President William Ruto has assured Kenyans that the Social Health Authority (SHA) will clear all October claims by next week as the government works to address challenges in transitioning from the National Health Insurance Fund (NHIF) to the new healthcare system.
Speaking during his State of the Nation Address, Ruto revealed that the government has paid Sh5 billion of the Sh12.9 billion debt inherited from the defunct NHIF.
He pledged to settle an additional Sh3.7 billion by tomorrow, bringing the total disbursement closer to clearing the outstanding balance.
“The good news is that SHA will pay all October claims in full by next week, and this process will continue seamlessly going forward,” said Ruto.
Earlier, the Council of Governors (CoG) had urged the government to expedite the release of Sh9.1 billion owed to counties to ensure effective service delivery in hospitals.
CoG Chair Ahmed Abdullahi noted that only Sh3.8 billion of the debt had been paid by May 2024.
“We call upon the SHA to expedite the payment of pending claims under NHIF and SHA to enable timely payments to vendors and ensure effective service delivery to patients,” Abdullahi said.
President Ruto emphasized the government’s commitment to Universal Health Coverage (UHC), stating that Sh2.5 billion would be disbursed this week to hospitals and service providers. He reiterated that over 15 million Kenyans have already enrolled in the new health scheme, which officially began on October 1, 2024.
“We are committed to ensuring all public health facilities are adequately funded to implement UHC effectively,” Ruto said during a church service at Soweto Catholic Church in Embakasi East, Nairobi.
However, the transition to SHA has been marred by challenges. The Kenya National Commission on Human Rights (KNCHR) raised concerns over SHA’s preparedness and capacity to manage the transition.
KNCHR Raises Concerns Over Transition
In its 2023/24 State of Human Rights in Kenya report, KNCHR pointed out that SHA has neither absorbed NHIF staff nor recruited sufficient personnel, leading to inefficiencies and uncertainty.
“SHA lacks the capacity and readiness to manage the transition effectively,” stated the report.
Key challenges highlighted include delays in developing the digital platform for managing the transition, poor coordination between national and county governments, and an incomplete empaneling process for healthcare providers.
Patients receiving long-term treatments under the NHIF system have reported disruptions due to inefficient data transfer between NHIF and SHA, resulting in service delays and confusion.
Additionally, some patients who made annual NHIF payments are unable to access essential services due to unclear processes for transferring prepaid funds to SHA. The report also noted errors in the SHA system, which inaccurately reflects membership periods, denying some long-term contributors access to services.
The KNCHR report criticized the means-testing process used to determine eligibility for SHA coverage. Concerns were raised that low-income individuals could be wrongly categorized into higher contribution brackets, potentially excluding them from accessing critical healthcare.
“The Commission cautions that the ongoing registration process should not be limited only to self and online registration to the detriment of people in underserved areas. Indigenous, minority, and marginalized communities should be prioritized,” the report added.
Further, the report highlighted that the benefits provided under SHA are seen as disproportionate to the increased contributions, failing to meet public expectations for improved healthcare services.
The report also flagged inadequate investments in the health sector, with allocations falling below the 15% threshold outlined in the Abuja Declaration of 2001. It called for increased funding to strengthen healthcare systems and address issues such as patient referrals and facility designations.
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