Six months of Taifa Care: Is Kenya’s health revolution on track?

The program is a key pillar of President William Ruto’s manifesto, aimed at ensuring equitable, quality, and affordable healthcare for all Kenyans.

It has been six months since the Kenya Kwanza administration rolled out its universal health coverage initiative under the Social Health Authority (SHA). 

Prior to the launch of SHA, the government laid the groundwork by passing legislation in 2023 to anchor the program. 

The Taifa Care program operates through three key funds: the tax-funded Primary Healthcare Fund, the Emergency, Critical, and Chronic Illnesses Fund, and the contributory Social Health Insurance Fund (SHIF). 

Salaried Kenyans contribute 2.75% of their monthly gross income to SHIF, while non-salaried individuals pay an equivalent annual amount. 

This program aims to provide affordable, quality, and accessible healthcare to the masses.

Despite the ambitious rollout in October last year, Taifa Care has faced significant hurdles. 

Many Kenyans still report out-of-pocket expenses for healthcare, undermining the program’s core objective. 

The initial challenge was onboarding the public due to system inefficiencies. 

However, once these were addressed, the government managed to increase registrations to nearly 20 million, a notable rise from those enrolled in the now-defunct National Health Insurance Fund (NHIF). 

A major concern remains the low contribution levels. Of the 20 million registered, only three million actively pay premiums, which continues to hamper service delivery. Stakeholders argue that SHIF is the only fund demonstrating some level of success. 

However, financial constraints have led private healthcare providers to withdraw credit services for SHA-registered patients, pending the clearance of NHIF arrears amounting to Ksh 30 billion.

Roselyne Murunga, Chair of the Health NGOs Network (HENNET), voiced concerns about the program’s functionality: 

“Something is not working, and we must ask why.” Balancing premiums with benefit packages remains a pressing issue. 

The government asserts that it has improved coverage, particularly for critical, chronic, and inpatient care. However, concerns persist over the limited support for treatment outside the country.

SHA is also battling allegations of financial mismanagement, particularly regarding its digital infrastructure. A report by the Auditor General revealed that the government invested Ksh 104.9 billion into the digital system without adequately reviewing crucial contractual clauses. 

As a result, the government allegedly lost control over critical system components. However, these claims have been strongly refuted by the administration.

Despite these challenges, the government has made notable strides in expanding healthcare services. 

The Community Health Promoters program has enhanced preventive healthcare, increasing screenings for lifestyle diseases and maternal health coverage at the grassroots level. 

However, underfunding remains the biggest challenge. Taifa Care was initially projected to cost Ksh 168 billion, yet the government allocated only Ksh 6.1 billion for SHA. 

The Ministry of Health is now requesting additional funds to sustain the program for the remainder of this financial year and beyond.