The transition from the National Health Insurance Fund (NHIF) to the Social Health Insurance Fund (SHIF), set to be rolled out on October 1, has raised significant concerns within the healthcare community in Kenya. Kahura Mundia, the deputy national chairperson of the Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU), has voiced strong objections, highlighting several critical issues surrounding the implementation of SHIF.
One of the most glaring concerns Mundia raised is the exclusion of dental services during SHIF’s first year of operation. This decision means that Kenyans will not have access to dental benefits under the new scheme, forcing individuals to seek alternative, often costly, dental coverage. Mundia criticized this omission, pointing out that dental health is integral to overall well-being, especially given the rise in oral-related emergencies and conditions like mouth cancer. This exclusion may lead to more out-of-pocket expenses for the general public, which could strain households, especially those already financially burdened.
Beyond dental services, the overall readiness of the SHIF rollout seems to be in question. Mundia revealed that health service providers, including both public and private facilities, have not been fully onboarded. Contracts between these providers and SHIF are yet to be finalized, meaning there’s uncertainty about which facilities will be available for registered Kenyans to access care. This lack of clarity could lead to confusion among patients when the scheme goes live, as they may not know where to seek medical attention.
Another critical point Mundia touched on is the funding—or lack thereof—for SHIF. According to him, no money has been allocated to SHIF or its emergency funds as the implementation date approaches. This raises concerns about the fund’s sustainability, especially considering the volume of cases health facilities deal with daily. Without timely disbursement of funds to the healthcare providers, there’s a genuine risk that the system might collapse under the weight of the demand.
In addition, public awareness appears to be another challenge. Despite the Ministry of Health reporting that 1.9 million Kenyans have already registered for SHIF, the public has not been provided with clear guidance on selecting service providers. As Mundia pointed out, significant resources are being spent on publicizing SHIF, but these efforts may fall short if the basic details, such as participating facilities, are not communicated to the registered individuals in time.
The concerns raised by the KMPDU about the transition to SHIF highlight several important gaps in the system. Without addressing these issues, the rollout may face challenges that could affect the quality of healthcare in Kenya and leave many citizens with unexpected medical costs. The government, through the Social Health Authority (SHA), will need to take urgent steps to ensure that SHIF is well-prepared, adequately funded, and that service providers are on board to prevent a potential healthcare crisis.