Document

Key findings:

• Membership and accessibility: The National Health Insurance Management Authority (NHIMA)’s membership is predominantly from the public sector, with significant representation from private sector employees. However, a notable information gap remains regarding the scheme’s benefits and registration processes.
• Quality of services: While 79% of respondents expressed satisfaction with services at NHIMA-accredited facilities, issues such as the unavailability of drugs, poor service delivery, and long approval processes were highlighted. Specifically, 46.3% of clients reported a shortage of medical commodities, and 32.5% identified drug shortages as a major problem.
• Client perceptions and experiences: The study indicated that clients appreciate the affordability of NHIMA services compared to out-of-pocket expenses. However, there is a need for better communication regarding service offerings and registration processes. Only 11% of respondents had accessed information via the NHIMA website, highlighting the necessity for more accessible communication platforms.

Operational challenges and recommendations:

To improve service delivery and client satisfaction, NHIMA is advised to:

• Enhance information dissemination through varied communication platforms.
• Develop models to expedite service delivery in accredited facilities.
• Ensure accredited health facilities have the necessary drugs, supplies, and equipment.
• Improve the user-friendliness of the NHIMA website and develop a USSD code for easier information access.
• Engage health facilities to ensure proper functioning of vital check equipment and adequate staffing.
• Establish well-stocked pharmacies near hospitals for convenient drug access.
• Explore collaborations with other service providers to address capacity shortfalls and avoid double medical aid payments for clients.