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NHIF foots Sh1.5bn bill as C-section births hit record high

The National Hospital Insurance Fund payouts for Caesarean section operations have crossed the Sh1 billion mark in a year, highlighting the cost burden of the procedure to insurers.

Official records show 65,278 mothers covered by the NHIF opted for C-section, a surgical operation to help deliver a baby, in the year 2017/18, up from 21,490 in 2016/17.

This saw the national health insurer pay Sh898 million more in 2017/18 to health facilities that performed the surgeries; from Sh621 million in 2016/17 to Sh1.5 billion.

More women are delivering through elective C-Sections, a trend that has alarmed medical experts.

C-section accounted for the biggest portion of NHIF’s maternity costs, and more than a third of the women covered by the fund opted for the operation. Three in five shillings NHIF pays for maternity costs go to Caesarean sections.


In 2015, the NHIF board increased the amount allocated to C-sections from Sh18,000 to Sh30,000.

The fund pays Sh10,000 for normal delivery, having increased it from Sh6,000.

“The increase in amounts payable for the procedure is seen as one of the factors driving more women to opt for C-section, having brought on board a large number of potential users who could previously not afford it,” Mr Gilbert Osoro, the benefits and contracting manager at the NHIF, said.

Use of C-section to deliver babies has been rising fast among Kenyan women because it shortens labour and cuts risks of complications associated with natural childbirth.

The procedure also generates more money for doctors and institutions compared to natural birth.


The World Health Organisation (WHO) in 2014 predicted that C-section would become even more common in Kenya if more women could access and afford it, in spite of the procedure being unnecessary in most instances.

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