Health Cabinet Secretary Aden Duale has explained why the government discontinued the EduAfya Medical Scheme, which provided comprehensive medical insurance for secondary school learners under the National Health Insurance Fund (NHIF), when the Social Health Insurance Fund (SHIF) was rolled out.

Speaking when he appeared before the Senate on Wednesday, May 14, 2025, Duale explained that challenges had been found in the system that was being used to manage the scheme.

According to Duale, the National Education Management Information System (NEMIS) that was used to roll out the programme was found to have fraud, misuse, and double payment arising from single treatment.

As a result, the programme was found to be unsustainable, and the government decided to re-consolidate all the special schemes into the Social Health Authority (SHA) benefit package.

“The Ministry of Education engaged the former National Health Insurance Fund (NHIF) to provide comprehensive medical cover for all students in public secondary schools. This scheme was branded EduAfya, commenced on May 1, 2018, and was renewable annually for a period of five years, lapsing December 31,” Duale said.

“This scheme was rolled out through the National Education Management Information System (NEMIS). There were several challenges that were found in that system. Fraud, misuse, and double payment were found in the Edu Afya programme arising from single treatment. The government resolved to re-consolidate all these special schemes into the Social Health Authority (SHA) benefit package.”

CS Health Aden Duale: Fraud, misuse, double payment was found in the edu afya programme arising from single treatment. The government resolved to re-consolidate all these special schemes into the Social Health Authority (SHA) benefit package. #SenateLive pic.twitter.com/thz4f7f80N

— Senate of Kenya (@Senate_KE) May 14, 2025

Sifuna seeks clarification

Duale was responding to Nairobi Senator Edwin Sifuna, who had questioned why the EduAfya programme was discontinued.

“Why was the EduAfya Medical Scheme, which provided comprehensive medical insurance for secondary school learners under the National Health Insurance Fund (NHIF), discontinued under the current Social Health Insurance Fund (SHIF) programme?” Sifuna questioned.

Sen. @edwinsifuna (Nairobi): Why was the EduAfya Medical Scheme, CS Duale, which provided comprehensive medical insurance for secondary school learners under the National Health Insurance Fund (NHIF), discontinued under the current Social Health Insurance Fund (SHIF) programme?… pic.twitter.com/ocTeJpyLjn

— Senate of Kenya (@Senate_KE) May 14, 2025

EduAfya discontinued

The Social Health Insurance Act, 2023, which repealed NHIF, established three new funds: the Primary Healthcare Fund, the Social Health Insurance Fund, and the Chronic Illness and Emergency Fund.

The Ministry of Education had contracted NHIF to offer a unique comprehensive medical insurance cover for public secondary school students.

The cover had been effective since May 2018. It covered all children in public secondary schools in Kenya.

In February 2023, a citizen petitioned the National Assembly to intervene over the poor implementation of the Edu-Afya Medical Scheme in public secondary schools.

The petitioner, Joyce Cherono, argued that the scheme was yet to be optimised.

“The petitioner is afraid that if intervention is not made towards ensuring that the programme is optimally implemented, the gains envisaged from the scheme will be lost,” National Assembly Speaker Moses Wetang’ula told MPs.

Through the cover, the government paid a premium of Ksh1,350 per student.

They were targeting three million students who were in public secondary schools to fulfil the Big Four Agenda – the provision of affordable health care.

The petitioner wanted the House to cause the relevant ministries to urgently review the framework for implementing the scheme to ensure it benefits all public secondary students equally.