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President William Ruto yesterday moved fast to forestall the impending crisis in the health sector and made leadership changes at the Social Health Authority (SHA) board.

With October 1—when SHA is expected to be in operation—less than 14 days away and with nothing to show any signs of the anticipated transition from National Health Insurance Fund (NHIF) to the new entity, Ruto replaced Timothy Olweny with Dr Abdi Mohamed as the SHA board chair.

Mohamed who will serve for three years effective September 17, has been serving as the Social Health Authority Independent Board Director.

In the changes made through a special gazette notice, Olweny was transferred to the board of the National Cancer Institute where he will serve as the chair for a period of three years.

Ruto is scheduled to officially launch the operationalisation of SHA in an event that sources intimated is likely to be postponed due to inadequate preparations by the Olweny-led board.

Sources at Afya House told People Daily how the President was forced into action after learning that nothing was happening on the ground despite the D-Day when NHIF is supposed to officially hand over its functions to SHA.

The last date for anybody to be admitted to any health facility under NHIF is September 30 and on November 1, NHIF will automatically cease to exist. All payments received on or before October 9, 2024 would be received by NHIF while payments received from November 9 onwards will be credited to SHA.

The board has neither recruited the pioneer staff nor established a secretariat that would oversee the running of the new entity that would be charged with the responsibility of overseeing the health insurance of Kenyans.

Timelines drawn

According to timelines stipulated in the SHA Act 2023, SHA was supposed to have recruited her staff by early July 1, and subsequently operationalise a full fledged secretariat by then, two important decisions that are yet to be made.

The team was also to have established the three key independent pillars Social Health Insurance Fund (SHIF), Emergency, Chronic and Critical Illness Fund and the Primary Healthcare Fund that are expected to drive President Ruto’s Universal Health Coverage (UHC ).

All are still pipe dreams.

And despite the SHA having embarked on recruitment of members ahead of the October 1 launch, the team is yet to map out health facilities to be accredited and the modus operandi.

“The President had to move fast after it became known to him that nothing was moving on the ground. There is nothing for the President to launch on that date. Olweny was just too slow in everything, ” a source told the People Daily.

The former Secretary General of the Kenya Association of Private Hospitals (KAPH) is also said to have failed to harness unity among board members.

Other members of the five-member SHA board include the Secretary General of the Central Organization of Trade Union (COTU) Francis Atwoli, Zakayo Gichuki , Jacinta Mutegi and Principal Secretaries for National Treasury and Health.

Sources said Atwoli had first raised concerns over the board’s failure to execute its mandate sometime in June and even at one time raised the matter with President Ruto.

Nothing going on

Consequently, Atwoli is reported to have skipped the board’s last three meetings on grounds that the chairman was not offering leadership.

“The meetings were a waste of time as board members were called without any agenda to discuss. There was nothing going on at all,” the source said.

Also of concern is SHA’s failure to institute mechanisms on how the more than Sh300 billion debts that NHIF owes various creditors would be offset. Health facilities alone are owed more than Sh32 billion.

Under the new SHIF scheme, formal sector employees are required to contribute 2.75 per cent of their monthly salaries.
Kenyans in the informal sector will pay a fixed monthly amount of Ksh.500.

In the previous NHIF system, contributions ranged from Ksh. 1,400 to Ksh.1,700 monthly, depending on salaries, with an equivalent employer match. Self-employed individuals previously made voluntary contributions of Ksh. 500.

On Monday, Health Cabinet Secretary Doborah Mulongo Barasa had disclosed that over 1.2 million people have so far voluntarily registered for the Social Health Authority (SHA) programme ahead of its rollout on October 1.

Speaking during the launch of the countrywide training, Barasa said SHA will move current National Health Insurance Fund (NHIF) members to the new system emphasizing the need to finish the registration process.

Digital health portal

“Over 1.2 million people have voluntarily registered. Ensure you register before visiting healthcare facilities. SHA will transfer existing NHIF members to the new system, so it’s important to complete your registration,” she said.

Barasa said the National Training of Trainers on the digital health portal is aimed at equipping healthcare workers with the skills needed to provide an improved healthcare experience.

She said the training will ensure nationwide coverage, enhancing operational efficiency for better patient outcomes, and strengthening health financing systems.

The training comes few days after Government Spokesperson Isaac Mwaura said the government was focused on public awareness and education regarding the transition from NHIF to SHA.

“The government has therefore directed all civil servants to register for the Social Health Insurance Fund (SHIF) by next month,” Mwaura had announced.

Mwaura announced that draft contracts with healthcare providers had been finalized.

Kenyans will, therefore, not be able to access healthcare services under NHIF after September 30, as the government plans to fully transition to the new health insurance scheme SHIFT.