KENYA—The Ministry of Health (MoH) has issued an update on the solutions it is adopting to address stakeholder concerns about the roll-out of the Social Health Authority (SHA) on October 1.
This comes amid reports that patients in both private and public healthcare facilities, especially those requiring life-saving procedures, are facing uncertainty due to confusion surrounding the transition from National Health Insurance Fund (NHIF) to the Social Health Insurance Fund (SHIF).
Many private facilities have expressed concerns about SHIF reimbursements, with some opting to demand cash payments for critical treatments such as dialysis during the transition.
In particular, medical institutions under faith-based organizations and the Rural and Urban Private Hospitals Association of Kenya (RUPHA) had voiced strong reservations about the new SHA contracts.
These groups argued that the government has yet to show commitment to paying the over Ksh.21 billion (US$162.14 million) debt owed to them by the now-defunct NHIF.
As a result, many facilities have declined to sign the new SHA contracts, claiming that the agreements are designed to exclude them from service provision and, by extension, disenfranchise Kenyan citizens in need of healthcare.
These facilities also expressed fears that the debt owed by NHIF might never be paid under the new system, with concerns that critical financial records could be lost or destroyed during the transition.
Adding to the public unrest, Kenyans began receiving messages informing them that they had been automatically transferred from NHIF to SHA.
This raised further concerns, with many questioning whether the Ministry of Health had the legal authority to move them without their consent.
In a recent statement, Mr. Harry Kimtai, Principal Secretary for the State Department of Medical Services, acknowledged the challenges encountered during the transition but assured the public that steps were being taken to address the issues and ensure a smooth and effective process.
According to him, the SHA claims system is now fully operational, and training for health facilities on the claims portal is ongoing and will continue in the coming weeks.
To address concerns from patients requiring renal and oncology services in private hospitals, Kimtai announced that 232 out of 353 renal and oncology providers have already committed to offering services under SHA.
He also clarified that pre-authorization is not required for NHIF members who have transitioned to SHA and are seeking renal and oncology care.
Regarding the ongoing SHA registration, Mr. Kimtai highlighted that the process is progressing nationwide, with hospitals providing information and assisting the public with registration.
He noted that beneficiaries can self-register by dialing *147# or through the SHA website, while community health promoters and SHA-designated registration points are also available for further support. So far, over 12.6 million Kenyans have registered for SHA.
On the issue of patient migration to SHA, Mr. Kimtai reassured the public that the National Health Information Exchange (NHIE) would ensure the secure management of patient data, with oversight by the Digital Health Agency.
This is done in strict compliance with the Social Health Insurance Fund (SHIF) Act and the Data Protection Act of 2019, thereby safeguarding patient consent.
Mr. Kimtai concluded by stating that contributions from former NHIF members would be transferred into the SHA system, and a means-testing instrument would be used to determine contributions for non-salaried members.
He also confirmed that the contracting process with healthcare providers is still underway, with all public health facilities and 1,577 private and faith-based facilities already having signed contracts with SHA.
Moreover, all health facilities have been instructed not to deny services during the transition period.
Sign up to receive our email newsletters with the latest news updates and insights from Africa and the World HERE
