In a significant overhaul of Kenya’s healthcare insurance system, the government has announced that Kenyans currently relying on the National Health Insurance Fund (NHIF) will need to re-register under the new Social Health Authority (SHA). This comes as the government aims to raise KSh 148 billion annually through deductions to support the newly established Social Health Insurance Fund (SHIF). Health Cabinet Secretary (CS) Deborah Barasa confirmed that over two million Kenyans had already registered for the new scheme, as the official rollout of SHIF commences today, October 1, 2024.

The transition from NHIF to SHIF marks a critical shift in Kenya’s healthcare funding structure. With a focus on expanding access to comprehensive healthcare services, the SHA will now be responsible for managing the country’s healthcare insurance. The Ministry of Health anticipates that the increased funding through SHIF will provide vital resources to improve preventive, promotive, curative, rehabilitative, and palliative health services across Kenya.

The Vision Behind SHIF: Enhancing Healthcare Access

The SHA is tasked with ensuring that healthcare services reach all Kenyans, regardless of income levels. Health CS Barasa highlighted that the goal of SHIF is not only to replace NHIF but to create a more robust and financially sustainable healthcare system. In her presentation to the National Assembly’s Committee on Health, she detailed the benefits the fund would bring to Kenyan citizens, emphasizing the importance of preventive and promotive care in reducing the burden of disease in the country.

Under SHIF, Kenyans will have access to a range of health services, including emergency care, critical care, and treatment for chronic illnesses. These services will be provided at Level 4, 5, and 6 healthcare facilities, which include county and national referral hospitals. By focusing on these high-level facilities, the government aims to ensure that even the most complex and severe cases can be adequately managed under the new scheme.

Rollout of SHIF: A Nationwide Activation

The rollout of SHIF will be executed across the country in stages. According to CS Barasa, the activation of SHIF will begin with 15 counties, where local government officials, including county health executive members and deputy commissioners, will lead the initial efforts. Governors and county health officials are also expected to support the process, ensuring that the digital systems required for the smooth registration and management of SHIF are up and running.

As part of the digital transformation efforts, the SHA will employ biometric registration, ensuring that Kenyans who register are easily identified within the system, reducing fraud and improving service delivery. This shift also reflects the government’s broader commitment to digitizing public services and enhancing efficiency across sectors.

SHIF Premiums and Public Concerns

One of the most talked-about aspects of SHIF has been the new premium structure. Compared to NHIF, SHIF introduces a tiered system based on income, with the aim of making contributions more affordable, particularly for low-income earners. For instance, individuals earning a gross monthly salary of KSh 6,000 will now pay KSh 165, a reduction from the KSh 300 previously paid under NHIF. Those earning KSh 15,000 will pay KSh 412, down from KSh 600, while those earning KSh 35,000 will contribute KSh 926, a slight reduction from KSh 950 under NHIF.

However, despite the reduction in premiums for some categories, many Kenyans have raised concerns about the perceived inadequacy of the benefits offered under SHIF. On social media and in public forums, citizens have expressed frustration that the services covered by SHIF may not meet their healthcare needs. One major point of contention is the allocation for critical services such as maternity care and inpatient services.

Under SHIF, women will receive KSh 10,000 for a typical delivery and KSh 30,000 for a cesarean section. In comparison, other private insurance schemes offer higher reimbursement rates for maternity services, leading many Kenyans to question whether SHIF is providing enough coverage. Additionally, SHIF offers KSh 2,240 per day for inpatient care, up to a maximum of 180 days per household annually, which some citizens have criticized as insufficient for managing long-term illnesses or serious medical conditions that require extended hospital stays.

Balancing Premiums with Benefits

One of the recurring debates surrounding SHIF is whether the new premiums justify the benefits provided. Critics argue that while the lower premiums may be appealing, the actual coverage is inadequate for many families. For example, users on social media platforms have pointed out that KSh 2,240 per day for inpatient care may not cover all necessary medical costs, particularly in private hospitals where treatment can be significantly more expensive.

In response to these concerns, the Ministry of Health has emphasized that SHIF is designed to complement the broader healthcare reforms being implemented by the government. These reforms include improvements in public healthcare facilities, the expansion of universal health coverage (UHC), and efforts to make essential medicines and treatments more accessible and affordable. The ministry has urged Kenyans to view SHIF as part of a long-term strategy to enhance healthcare services across the country, rather than a standalone solution.

Challenges Ahead: Public Sentiment and Policy Adjustments

Despite the government’s optimistic projections, the implementation of SHIF has not been without challenges. Public sentiment has been mixed, with many Kenyans voicing their dissatisfaction during online SHIF information sessions. Some citizens have expressed concerns about the lack of clarity regarding the specific services covered under SHIF, with one participant asking, “Why would a system cost KSh 106 billion? Why are the benefits of NHIF still better than SHIF?”

The Ministry of Health has acknowledged these concerns, noting that SHIF is still in its early stages and that adjustments will be made as necessary. Health CS Barasa has assured Kenyans that the government is committed to addressing any issues that arise during the rollout and that ongoing consultations with healthcare providers and the public will be a key part of the process.

Looking Ahead: SHIF and the Future of Healthcare in Kenya

As Kenya embarks on this ambitious healthcare reform, the success of SHIF will depend on the government’s ability to balance affordability with comprehensive coverage. The KSh 148 billion targeted annually through SHIF deductions is intended to bolster the country’s healthcare infrastructure and ensure that all Kenyans have access to essential medical services. However, it remains to be seen whether the new system will be able to meet the high expectations of the public.

The government has set high hopes for SHIF as a tool for achieving universal health coverage (UHC), a key goal under Kenya’s Vision 2030 development agenda. If successful, SHIF could serve as a model for other countries in the region looking to improve their healthcare systems. However, the path ahead is likely to be fraught with challenges, particularly in managing public perception and ensuring that the promised benefits materialize for all Kenyans.

In the meantime, the Ministry of Health has called on Kenyans to register for SHIF and actively participate in shaping the future of healthcare in the country. As Health CS Barasa aptly put it, “This is a collective effort. Every Kenyan deserves access to quality healthcare, and SHIF is our vehicle to achieve that goal.” The coming months will reveal whether this ambitious initiative can truly transform Kenya’s healthcare landscape for the better.

Photo source: Google

By: Montel Kamau

Serrari Financial Analyst

1st October, 2024