Health Cabinet Secretary Aden Duale has clarified the government's termination of the EduAfya medical insurance scheme for all public secondary school students, replacing it with the Social Health Authority (SHA) benefits package.
Speaking before the Senate on Wednesday, May 14, Duale explained that this programme, which lapsed in December 2023, faced significant challenges, including fraud, misuse, and double payments for single treatments.
According to Duale, these problems were linked to the NEMIS, which was used to manage the programme. He added that if the Senate wanted specific details, he could provide the names of institutions involved in the fraud.
“Hon Speaker, this scheme was all out through the National Education Information System (NEMIS). Several challenges were found in that system: fraud, misuse, and double payments, which led to the halt of the institution arising from a single treatment,” he said.
On January 16, the government announced plans to revamp the contentious EduAfya scheme to incorporate all school-going children. Through the 2025 Budget Policy Statement, the National Treasury said the government was keen on implementing strong institutional and strategic measures to extend the impact of Universal Health Coverage (UHC).
EduAfya was a medical insurance programme introduced by the Ministry of Education in partnership with the former National Hospital Insurance Fund (NHIF).
The programme was launched on May 1, 2018, and was designed to provide health coverage to all students in public secondary schools. It was renewable every year for five years, ending on December 31, 2023.
“The Ministry of Education engaged the former National Hospital Insurance Fund to provide medical insurance coverage for all students in public secondary schools. This scheme was branded EduAfya, commenced on the first of May 2018, and was renewable annually for a period of five years, lapsing December 31,” he said.
To address these issues, the government has decided to consolidate EduAfya and other special schemes managed by the now-defunct NHIF into the SHA benefits package.
Duale said this move is aimed at providing quality healthcare for all Kenyans and ensuring that every child has access to the best health services, as guaranteed by the Kenyan Constitution under Article 53(1c) and the Children's Act.
“Therefore, Hon Speaker and senators, the consolidation of the EduAfya scheme with all the schemes that were managed by the defunct NHIF is geared at implementing the highest attainable standards for all Kenyans and furthering the rights of the child. Under SHA, students belong to households and are eligible to benefit from the three funds,” Duale explained.
Students who were under EduAfya will now be covered through their households under the SHA programme, ensuring continued access to medical services and improved oversight to prevent issues of fraud and misuse.
