Eduafya folded in new health scheme as parents urged to register children

When the National Hospital Insurance Fund official engaged pupils on the EduAfya programme during the Nairobi ASK show. [Courtesy]

The Ministry of Health has said learners are being registered as dependents under the new health scheme managed by the Social Health Authority (SHA).

In an interview with The Standard, Medical Services  Principal Secretary Harry Kimutai said the move will guarantee access to comprehensive healthcare services.

Kimtai said registering learners under the new medical scheme is part of the Kenya Kwanza administration's agenda towards achieving Universal Health Coverage (UHC).

Registered dependents, in this case learners, will be covered under the Social Health Insurance (SHI) scheme, providing them with enhanced health benefits and financial protection of their parents against medical expenses.

“All school-going children ranging from PP1, PP2, lower/primary, secondary, tertiary and university are required to register as dependants under SHA,” PS Kimtai said in an interview.

He added, “This comprehensive registration ensures that all learners, regardless of their education level, are covered under the new scheme”.

The comprehensive registration approach, he said, will ensure all learners in all academic levels are covered.

Acting SHA Chief Executive Officer Elijah Wachira said the strategy to reach learners is engaging them through school heads - including head teachers associations, directors of education and parents associations to explain the benefits of having a health scheme.

“SHA and both ministries of education and health will ensure parents understand the benefits of registration and the registration process itself,” Wachira said.

In the ministry’s policy, all learners shall be registered as dependents of their parents under the SHA scheme.

During registration, parents are required to provide their children’s birth certificates and any other necessary identification documents.

Whilst all school-going children must be registered as dependents under SHA before the commencement of the third term, parents will continue registering the learners up to the end of September.

“It is crucial to complete the registration process promptly to avoid any disruptions in accessing healthcare services,” warned Kimtai.

He added that learners who are not registered may face challenges accessing healthcare services, as they will not be covered under the SHA scheme.

“They (learners) will not be locked out of learning. The Ministry of Health emphasises the importance of timely registration to avoid any inconveniences or potential disruptions in accessing healthcare services,” added the PS.

Social Health Authority (SHA), which replaces the defunct National Health Insurance Fund (NHIF), will be officially launched on October 1, ahead of the 2.75 per cent deductions set to commence on November 22, 2024.

Under NHIF, learners were covered through EduAfya, a scheme that will not exist under the new health scheme.

Kimtai further noted that EduAfya only covered learners in public secondary schools, leaving out those in private schools - including the ones in urban and rural informal settlements - and PP1, PP2, primary and junior secondary pupils and students.

“The new SHA scheme will provide enhanced benefits under its management, ensuring that all students previously covered under EduAfya continue to receive comprehensive healthcare services without interruption,” clarified Kimtai.

The PS also highlighted that in the new scheme that requires all households to register and pay their contribution of 2.75 per cent of their gross income, will automatically cover their children.

Medical Services Principal Secretary, Harry Kimutai when he appeared before the National Assembly Health Committee at Parliament on May 20, 2024. [Boniface Okendo, Standard]

Further, he said SHA also has the Primary Healthcare Fund and Emergency, Chronic, and Critical Illness Fund, which are budgeted for, to ensure that all Kenyans, including learners, have access to essential healthcare services without incurring out-of-pocket expenses.

Though there have been multiple court cases against the establishment of the new scheme and its actualisation, the PS maintained that SHA will successfully be implemented to help Kenya attain its healthcare agenda.

The ministry's data shows that over 800,000 people have registered with the new scheme so far.

“The government is committed to achieving UHC for all Kenyans, as evidenced by the establishment of SHA and the enactment of supportive legislation like the Social Health Insurance Act of 2023" said Kimtai.

"This commitment ensures that there is political will and resources dedicated to making SHA a success,” emphasised the PS.

He added that there is a robust Implementation Plan that has seen SHA built on a well-thought-out framework that includes a centralised digital platform, the deployment of Community Health Promoters (CHPs), and the creation of dedicated funds to cover various health needs.

The measures are designed to improve healthcare accessibility, reduce financial barriers, and ensure quality service delivery across the country.

Also, he said, there is an enhanced Healthcare Infrastructure and Capacity framework that includes significant investments in healthcare infrastructure and workforce development under SHA.

Under workforce development, at least 107,000 CHPs have been recruited to help achieve the Kenya Kwanza administration’s agenda on promotive and preventive health, at the household level.

Unlike NHIF, he said, SHA offers innovative use of Technology.

In the scheme, there is the introduction of a centralised digital platform under the Digital Health Act of 2023, which enhances efficiency, reduces opportunities for fraud, and ensures consistent delivery
of quality services.

“This technology-driven approach is a game changer in managing health records and improving service delivery across Kenya,” he said.

In the NHIF, most operations are paper-based, which makes it hard, for example, to trace patients' records in case they need care in a different hospital and locality.

Whereas Kenya greatly depends on donor support to run respective health programmes like malaria, Tuberculosis (TB), and HIV/AIDS campaigns, the new scheme, according to the ministry, will provide sustainable financing.

Over-dependency on donors has seen a struggle in the provision of services like HIV prevention, with a shortage of free condoms and delay in vaccination of newborns due to disruption in the supply of vaccines being witnessed.

The family planning programme has also been affected.

“SHA is backed by a well-structured funding mechanism, including the Primary Healthcare Fund, Social Health Insurance Fund, and Emergency, Chronic, and Critical Illness Fund,” explained Kimtai.

These funds ensure that there is adequate financial protection and that resources are allocated effectively to meet the healthcare needs of all Kenyans.

Further, the success of SHA is supported by partnerships with National and county governments, state departments such as like education, social protection, international organisations, NGOs, and private sector stakeholders.

“These collaborations provide additional expertise, resources, and funding to support the implementation and sustainability of SHA,” said Kimtai.