The Ministry of Health is under mounting pressure to resolve issues plaguing the implementation of the Social Health Insurance Fund (SHIF), as raised by health and women’s rights advocacy groups KELIN and FIDA-Kenya. The transition from the National Health Insurance Fund (NHIF) to SHIF, mandated by the Social Health Insurance Act, 2023, has sparked widespread confusion and disruptions in healthcare access, especially among vulnerable populations.
Advocacy Groups Raise Alarm
In a statement issued on November 18, 2024, KELIN and FIDA-Kenya criticized the lack of public awareness and operational clarity surrounding the transition. They warned that millions of Kenyans—particularly persons with disabilities, minorities, and low-income families—are being denied essential health services.
Hortense Minishi, Deputy Executive Director at KELIN, emphasized the constitutional guarantee of the right to health under Article 43, noting that the ongoing transition has exposed significant gaps:
“The current challenges undermine the dignity and constitutional rights of Kenyans. We call on the Ministry of Health to take swift action to address these issues and reaffirm its commitment to equitable health care for all.”
Disruptions and Recommendations
Reports of patients being turned away from health facilities, detained over unpaid bills, and experiencing interruptions in chronic disease management underscore the scale of the crisis. Advocacy groups have urged the Ministry and the Social Health Authority (SHA) to implement:
- Clear operational guidelines for SHIF.
- Public education campaigns to inform citizens about the transition.
- Immediate settlement of NHIF claims to ease the burden on health facilities.
They also raised concerns about the future of key programs such as Linda Mama, EduAfya, and HIV treatment initiatives, urging clarification on their integration into the SHIF framework.
Risks from Digital Transformation
While acknowledging the promise of health record digitization, KELIN and FIDA-Kenya warned that the digital divide risks excluding marginalized communities unless policies are designed to ensure inclusivity. They called for robust feedback systems to address grievances from patients incurring out-of-pocket costs during the transition.
Emergency Care and Dispute Resolution
The groups highlighted the need to safeguard access to emergency care by establishing clear protocols and timelines. They also called for the operationalization of the Social Health Insurance Dispute Resolution Tribunal to handle complaints efficiently.
Alignment with Universal Health Coverage
KELIN and FIDA-Kenya stressed that the transition must align with Universal Health Coverage (UHC) principles by eliminating financial barriers, allocating sufficient resources, and prioritizing the rights of vulnerable populations.
The Ministry of Health faces growing public and institutional pressure to address these systemic issues and ensure that SHIF delivers on its promise of equitable healthcare for all Kenyans.
