WANANCHI OPINION: The Promises and Challenges of the Social Health Insurance Fund

The establishment of the Social Health Insurance Fund (SHIF) in Kenya signifies a new era in healthcare provision and financing in the country.

This is set to replace the National Health Insurance Fund (NHIF) and seeks to extend health cover to every citizen in the country irrespective of their ability to pay for healthcare. However, in line with the operations of SHIF, there are several issues of concern and challenges that have been experienced.

SHIF has been prearranged to be more inclusive and fairer as compared to NHIF. A particularly noteworthy aspect of SHIF involves its emphasis on the concept of Universal Health Care (UHC).

This means that the dignity of the Kenyan people with or without jobs and those who are earning wages and salaries or income will get basic services in the needed aspects of health.

This is a key step toward enhancing health equity within the Kenyan population as many individuals, using informal employment or residing in rural settings, were not captured under NHIF.

Employees shall pay 2.75% of their income to SHIF. This progressive contribution system means that those earning more make a bigger contribution to the program, which in turn may help contribute to the costs of healthcare for those earning less.

Furthermore, SHIF seeks to address issues of corruption which have been realized within the NHIF structure as well as inefficiencies that are occasioned by non-digitalized processes. This could lead to better management of health care resources and hence augment quality health care delivery.

An additional key benefit of the proposed reform is that SHIF can help redress healthcare disparities in Kenya. The NHIF has been widely criticized for limited absorptive capacity and various bureaucratic barriers exhibited especially by the end beneficiaries.

In this regard, national identity cards instead of NHIF cards are applied in SHIF that helps to facilitate and enhance access to health services. This is especially the case among the target groups who might lack the resources or information on how to deal with bureaucratic systems.

Further, the SHIF offers provisions for overall health checkups, kidney dialysis, kidney transplantation, basic medicines, and several life-saving equipment. These services are importantly used for the diagnosis of chronic diseases and for preventing further deterioration of health, which can enhance the well-being of many Kenyans.

Since the SHIF aims for health sectors to upscale the practice of preventive and promotive healthcare, there might be a decreased prevalence of diseases in the long run and financial strain on sectors.

Thus, while examining the advantages of the proposed system – SHIF – it is also necessary to look at the potential drawbacks.

One of the key concerns is an increased cost to the employees arising from the implementation of reforms.

In the current difficult economic situations, it has become a herculean task for Kenyans to feed themselves.

The compulsory 2.75% contribution to the SHIF can be regarded as an additional tax, and therefore can provoke resistance from the public.

One key area that need attention is in the need for the government to adequately sell the vision of the SHIF and how the contributions of the fund will meaningfully assist in enhancing health care services.

Another issue that may affect the health of the people is the implementation of the change in the NHIF to SHIF. The NHIF has been operational for many years now, the recipients of the health funds are familiar with the system and the hitherto coverage.

The swine to SHIF has to be gradual in order to allow everyone time to adjust in order not to disrupt health care. The public will have to be educated on the new processes and the government will need to support the changes to guarantee a smooth transition.

It will also be noted that technology will be a key enabler in achieving the outcomes of SHIF.

Thus, SHIF can enhance the effectiveness, minimize corruption, and increase transparency by utilizing digital platforms for administrative activities. For example, adopting national identity cards for the delivery of health services can facilitate identification and minimize fraud.

Also, digital health records can help in improving the flow of health care delivery since health care information is up-to-date and easily accessible to the providers.

Nevertheless, the use of digital technology is not without a hitch. Personal data protection is a critical concern, as several health records will be kept and retrieved from electronic devices.

The government must ensure that adequate funding is directed towards cybersecurity in order to safeguard patients records and uphold the confidence of the public. SHIF is a stride towards attaining UHC in Kenya.

Through delivering and availing quality and equal healthcare services for all citizens, SHIF holds the promise of revolutionizing the healthcare system in Kenya.

Nonetheless, the success of SHIF will depend on its implementation, communication, and the public at large. If properly supported and sustained, the principal vision of SHIF can lead to a healthier and fairer Kenya.