The transition from the National Health Insurance Fund (NHIF) to the Social Health Authority (SHA) has been marred by controversy, with claims that entrenched cartels within the Ministry of Health (MoH) are actively sabotaging the new system. The national chairman of the Kenya Union of Clinical Officers (KUCO), Peterson Wachira, has alleged that the same corrupt networks that led to the downfall of NHIF are now hindering the effective rollout of SHA.
Speaking on Tuesday, hours after clinical officers began their nationwide strike, Wachira said these cartels are responsible for the current healthcare crisis, citing systemic failures in the new health scheme. He accused these networks of frustrating efforts to streamline healthcare financing in the country.
The SHA was introduced as a replacement for NHIF to improve the efficiency and accessibility of healthcare services for Kenyans. However, since its implementation, the new system has faced significant issues, including system failures, patient verification difficulties, and delays in reimbursements to hospitals. These challenges have left many Kenyans struggling to access medical care despite mandatory deductions from their salaries.
Currently, employees are required to contribute 2.75% of their monthly earnings to SHA, yet the expected benefits remain elusive. The transition from NHIF to SHA has been anything but smooth, with healthcare providers expressing concerns over delayed payments and operational inefficiencies.
The ongoing strike by clinical officers has further complicated the situation. The healthcare workers are demanding recognition and inclusion in the new scheme, arguing that the Social Health Authority has sidelined them. Specifically, they are pushing for:
Recognition and Empanelment – Clinical officers want health providers licensed by the Clinical Officers Council to be included in SHA’s system so they can offer services under the scheme.
Implementation of Past Agreements – They are also demanding the full implementation of agreements reached in a previous return-to-work formula, which included promotions, comprehensive medical coverage, and the confirmation of clinical officers in permanent and pensionable positions.
Fair Contracting and Payments – KUCO has raised concerns about the lack of clear contracting mechanisms and delayed payments to healthcare facilities run by clinical officers.
According to Wachira, these issues have persisted due to deliberate interference by powerful individuals who benefited from NHIF’s inefficiencies and are now working to undermine SHA
Health Cabinet Secretary Deborah Barasa has called for patience, stating that her ministry is reviewing SHA’s benefits and tariffs. She assured Kenyans that changes would be communicated by March 1. However, with ongoing system failures and unresolved concerns from healthcare workers, public confidence in the new scheme remains low.
The Ministry of Health has also blamed NHIF’s outstanding debt of KSh 43 billion for some of the service disruptions, further complicating the transition. Meanwhile, health organizations and civil society groups have expressed concern over the deteriorating state of public healthcare, particularly in specialized services like cancer treatment.
Wachira has urged the government to take strong measures against the alleged cartels operating within the Ministry of Health. He emphasized that unless these corrupt elements are dealt with, the challenges plaguing the healthcare system will persist, ultimately harming ordinary Kenyans who rely on public health services.
As the standoff between the government and clinical officers continues, many Kenyans remain frustrated, struggling to access the medical care they are paying for. Whether the government will meet the demands of the striking workers and tackle corruption within the healthcare sector remains to be seen.
