“If it ain’t broke, don’t fix it” so goes the old English adage.
At the point of attaining independence, Kenya had a goal of three critical things; eradicate hunger, end ignorance and wipe out disease. The jury is out there and Kenyans can give a score on the progress, decades later. However, one thing is clear; healthcare remains one of the most critical issue among the Kenyan populace.
Illness is one of the most challenging matter for affected families. It is very demanding psychologically, materially and financially. Having a sick family member whips spouse, parents, and siblings’ mental state to a point of depression. Worse, is when the situation is that the affected person is the family head and is expected to be the stronger one for the rest. This can often lead to the family disintegration especially where family members cannot withstand to see their family head suffering and not being able to lead them.
Financially and materially, sickness is one of the leading causes of financial drain for families and society. Medicare is not cheap and therefore, regardless of the nature of sickness, families have to incur expenses, often nibbling of other budgetary allocations for food, education and other necessary family plans.
In some cases and depending on the cost of medicare, families are forced to take loans, organize fundraisers and dispose of property tossing people into untold poverty. Children drop out of school, family projects stall and in some cases auctioneers come knocking to recover unsettled debts. It gets worse if the nature of treatment has it that palliative care has to be involved, specialized treatment like dialysis or physiotherapy, which demands for constant flow of cash.
To alleviate all this suffering for families and affected persons, the Social Health Agency (SHA) was established under the Social Health Insurance Act of 2023. This officially replaced the National Hospital Insurance Fund (NHIF) in October 2024 to provide affordable and equitable healthcare to all Kenyans through Universal Health Coverage (UHC).
While Kenyans were elated due to the nice packaging and marketing strategy used by politicians during political campaigns, the joy was short-lived. Stories are all over the media, social places and within families, how the health scheme, which was to be a panacea for their problem, is now a source of agony.
The mandatory contribution by salaried Kenyans, according to expert estimates nets an approximate 7 billion shillings in a month! This means that over 80 billion shillings is collected within a year. These funds, if properly budgeted and put into proper use could guarantee free healthcare in all level facilities and regardless of the ailments.
It is very disappointing that despite the huge collections, Kenyans continue to suffer due to ailments that require little money while others die due to avoidable circumstances. Media reports show that many Kenyans have been detained in hospitals since SHIF pays for a very small percentage. One of the stories has it that a middle-aged woman has been detained in hospital for over five months since SHA only committed to pay Ksh. 380,000 for a Ksh. 2.9 million-hospital bill. This comes after another old frail had been detained in a private hospital for a Ksh. 2.8 million with the hospital declining SHIF. This beats the logic of having SHA as a Universal Health Coverage if some hospitals do not recognize it obviously for challenges in being paid. It took a lot of ‘’noise’’ from social media to have her released.
It is obvious that that SHA and SHIF is missing its objectives, Kenyans continue to suffer, and others die due to avoidable circumstances. It behooves experts, legislators and policymakers to review and diagnose afresh the problem of health funding in Kenya. It is not working, let us fix it.
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