There has been a national outcry over the management of the Social Health Insurance Fund (SHIF). The major concern has been around access to services, with many patients being turned away.  

Arguments have also been advanced that the transition from NHIF and SHIF was shambolic.

The government stands accused of delaying remittances to firms that handled the insurance scheme while State officials were flagged for ineptitude and cutting illegal deals. 

Many healthcare providers have reported issues logging into the system managed by the Social Health Authority. 

According to the SHA Healthcare Providers Consortium survey, 64 per cent of providers lacked credentials to access the system, severely limiting their ability to treat patients. 

The digital claims processing system has been plagued with failures, forcing providers to revert to manual claims forms.

This regression has been a direct response to protests from healthcare providers who found themselves unable to access necessary services. 

The success rate for patient verification stands at only 50 percent with many hospitals struggling with incorrect family member registration details. 

That is why we hope that the reforms proposed by the Ministry of Health will yield fruit. We gather that the State has agreed to enhance the packages provided for under SHIF. 

Documents in possession of People Daily, prepared ahead of a Cabinet retreat in mid-April, show that beneficiaries will be entitled to the enhanced benefits package. 

For instance, the package for oncology (cancer) treatment has been raised from Sh400,000 to Sh550,000, Intensive Care Unit (ICU) services from Sh4,480 to Sh28,000, while access to primary health care and emergency, chronic and critical illnesses funds is to be given to all Kenyans. 

It is understood that the government has in the 2025/2026 financial year budgeted Sh81.7 billion as SHIF premiums that will support national government-sponsored facilities and Sh712 million for health information system programmes. 

Some Sh150 million will be set aside for elderly persons with disabilities, Sh2.05 billion for Linda Mama, Sh4 billion for county government-sponsored indigents, Sh61.1 billion for the Primary Health Care Fund, Sh107 billion for the Emergency, Chronic, and Critical Illness Fund, and Sh8.5 billion for Public Officers Medical Scheme.