State embarks on door-to-door drive to shore up SHA registration

Community Health Promotion Services (CHPS) staff assist citizens with enrollment for the new Social Health Insurance Fund (SHIF) at Mbagathi Hospital, Nairobi on Nov 27, 2024. [Collins Oduor, Standard]

Efforts by the government to onboard more Kenyans in the Social Health Insurance Fund (SHIF) are beginning to show progress as the multi-faceted approach employed by the government begins to pay off.

The national government and some counties have adopted a door-to-door campaign as community leaders and politicians join the efforts to rally more people to embrace the new system.

According to Health Cabinet Secretary Deborah Barasa, as of last week, over 14 million Kenyans had registered for SHIF with the number expected to rise steadily in the coming weeks.

The new approach has seen staff members of the Ministry of Interior and National Coordination, counties and health volunteers rally Kenyans to embrace the new healthcare system.

The chief barazas that previously served as avenues to settle local disputes have turned into a focal point to rally Kenyans to embrace the new health scheme.

For instance, Embu County Commissioner Jack Obuo who is leading the drive through his weekly barazas, said they target to register 206, 000 households into the scheme by the end of December.

The collaborative approach adopted by the government has seen 34,748 employers and 6,517 healthcare facilities onboarded to assist with processing claims and streamlining the services.

But as this happens, some Kenyans still believe the transition from the National Hospital Insurance Fund (NHIF) was unnecessary, and that they are yet to feel the impact of SHIF.

They claim some facilities are still forcing them to pay for services using cash and have rejected the system. Others, however, believe the government is on the right track with the rollout of the Social Health Authority.

A spot check by The Standard across the country established that although some Kenyans are still in the dark about the potential benefits of the new health scheme, perceptions are slowly changing.

In Kakamega, Kevin Atika, a patient at Kakamega General Hospital described the scheme as a potential game-changer in improving access to healthcare.

“I am a beneficiary of the SHIF and so far the experience is good. I also had my doubts but I believe it is a system that can transform our healthcare if the National Treasury disburses funds to counties in time to equip facilities with medicine,” Atika said.

And he is not alone. Mary Akumu, a patient who underwent throat surgery claims the Social Health Authority catered for the services and she did not have to struggle with paying out of her pocket.

Kakamega CEC for Health Bernard Wesonga said the national government has corrected and improved on the gaps and weaknesses that were creating public outcry.

“We are doing well with the system and it is working well. I have seen patients being treated even for the chronic diseases that many thought was impossible,” said Dr Wesonga.

ALSO READ: Government to refund patients who paid own fees during SHIF rollout

Records by the Ministry of Health indicate that Nyeri was leading with the registration with 21 per cent, the highest in the country, followed by Kirinyaga at 20 per cent, Kiambu at 19 per cent, Laikipia and Embu tied at 18 per cent, Tharaka Nithi at 17 per cent and Nyandarua at 16 per cent.

Additionally, Uasin Gishu, Bomet, Kericho, Taita Taveta, Nandi, Nakuru, Elgeyo Marakwet, Kisumu, Kisii, Nyamira and Kajiado counties are also performing well and registered 15 per cent and above 1.2 million.

In Kisumu, a group of Community Health Promoters (CHPs) have been visiting homesteads to encourage residents to register under the healthcare system.

They are working with religious leaders and chiefs to mobilize people to register into the system.

Maurice Okello, a CHP in Kisumu East, said through his frequent visits to homesteads to check on their health status, he has managed to convince tens of families to register for SHIF.

“The perceptions are slowly changing and we hope that more people will join us in this quest to back this system that is capable of saving lives,” he explained.

In Migori, patients who struggled to get services after they were turned away by hospitals claimed that they were no longer being turned away by the health facilities.

Instead, those who were not registered in the SHA system were being registered at the facility and treated.

Similarly, in Nyamira, Governor Amos Nyaribo joined the efforts to rally more people to enlist for the programme in a change of a strategy that has seen politicians join the marketing train for the new healthcare system.

Nyamira is among the counties that have been struggling to shore up its numbers.

“The official registration drives is the last effort that we are adopting to ensure that no one is left out,” Nyaribo said.

The mission has also seen MPs friendly to Kenya Kwanza government also rally their constituents to back the new healthcare scheme.

At the Coast, however, a section of patients are still in pain over the transition from the NHIF to SHA and SHIF.

Winston Otum, a Mombasa resident, said he has been in trouble since the transition to the new health scheme as he has to pay cash for services at a public hospital.

“Since October 1, I have been forced to pay cash for services. Although in the past I used to buy drugs, the situation is worse since I have to pay cash for everything,” he said.

Clear system

Patients like Otum will continue to suffer as private hospitals yesterday said SHA was not working, and that reports from State officers to the contrary were a public relations gimmick.

ALSO READ: Win for gov't as Court of Appeal allows SHIF rollout

Rural and Urban Private Hospital Association (UPHA) Chairman Brain Lishenga said thousands of patients waiting to be operated on are stranded as hospitals have not gotten approvals.

“We cannot operate on somebody without getting authorization from SHA stipulating agreement on how the payment will be done after the services. Since October, operations have been on hold,” said Dr Lishenga.

Lishenga said although the private hospital doctors were supporting SHA, there was a need to release more funds as only Sh1.3 billion had been released from the promised Sh3.8 billion.

He asked the government to stop playing public relations by lying to Kenyans that it had disbursed or paid private hospitals all the arrears and asked it to release the remaining Sh3.7 billion.

He said many patients were suffering because SHA had not come up with a clear referral system.

[Report by Anne Atieno, Willis Oketch, Benard Lusigi, Isaiah Gwengi and James Omoro]