Stakeholders say Kenyans are not ready to transition to SHIF

Health CS Deborah Barasa (center), PS Medical Services Harry Kimtai (left) and SHA Chairperson Dr Abdi Mohamed before National Assembly's Health Committee to discuss the rollout of the Social Health Insurance Fund (SHIF) in preparation for the Universal Health Coverage launch on 1st October 2024 [Elvis Ogina, Standard]

The day for the much anticipated shift from NHIF to SHIF is no longer nigh, but here.

But as the government pushes to see this shift through, the Kenya Union of Clinical Officers claims Kenyans are not ready for the switch.

The Union through, the Secretary General, George Gibore, said the government would have taken more time to look at the transitioning process considering the financial constraints and even the infrastructure of most level 2, 3, and 4 hospitals.

"Some of us expected this for some time, but it never was implemented because we have never been prepared for this and my feeling is that we are still not prepared,” he said.

He went on to state that medical practitioners and Kenyans are still not well prepared, stating that the SHA act provides that it’s the individual to pay more.

He said it is the government's responsibility to identify those who are supposed to benefit from the programme so that people can trust the process.

Gibore added that the government does not have the funds to roll out the SHA programme.

Under SHA, we have 3 funds - the Primary Care health fund which is a government fund was projected at a budget of Kshs 50 billion. Unfortunately, they only provide Kshs 4.1 billion which is a drop in the ocean without proper study to support this budget.

Another issue was that the government was to provide another Sh 100 billion for Emergency and Critical Care Fund which have now been moved to cater for chronic illness, cancer issues, and any other emergency issues that may come up.

“For this year, they project that their budget would be Kshs 70million, but what did we get? Only Kshs 2.9Million so if this is the Money we got, look at the percentage that will be able to offer the services required?” he added.

The emergency and critical care for the primary health care fund, he said, is expected to provide for level 2,3 and 4 hospitals.

“You see the money we will be depending on is the one that we are waiting for people to contribute. What about the people the 1.8 Million people who have already paid for SHA? How are they transitioning those who had paid for the NHIF, whom are they transitioning with? This is a very big problem,” he said.

He noted that there is a need for a clear structure of transition.

“My sentiments are that the government is not prepared to transition to the SHA programme, financially, and the infrastructure is not well put,” he added.

Earlier, Medical Services Health Principal Secretary, Harry Kimtai, said that registration to the new scheme is a must for all Kenyans.

Kimtai insisted that SHA will serve all Kenyans unlike NHIF, which, he said, was discriminatory and mostly favoured the employed.

Presidential advisor on health who is also a health economist, Daniel Mwai, on his part said healthcare financing has been a major challenge in the country, an area that has been corrected under SHA.

Dr Mwai said the system is a creation and improvement informed by past systemic failures.

The new scheme entails pooling risks and having an established premium.

NHIF, according to Mwai, heavily targeted 20 per cent of Kenyans in formal employment, leaving out 80 per cent in the informal sector, who are all included in the new scheme.

In the new scheme, deductions have been capped at 2.75 per cent, with low-income earners paying less compared to NHIF.

For instance, a person earning Kshs 3,000 shall pay Kshs 82.50 as compared to current monthly deductions of Kshs 150 to NHIF.

Mwai said NHIF also did not provide adequate insurance to patients with chronic diseases in need of services like chemotherapy and dialysis.

In SHA, the exchequer will cater to the Primary Healthcare Fund and ECCIF, whereas contributions shall be made to SHIF.

Patients who deplete SHIF will access care with ECCIF.

The new scheme also does not have premiums, with standardized services devoid of the amount contributed.