Kenya’s newly established Social Health Authority (SHA) has registered more than 12 million members in its first week of operation, as the country transitions to a new social health insurance system.
The Kenyan government announced on Sunday that 12,704,548 individuals had been registered with the SHA since its launch on 1 October. This figure includes verified members from the defunct National Hospital Insurance Fund (NHIF) who have been transitioned to the new system.
“We thank all Kenyans who have engaged and supported in the process of transition,” the government said in a press statement. “We also wish to thank the many Kenyans who have given invaluable feedback on the challenges they have experienced during this transition.”
The SHA rollout aims to provide high-quality healthcare to all Kenyans without causing financial hardship. Under the new system, registered beneficiaries are entitled to free access to primary healthcare services at various levels of health facilities.
Registration for the SHA is ongoing through multiple channels, including a USSD code (*147#) and web-based portals. However, the government noted that many beneficiaries are not adding their dependents during registration and urged them to do so to ensure their family members can also access healthcare services.
The transition to the new system has not been without challenges. The government acknowledged issues with the e-claims portal in the initial days of the rollout, particularly regarding member verification and claims processing. These problems have since been addressed, according to the statement.
“The E-Claims system is up and running,” the government reported. “A total of 10,904 end users have been trained, enrolled and their credentials sent.”
The contracting of health facilities has been a key focus of the rollout. All public hospitals from levels 2 to 6 have been contracted and are offering services to SHA registered beneficiaries. As of 6 October, 1,442 private and faith-based health facilities had also returned signed contracts.
The government clarified that an earlier report of 1,577 contracted health facilities was due to a duplication error. A list of all contracted facilities is available on the SHA website, categorized for ease of access.
Negotiations with private and faith-based hospital associations have resulted in an agreement for all their facilities to return signed contracts by 8 October. In the meantime, these facilities have committed to ensuring continued access to healthcare services for SHA registered beneficiaries during the transition period.
The issue of pending bills from the previous NHIF system is being addressed. The government stated, “We have agreed with the Healthcare Providers that a joint committee Chaired by the Principal Secretary, State Department for Medical Services, shall be constituted to undertake verification of all pending bills incurred under the defunct NHIF.”
The transition to the new system has raised concerns among some healthcare providers about payment for services rendered during this period. The government has pledged to prioritize bills incurred since 1 October and maintain frequent consultations with healthcare providers.
Despite the challenges, the government reaffirmed its commitment to ensuring a smooth transition. “We assure you that we are working round the clock to ensure all challenges have been and continue to be addressed,” the statement read.
The SHA has set up a customer experience centre to provide support and assistance to the public. Kenyans can reach out for help through the toll-free number 0800 720 601.
