benefits of nhif in kenya – 10 plus major advantages

Last updated on July 28th, 2023 at 11:09 am

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Here is a list of all the benefits of NHIF – National Hospital Insurance Fund (NHIF).

As previously mentioned on this site, NHIF is a government-owned agency that provides health insurance to Kenyans over the age of 18 with a monthly income of Ksh 1,000 and above.

Since its inception in 1966, NHIF has been able to adapt to the changing health care needs of Kenyans, the role and restructuring of the health sector.

NHIF registers all eligible members in formal and informal sectors.

For those in the corporate sector, membership is mandatory.

For those in the non-service sector and retirees, membership is open and voluntary.

Benefits of NHIF Package

The NHIF Benefits package is the total of health services that a member is entitled to for the premium paid to the Fund.

Components of The NHIF Benefits Package

1. Consultation

The general outpatient consultation is provided for by the staff below

Medical Officer
Dental Officer
Nurse/Midwife

Clinical Officer
Community Oral Health Officer

2.Laboratory investigations

Haematology (Hb, RBC/WBC counts, hematocrit, peripheral film)

Differential white cell count
Peripheral Blood Film
Sickle Cell Test v. ABO & Rh Grouping

Syphilis Screening
Gram Stain
Ziel Nielsen Stain

Potassium Hydroxide Preps
Wet preparation
Urinalysis

HIV Test
Pregnancy Test
Widal Test

Stool for o/c
Blood Slide/ thick film for Malaria Parasite
Cervical Smears –cytology

Urine Microscopy (deposit)
Blood Glucose
Blood Transfusion Collection, Screening and Storage Compatibility Test and Blood Unit

Bleeding and coagulation time
Parasitological (RDT)

3. Drugs administration and dispensing

This is provided as per the needed care during the visit inpatient or outpatient visit as per the accreditation status of the facility.

4.Dental Healthcare Services

Tooth Extraction

5.Radiological Examinations

Hand and Finger – AP/LAT
Wrist Joint – AP/LAT

Forearm – AP/LAT
Chest – PA
Chest – PA & LAT

Clavicle – PA/AXIAL
Scapula – AP/LAT
Sterno-Clavicular

Foot and Toes – AP/LAT
Ankle Joint – AP/LAT
Leg – AP/LAT

Knee Joint – AP/LAT
Skull – AP/LAT
Plain Abdominal x-ray

Facial Bones – A.P.&LAT

6. Nursing and Midwifery Services

Regular Nursing Care
Drugs and Vaccines Administration

Observations of vital signs
Temperature
Pulse

Respirations
Blood Pressure
Personal Hygiene Care – Bed bath

Skin Care
Treatment of pressure areas
Tepid Sponging

Specimen Collection

Blood
Sputum

Swabs (Pus, throat, etc)
Stool
Urine

Pap Smear

-Oxygen Administration and care per hr.

-Disinfection and Sterilization(pack)

-Suction

-Intravenous infusion care

Ear Syringing

Giving Enema
Giving suppository
Last offices

Eye swabbing/irrigation
Tube feeding
Surgical Dressing

Small wound
Medium wound
Catheterization and Removal of Urinary Catheter

Washout/lavage
Stomach
Suturing

Small wound
Medium wound
Removal of suturing

Vulval toilet

MIDWIFERY PROCEDURES

Labour monitoring including parto-graphing and Normal delivery and Caesarean Section

Incision and Drainage of Cyst/Absess
Manual Vacum Aspiration (MVA)
Pap Smear

Ultrasound – (General)

FAMILY PLANNING PROCEDURES

Counselling clients for Family Planning

Natural Family Planning Education and training
Contraceptives

7. Surgical Services

General Surgery

Minor Surgery

Incision and Drainage

Circumcision (except for therapeutic and not cultural indications)
Excision of lipoma
Excision of Ganglion

Excision of Sabaceous Cyst
Incision and Drainage
Excision of lipoma

Lymph Node Biopsy

Orthopaedic Surgery

Minor Surgery

Joint Aspiration
POP Applications

Neurosurgery

A suture of scalp wounds (GA&LA)

Paediatric Surgery

A release of Tongue Tie

8. Radiotherapy

9.Physiotherapy Services

Exercise therapy( per session)
general exercise
pre & post natal

pre & post-operative
specialized exercise training
keep fit/group exercise

manipulative therapy
reduction of joints, fractures and POP immobilization / splinting

OTHER SPECIALISED SERVICES

1. Renal Dialysis.

This will be offered to the patient inpatient or outpatient.

2 Drug and Rehabilitation services

Members are entitled to treatment in an accredited rehabilitation centre.

These services above translate to the following benefits under the prescribed level of the facility.

1.Medical consultation with a Doctor, Clinical Officer or Nurse

2. Specialist care in hospitals and similar institutions for inpatient and outpatient (ambulatory) care

3. Drugs and essential medical supplies

4. Hospitalization ( in-patient care) when needed

5.Dental care

6. Referral where necessary

7. Any other benefits as may be reviewed and approved by the NHIF Board Tertiary care such as specialized surgery, chronic diseases management intensive care, and cancer therapy may be covered once a program for the same is put in place.