The rollout of the new Social Health Insurance Fund (SHIF) has ignited strong opposition from both the public and county governments, with concerns over inadequate consultation and growing fears for the future of healthcare access.
During the Council of Governors (COG) quarterly meeting held in Naivasha, county leaders, led by Tharaka Nithi Governor Muthomi Njuki, accused the national government of sidelining counties in the implementation of the new medical scheme.
Governor Njuki, who chairs the COG health committee, revealed that none of the 47 counties had signed an Intergovernmental Participatory Agreement (IPA) with the implementation authority.
“Counties manage most health facilities, yet we were completely bypassed in this critical transition. How can we be expected to support a program when key agreements remain unsigned, and critical facilities are not yet registered?” Njuki questioned during the meeting.
His concerns are shared by millions of Kenyans, who accuse the government of failing to involve the public in the decision to dismantle the National Health Insurance Fund (NHIF) without a proper transition plan.
The NHIF, which was officially discontinued on September 30, 2024, has left many patients, particularly those with chronic illnesses, in a vulnerable position without medical coverage.
Tens of health facilities across the country remain unregistered under the new SHIF, leaving patients facing significant uncertainty. Njuki called on the Treasury to urgently increase funding to support the transition, pointing out the severe challenges hampering the process, including a lack of sufficient devices for registering new members.
“The Treasury must intervene. This exercise is fraught with problems, and without more resources, it is the patients who will suffer most,” Njuki said.
Despite the criticism, Public Health Principal Secretary Harry Kimutai assured governors that the government was aware of the teething issues and was working to resolve them.
He acknowledged that the registration process had been slow but promised that 65,000 additional registration devices would be procured to ensure every public health facility could register members efficiently.
Kimutai also reassured patients previously covered under NHIF, stating that their chronic illness treatments would still be covered under SHIF.
The Ministry of Health, he added, is currently auditing the Ksh.30 billion that NHIF allegedly owes counties and has already released Ksh.1 billion to the Kenya Medical Supplies Authority (KEMSA) to procure much-needed medical supplies for the counties.
“Yes, there are challenges, but the government is taking active steps to ensure a smooth transition. Patients with chronic illnesses will not be abandoned. We are in talks with the Council of Governors and other stakeholders to resolve these issues,” Kimutai emphasized.
Elijah Wachira, the CEO of the Social Health Authority (SHA), reported significant progress despite the challenges, noting that over 12.5 million people had been registered within the first two days of the SHIF rollout, with 9 million members transferred from NHIF to SHIF.
He termed the transition as “85 percent successful” but acknowledged that the sheer volume of Kenyans eager to join the new health scheme had slowed down the registration process.
“We’ve seen overwhelming interest in SHIF, and that has stretched our capacity temporarily. The exercise is ongoing, and we are confident it will soon run smoothly,” Wachira said.
However, the Chair of the County Executive Committee (CEC) Health Caucus, Rosylene Omollo, raised further questions about the program’s implementation period and structure.
She voiced concerns echoed by Nandi County’s Health Executive Ruth Koech, who demanded clarity on how the government intends to clear the over Ksh.30 billion debt NHIF owes to counties.
“We cannot continue with business as usual when counties are still owed billions from NHIF. The government needs to offer a clear roadmap for settling these debts before asking us to fully commit to SHIF,” Koech stated.
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