SHA and SHIF, a Misdiagnosis of Kenya’s Healthcare

“If it ain’t broke, don’t fix it,” so goes the old English adage. At the point of attaining independence, Kenya had three critical goals: eradicate hunger, end ignorance, and wipe out disease. The jury is out there, and Kenyans can give a score on the progress decades later.  However, one thing is clear: healthcare remains one of the most critical issues among the Kenyan populace.

Healthcare burden in Kenya

Illness is one of the most challenging matters for affected families. It is very demanding psychologically, materially, and financially.

Having a sick family member wipes out the spouse, parents, and siblings’ mental state to the point of depression.

Worse, is when the situation is that the affected person is the family head and is expected to be the stronger one for the rest.

This can often lead to family disintegration, especially where family members cannot withstand seeing their family head suffering and not being able to lead them.

Also Read: SHA Packages Teachers in Every Job Group Will Enjoy After TSC Shift from Minet

Financially and materially, sickness is one of the leading causes of financial drain for families and society.

Medicare is not cheap, and therefore, regardless of the nature of the illness, families must incur expenses, often nibbling into other budgetary allocations for food, education, and other essential family expenses.

In some cases, and depending on the cost of medical care, families are forced to take loans, organize fundraisers, and dispose of property, tossing people into untold poverty.

Children drop out of school, family projects stall, and in some cases, auctioneers come knocking to recover unsettled debts.

It gets worse if the nature of treatment requires palliative care to be involved, specialized treatment like dialysis or physiotherapy, which demands a constant flow of cash.

SHA Shift

To alleviate the suffering of families and affected persons, the Social Health Agency (SHA) was established under the Social Health Insurance Act of 2023.

This officially replaced the National Hospital Insurance Fund (NHIF) in October 2024, providing affordable and equitable healthcare to all Kenyans through Universal Health Coverage (UHC).

While Kenyans were elated by the attractive packaging and marketing strategies used by politicians during political campaigns, the joy was short-lived. Stories are everywhere in the media, on social media, and within families about how the health scheme, which was supposed to be a panacea for their problems, is now a source of agony.

The mandatory contribution by salaried Kenyans, according to expert estimates, nets approximately 7 billion shillings per month! This means that over Ksh 80 billion is collected in a year. These funds, if properly budgeted and used, could guarantee free healthcare across all levels of facilities and regardless of the ailment.

Concerns

It is very disappointing that despite the huge collections, Kenyans continue to suffer due to ailments that require little money, while others die due to avoidable circumstances.

Media reports show that many Kenyans have been detained in hospitals since SHIF pays for a very small percentage.

One of the stories has it that a middle-aged woman has been detained in hospital for over five months since the SHA only committed to pay Ksh. 380,000 for a Ksh. 2.9 million-hospital bill.

Also Read: Duale Gazettes 36 Ailments that SHA Will Cover Abroad [FULL LIST]

This comes after another old, frail person was detained in a private hospital for Ksh. 2.8 million with the hospital declining SHIF.

This undermines the logic of having SHA as Universal Health Coverage if some hospitals do not recognize it, obviously due to challenges with payment. It took a lot of ‘’noise’’ from social media to have her released.

It is obvious that SHA and SHIF are missing their objectives; Kenyans continue to suffer, and others die due to avoidable circumstances. It behooves experts, legislators and policymakers to review and diagnose afresh the problem of health funding in Kenya. It is not working; let us fix it.

This article was written by Lucas Kimanthi, who is a Governance and Human Rights Expert. The views expressed in this opinion piece are the author’s own and do not represent The Kenya Times’ editorial position.

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