Marwa: Expanding social health insurance in Kisumu County, Kenya

“Marwa”, which is the Luo word for “ours”, is the name of the Kisumu Solidarity Health Insurance Scheme. Marwa is a digitally enabled health insurance scheme under the umbrella of UHC, designed to ensure that the most vulnerable and the non-poor informal sector populations of Kisumu County also have access to affordable and quality healthcare services, whenever they need it, and without suffering financial hardship. Underwritten by the National Hospital Insurance Fund (NHIF), Marwa contributes to UHC by identifying those who can pay and ensuring that they contribute, while subsidising those who cannot. In parallel, Marwa also helps clinics improve their quality. The initiative is an outcome of a MoU between the Kisumu County government and PharmAccess Foundation, whom they asked for support with technical assistance to help set up the scheme.

Pilot objectives

• Develop and implement the strategy to expand population coverage in Kisumu County to enrol the non-poor informal sector and retain them as members.
• Support efforts to ensure that the most vulnerable households remain covered and expansion plans by the Kisumu County Government are rolled out.
• Provide technical assistance to the Kisumu County Government on data insights through the digital platforms to drive decision making.

Pilot activities

• Analysing the structure of Kisumu’s population by socio-economic groupings and conducting research into the most promising distribution channels that Marwa can use as enrolment agents/aggregators of large groups to enrol the informal sector
• Executing strategy for extension of the Marwa programme to the population that is currently not included. Activities include marketing, partnership management and enrolment.
• Working with distribution/enrolment partners to pilot test and/or monitor their pilot projects on enrolment into Marwa.
• Working with partners to scale up initial efforts to cover as many groups of citizens (and their families) as possible under Marwa.
• Developing and running education campaigns to build awareness of Marwa for the informal sector.

Learning agenda

• How can programmes such as Marwa “reach scale” quickly, expanding population coverage for UHC, particularly of the informal sector? What is the most efficient distribution/enrolment model (including channels, training and incentives)?
• How can digital technology be used to facilitate the end-user’s journey and make operations more efficient?
• What key health funding and healthcare related data can be generated through the engagement with enrolment and technology partners, and how can this be used by the senior management of programmes like Marwa to make data-driven decisions?

Click here for a detailed activity description.