Fix ailing SHA scheme, Nyamira Senator O’Mogeni tells govt 

Nyamira County Senator Okong’o O’Mogeni Friday called on the government to urgently fix the troubled Social Health Authority insurance system.

He said the system was still saddled with challenges thus posing a risk to millions of Kenyans who are relying on it to fund their treatment.

“We are living in a country that is sick on everything from its health system to the leadership.Sometimes you wonder what else is functioning properly in a country suffering from mismanagement,” O’Mogeni said.

The Senator was speaking Friday in Borabu while visiting families that lost their loved ones in a grisly accident in Kijauri two weeks ago.

He expressed frustration over the dysfunctionality of the system , which was introduced to replace the National Health Insurance Fund (NHIF).

He accused the government of abandoning millions of Kenyans who now struggle to access affordable healthcare.

“People in rural areas are suffering. Hospitals are turning away patients due to lack of clarity and support from the national system.”

He thus called on the Ministry of Health to urgently streamline the new scheme, warning that the continued failures could cost lives and erode public trust in government reforms.

The senator further demanded a comprehensive audit of the rollout process, saying accountability was lacking and citizens deserved answers.

A survey by the Rural and Urban Private Hospitals Association of Kenya (Rupha) speaks of the increasing difficulties in implementing SHA reforms.

While there have been strides in e-contracting and patient verification, these gains are being overshadowed by significant setbacks in claims management, reimbursement models, and the financial stability of healthcare providers.

“The overall SHA transition score has fallen from 46% to 44%, signaling a regression in implementation. Key service delivery areas such as financial health, system functionality, and outpatient reimbursement have deteriorated.”

“Despite improvements in e-contracting and patient verification, these gains are outweighed by mounting challenges in claims management and provider financial stability,” said Dr. Brian Lishenga, Rupha’s chairperson.

On Friday, O’Mogeni said even with the system, Kenyans in the rural regions are cash strapped to afford paying for it.

“When we make decisions, let’s factor in the disparities especially in income”he stated.

At least ten people died during the accident.