It has been recognized that a major challenge in developing countries is how to ensure that the poor are included in health financing arrangements and they can access benefit from health insurance coverage as the non-poor.

Poverty levels in Kenya remain high, with estimates indicating that over 40 per cent of Kenyans are poor. Further, out-of-pocket expenditure accounts for approximately a quarter of total health spending in Kenya. With such high levels of poverty and out-of-pocket spending on health, the poorest of the population are generally systemically excluded from benefiting from health care services and, therefore have worse health indicators than the general population.

As such, the Ministry of Health, through NHIF designed the Health Insurance Subsidy Programme (HISP) and Subsidy Programme for Older Persons and Persons with Severe Disabilities to provide outpatient and inpatient care for the indigents, older persons and the disabled in Kenya. NHIF has been implementing this programme since 2014 and so far, over 200,000 beneficiaries have enjoyed this cover. NHIF has cumulatively paid over KES 700 million in benefits.