The process of changing the architecture of the health finance scheme in Kenya has left many beneficiaries unsure of how the looming transition to the Social Health Insurance Fund (SHIF) will work.
This is even as the government is currently transitioning to the new reforms and benefits packages in line with the new health financial architecture - SHIF.
SHIF has been described by the government as aiming to provide comprehensive coverage to all Kenyans. Under this new model, the vulnerable population will gain access to a broad spectrum of perks.
These benefits will include screening, some transplants, essential medications, and access to vital medical equipment, the majority of which were not easily accessed under the National Health Insurance Fund (NHIF).
All these enhanced packages are effective from July 1, all members are required to register for SHIF and enjoy the benefits.
The Social Health Authority (SHA) has a primary health care fund to address primary health care needs, a social health insurance fund to provide curative care, and an emergency chronic and critical illness fund responsible for managing medical emergencies.
“We want to prevent and promote wellness. We are taking care in terms of preventive, promotive, curative, rehabilitative, palliative care to see through primary health care,” detailed Chair of Social Health Authority, Timothy Olweny during an interview with Spice FM on Wednesday.
Under NHIF, the chronic and illness fund, to which implementation was met with several challenges, was purposely for critical emergencies. The government in fulfillment of constitutional health imperatives was mandated to annually disburse these funds without failure by the exchequer.
Olweny, however, pointed out some of the challenges they had encountered towards realizing the full implementation of the fund.
“One of the challenges we have had is on those who have exhausted their cover under NHIF,” he said.
To overcome such challenges in the future, the government has rolled out a second fund to cater to those with chronic and critical illnesses as encompassed in SHIF.
NHIF was equivalent to one of the funds under the Social Health Authority. SHIF comes in to replace NHIF with new benefits as initially stated.
The Social Health Authority (SHA) stated that transitioning to the new health scheme was occasioned by the inability of the NHIF to achieve the initial mandate.
To enjoy the benefits of the new health funding model, the beneficiary will be required to initiate new registration. The new registration in SHIF would target households as opposed to individuals as was in the case of NHIF. Those in formal employment are poised to pay a flat rate as opposed to those on contracts.
“Those in formal employment are going to pay a fixed proportion of their income as opposed to those in informal employment,” Timothy Olweny added.
Those already in the NHIF scheme will, however, have a faster and more efficient registration process as most of their details are in the health scheme system.
NHIF beneficiaries will use the USSD code to key in extra information needed adding on to the previous data. The beneficiary's biometrics will also be collected. The Ministry of Health is expected is to announce further details regarding the same in due course.
