The government has moved to address the public pressure on the implementation of the Social Health Insurance Fund (SHIF) and agreed to enhance the packages provided under the fund.

Documents seen by People Daily that have been prepared ahead of a Cabinet retreat in mid-April show that beneficiaries will be entitled to the enhanced benefits package under SHIF.

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.

To this end, the documents shows that government has in the 2025/26 financial year budgeted Sh81.7 billion as the SHIF premiums that will  support national government sponsored facilities, Sh712 million for Health Information System Programme, Sh150 million for Elderly Persons with Disabilities, Sh2.05 billion for Linda Mama, Sh4 billion for county government sponsored indigents, Sh61.1 billion for Primary Health Care Fund, Sh107 billion for Emergency, Chronic, and Critical Illness Fund and Sh8.5 billion for Public Officers Medical Scheme.

The document is a response to Head of Public Service Felix Koskei who requested the ministry to forward gap analysis and forward prioritisation matrix ahead of the Cabinet retreat.

Low engagement

The document, which shows there has been a 133 per cent increase in SHIF membership with the current registration standing at 21 million people compared to eight million that had registered with the defunct National Health Insurance Fund (NHIF), blames a number of issues for the low enrolment.

These include low registration in some counties, members registering but not paying the premiums, members registering and only paying when they need benefits, leading to adverse selection as well as late remittance of member contributions by employers.

With regards to operationalisation of the Digital Health Agency, which requires Sh200 million for operations, the report shows that over 20 million Kenyans have been registered through the digital platform while in respect to digitisation of health facilities, the report shows that the roll out of TaifaCare is ongoing in Mombasa, Embu and Kirinyaga that have been clustered in the phase one roll-out.

On claims submission from health facilities through the health provider portal, the report shows that 8,615 health facilities out of 15,000 have been enrolled while 5,665 digital equipment have been distributed across the country.

On the calls to enhance primary health care, the report shows that 106,542 (99.6 per cent) Community Health Promoter (CHPs) have been trained as well as provided 100,000 kits containing basic medical equipment.

Through the CHP Programme, a total of 8.5 million households out of a targeted 12.5 million have been visited, translating to 68 per cent coverage while 225 out of 315 Primary Care Networks have been established representing 71 per cent coverage.

Stipends question

In terms of stipends, the report shows a 233 per cent increase in the number of CHPs receiving Sh2,500 stipend from 29,000 in 2022 to 96,542 in 2025. The provision of the stipend has also been streamlined to ensure prompt payment.

The report however raises concerns that 10 counties are not paying the stipends, 7000 CHPS kits have been missing, all households yet to access and get registered adding that there have been stock outs for consumables in the kits while whitelisting for CHPs is yet to be fully implemented.

Currently, the report says that there are 30 doctors,’ nurses, midwives and clinical officers for over 10,000 people which is 68 per cent of the total required to meet the SDG3 target.