Kenya’s Transition to the Social Health Insurance Fund (SHIF): What You Need to Know
Kenya is on the verge of a transformative healthcare shift with the launch of the Social Health Insurance Fund (SHIF) in October 2024, replacing the long-standing National Health Insurance Fund (NHIF). This new initiative aims to expand access to healthcare services for all citizens, marking a significant step towards achieving Universal Health Coverage (UHC).
What is SHIF?
The SHIF is a government-driven initiative designed to provide comprehensive health coverage for Kenyans. It replaces NHIF, a system that, while in place for 58 years, struggled to fully meet the healthcare needs of the population, particularly the informal sector. SHIF introduces a more inclusive and equitable system where everyone, including those in informal employment, can access essential healthcare services (Nairobi Wire)(Citizen Digital).
Key Features of SHIF
- Mandatory Contributions: Formal sector workers will contribute 2.75% of their salary, while the self-employed and informal workers will pay a lower, fixed contribution. The government will also subsidize payments for those unable to afford the costs(Nairobi Wire)(Tuko.co.ke – Kenya news.).
- Comprehensive Coverage: SHIF aims to cover a wider range of medical services, including outpatient, inpatient, and critical care. Specialized care for chronic diseases like cancer, diabetes, and hypertension will be provided at discounted rates. For instance, dialysis services will be covered up to KSh 85,200 per month making it 1.2m per year up fron Ksh960,000 of NHIF, and oncological services will receive coverage of up to KSh 400,000(Tuko.co.ke – Kenya news.)(Citizen Digital).
- Improved Maternity Care: The integration of the Linda Mama program into SHIF ensures enhanced maternal care, with KSh 10,000 for normal deliveries and KSh 30,000 for C-sections which have remained unchanged from NHIF, aiming to reduce maternal mortality rates(Nairobi Wire).
- Digital Transformation: SHIF is nearly 100% digitized, eliminating the need for physical cards. Beneficiaries will access services using their National ID cards, supported by biometric verification. This digital shift promises to enhance transparency, reduce corruption, and simplify access to healthcare(Citizen Digital).
Benefits and Challenges
SHIF is expected to bring more people into the healthcare system, particularly those in the informal sector, who were previously underserved. The fund will cover essential health services and provide preventive, curative, and rehabilitative care(Nation)(Kenyans). However, there are concerns over the increased financial burden on high-income earners, who will see higher deductions from their salaries. Additionally, some have raised questions about the transition process from NHIF to SHIF, with uncertainties about how existing NHIF contributions will be handled(Nation) and the huge cost the transition will take of about Ksh104Billion.
Conclusion
The introduction of SHIF represents a significant move toward universal healthcare in Kenya. With its focus on inclusivity, comprehensive care, and digital efficiency, it has the potential to reshape the country’s healthcare system. However, as the system rolls out, addressing concerns over contributions and ensuring a smooth transition will be key to its success.