The government has postponed the rollout of the much-anticipated health benefits under the social health insurance program until further notice. This delay is primarily due to issues with the ICT system that will support the new health regime.
Although the system had been tested several times, it was not yet ready for deployment. Additionally, the ministry delayed the validation and gazettement of the new benefits package.
Health Cabinet Secretary Susan Nakhumicha announced on Friday that the National Health Insurance Fund (NHIF) will continue operating under the current system until further notice. She attributed the postponement to the withdrawal of the Finance Bill, which had allocated approximately Sh6 billion to two critical funds formed to support the Social Health Authority.
“In light of the withdrawal of the Finance Bill, 2024 that sought to finance the Primary Healthcare Fund and the Emergency, Chronic and Critical Illness Fund and set aside funds for indigents and vulnerable persons, the ministry is reworking to align to this reality. Therefore, the existing NHIF contributions and benefits will continue until we roll over to SHA,” she said at a press briefing at Afya House.
The ministry published the proposed SHA benefits package two weeks ago and asked Kenyans for their views before the package is gazetted.
According to the law, SHA benefits should begin on July 1. The Social Health Insurance (General) Regulations, 2024, says registration of members should be completed by June 30 and health services under the Act begin July 1.
“The SHA Act requires the design and publication of a new benefit package. We have, through a consultative process, developed and recently advertised the tariffs and benefit package for public participation and stakeholder input. Feedback has been incorporated ahead of a national validation and formal gazettement before the roll out,” Nakhumicha said on Friday.
She added that there are other pending issues, including the fact that health facilities that will offer services have not been contracted. Contracting can only happen when the benefits package is clear.
“The Social Health Authority board has requested and received from the regulatory bodies the list of empanelled facilities that will facilitate the SHA board to initiate contracting for purposes of service delivery ahead of the roll out,” Nakhumicha said.
The postponement of the Social Health Authority (SHA) rollout follows delays and cancellations of key activities that were scheduled in the past two weeks. For instance, a national validation exercise was planned to take place on June 21 at the Kenyatta International Conference Centre, but it did not occur. Similarly, the launch of SHA registration, expected to follow on the same date at Uhuru Park, was also canceled.
Health Cabinet Secretary Susan Nakhumicha stated that the registration for SHA would now begin next week.
“I hereby announce that registration shall commence from 1 July 2024. This will be conducted countrywide through self registration by use of a USSD *147# or www.sha.go.ke, assisted registration by Community Health Promoters, visiting the NHIF Offices and other registration points as the SHA board will designate. Please note that registration is free,” she said.
The SHA Act was enacted on October 19 last year and came into operation on November 22, 2023 (the appointed day), providing a twelve-month period to wind up the National Health Insurance Fund (NHIF). Two weeks ago, the team managing the transition from NHIF to SHA highlighted that continuing to use NHIF systems past July 1 would have financial implications, as the licenses and contracts for the NHIF system need to be renewed. They also pointed out that the Sh8 billion digital system, on which SHA will operate, is not yet ready.
“The ICT SHA system was piloted in Marsabit. Dry runs revealed that the new system was not ready and challenges are being addressed and a second repeat dry run that encompasses proxy mean testing may be done thereafter,” the team said in its meeting on Friday last week.
Section 47 of the Social Health Insurance Fund Act mandates that digitization and processes must be carried out using a secure, interoperable, verifiable, and responsive technology through an information system. This system is designed to support various functions, including:
– Registration of members
– Member identification
– Contributions to the Fund
– Empanelment of facilities
– Execution of contracts
– Notification and pre-authorization
– Claims management
– Settlement of claims
