The Social Health Authority (SHA) has responded to rising concerns over differences in health coverage for civil servants and the general public following the death of a child due to confusion over treatment benefits.
The case has raised serious questions about the fairness and clarity of the new healthcare system under SHA.
Speaking during a press briefing on Wednesday, January 22, SHA Acting CEO Robert Ingasira, said that the baby who passed away was an incident tied to confusion over overseas treatment cover.
“It is unfortunate that we lost the baby, but just to emphasize that SHA is providing support for foreign treatment, and we are meeting the cost to the tune of Ksh500,000,” said Dr Ingasira.
Further, he confirmed that civil servants were under an extended scheme.
Also Read: Govt Issues Update to Civil Servants Using NHIF Cover
SHA CEO Explains the Civil Servants Scheme
At the same time, the CEO insisted that the scheme was just an extension of the one used by the rest of Kenyans.
Moreover, he noted that the scheme was being slowly integrated into the newly implemented universal healthcare system, and soon both civil servants and Kenyans would be able to benefit from SHA alike.
The authority clarified that the transition was temporary and intended to ensure smooth integration.
“We have a separate scheme for civil servants but the benefit I have talked about is uniform and is available to all Kenyans who are under SHA. The civil servant’s scheme is an extension.
“There was an already existing cover for civil servants and there was transition of the same. So, it is just an additional few more months to ensure a smooth transition of that into SHA. Otherwise, every Kenyan is going to be in SHA,” explained the authority.
Also Read: Baby Stuck in ICU Over SHA Confusion Dies
On an October 2024 notice, the government indicated that the contract issued for the provision of medical cover for civil servants, provided by the National Health Insurance Fund (NHIF), began on July 1, 2023, and was due to end on June 30, 2024.
However, to accommodate necessary adjustments, the contract was first extended by three months, running through September 30, 2024.
Therefore, to ensure that beneficiaries do not face gaps in their healthcare coverage, the scheme extended the contract again to November 21, 2024.
“Following the lapse of the extension of the Civil Servants Medical Insurance Scheme on 30th September 2024, the State Department for Public Service in consultation with Social Health Authority (SHA) has agreed to extend the contract up to 21st November 2024.”
Benefits and Cost Limits
Also, the officials were questioned about public dissatisfaction regarding treatment benefits and cost limits.
The SHA CEO confirmed that while it was aware of the case involving a family in Baringo seeking assistance for a child with heart disease, it was working with the affected families to provide support where necessary.
“We were made aware of the case from Baringo (a child with heart disease) and I would wish to clarify that the baby has been traced with the family, and they are being attended to at the hospital.
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