe that the program has been underutilized because of the challenges students have in accessing medication.
This is because many health care providers have indicated that they require letters from head teachers to attend to children, which delays access to medical treatments, according to Kahi Indimuli Kahi, the outgoing Kenya Secondary Schools Heads Association (KESSHA).
Despite President William Ruto’s support for universal health coverage, this move has raised concerns among parents and educators about why a project of such a noble and essential cause would be abandoned, as well as the destiny of pupils with existing and undetected chronic diseases.
Furthermore, on November 30, NHIF Chief Executive Officer Elijah Wachira warned Parliament that the program has not been included in the newly formed entities that will replace the fund, leaving over 3.4 million learners without medical coverage.
These entities include the Primary Healthcare Fund, the Social Health Insurance Fund, and the Emergency, Chronic, and Critical Illness Fund.
Mr. Wachira told MPs that if the contracts are terminated, the ministries of health and education will have to find a new provider because the NHIF will no longer exist.
Silas Obuhatsa, chairman of the National Parents Association, warned that ending such a program would harm the most vulnerable students.
Obuhatsa stated that the medical scheme has been a pillar for students suffering from long-term diseases and that failure to extend it could jeopardize their education and lives.
He is still concerned about what would happen to the beneficiaries because this is a program targeted at providing preventive, curative, and management services for chronic diseases.
According to the most recent data on the medical program, released in 2019, 606,893 students sought medical attention between January and December of that year, out of the 2.7 million students insured during the same period.
It is yet unknown whether the lack of medical coverage would have an impact on pupils’ learning or contribute to increasing absenteeism.