SHA rollout successful despite challenges, governors say

Governors have voiced their support for the Social Health Authority (SHA), urging Kenyans and stakeholders to refrain from premature criticism of the newly introduced healthcare programme.

Led by the Council of Governors (CoG) Chairperson Ahmed Abdullahi, the county bosses called for patience during the SHA rollout, describing current challenges as "teething problems."

This support comes at a time when many Kenyans are struggling to access healthcare, as the country transitions from the National Hospital Insurance Fund (NHIF) to the SHA.

Abdullahi insisted that SHA is a crucial step toward achieving Universal Health Coverage (UHC). “There is nothing new that does not come with teething problems. It’s normal, but we must focus on making SHA work,” said the Wajir Governor during the launch of the Financial Management and Procedures Manual for county health spending units.

He acknowledged the programme’s challenges, attributing them to misinformation and negative perceptions. “The only problem with SHA is the negative talk discouraging Kenyans from registering,” he said, despite widespread public disappointment.

Abdullahi shared a success story from Wajir County where a patient underwent hip replacement surgery at the Wajir County and Referral Hospital, with the Sh336,000 bill fully covered under SHA. “This is proof that SHA is working,” he stated.

According to Abdullahi, 5,300 public health facilities have already been registered, licensed, and empanelled under SHA. He highlighted that counties have played a significant role in registering 14.8 million members, enabling access to tax-funded primary healthcare at Level 2 and 3 hospitals.

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He urged public health facilities to embrace SHA, ensuring they register and benefit from the programme. “We do not want SHA to be a preserve of private facilities like NHIF was. This is our opportunity, and we must register in large numbers,” Abdullahi said.

The Financial Management and Procedures Manual aims to improve accounting and financial management in county health spending units. However, Abdullahi emphasised that its success depends on sufficient funding for healthcare facilities.

“If we mobilise people to register and secure the Sh900 allocation per person annually for Level 2 and 3 facilities, we will ensure the availability of funds to run these facilities effectively,” Abdullahi said.

Baringo Governor Benjamin Cheboi echoed this sentiment, urging Kenyans to support SHA and allow its implementation to address genuine challenges. “SHA is like a newborn baby—it must cry at birth but will grow strong with care. We are confident it will help achieve the elusive UHC in Kenya,” Cheboi said.

He noted that each registered Level 2 or 3 facility under SHA would receive Sh900 per enrolled member annually, ensuring free healthcare services at lower-level facilities.

The manual aligns with the Facility Improvement Financing (FIF) Act 2023, which provides a framework for counties to collect, retain, and utilise revenue generated by health facilities. Abdullahi noted that 43 of the 47 counties now allow facilities to retain revenue, though challenges remain in ensuring accountability.

“This manual ensures that health units get it right from the start. Proper financial management is key to delivering quality healthcare services,” Abdullahi said.

The guidelines aim to resolve conflicts between finance and health teams over revenue use, which has occasionally been diverted to other county sectors.

Public Health Principal Secretary Mary Muthoni lauded the manual’s introduction, citing the rising demand for quality and affordable healthcare. “The FIF manual will help counties mobilise domestic resources for health, catalysing quality care and enhancing competitiveness in public health facilities,” Muthoni said.

The manual has been successfully piloted in Nyandarua, Lamu, and Meru counties, providing a model for nationwide adoption.

The governors appealed to health workers and citizens to support SHA by encouraging registration. “Let us stop the negative myths about SHA and work together to make it succeed,” Cheboi said.

The transition to SHA  represents a pivotal moment in Kenya’s healthcare reform, with governors insisting that collaboration and patience are vital for its success