The new Social Health Authority (SHA) is not ready for its full launch next week, according to the team overseeing the rollout. The Transition Committee, responsible for facilitating the shift, has recommended that the National Health Insurance Fund (NHIF) continue its operations while the SHA is launched in phases.
Several key components necessary to support the new health authority are still under development. The full transition from NHIF to SHA was initially scheduled for July 1, 2024.
“The ICT SHA system was piloted in Marsabit. Dry runs revealed that the new system was not ready. Challenges are being addressed, and a second dry run, including proxy mean testing, may be conducted thereafter,” stated the team during their meeting last Friday.
ICT experts have been asked to explore SHA alternatives, particularly in the registration and contribution domains. There is a possibility of reverting to NHIF regulations if necessary.
Minutes from the meeting, seen by the Star, highlighted the financial implications of continuing to use NHIF systems beyond July 1, as licenses and contracts for the NHIF system will need renewal.
Section 47 of the Social Health Insurance Fund (SHIF) mandates that digitization and processes be conducted using secure, interoperable, verifiable, and responsive technology through an information system. This system supports member registration, identification, contributions, facility empanelment, contract execution, notification and pre-authorization, claims management, and settlement.
Despite these setbacks, progress has been noted, including the preparation of key messages by the Ministry of Health and meetings with media and stakeholders. A public participation report for the proposed SHA benefit package was received last week, and amendments are ongoing.
The digitized ICT template for developing the package is complete, but the SHA board needs to incorporate suggested changes and gazette a new benefit package.
“The Transition Committee needs to formally address the issues identified for the alternative plan, including staggered implementation of the benefit package. Communication methodologies, including the spokesperson, must be clarified,” they added.
The committee, chaired by KapKirwok Jason, includes doctors Daniel Mwai, Kipruto Chesang, Jacinta Wasike, Elizabeth Wangia, Jacob Otachi, and Stanley Bii. Other members are Gladys Wambui, Stephen Kaboro, and Christopher Leparan. KapKirwok and SHA Chair Timothy Olweny declined to comment.
Council of Governors Chair Anne Waiguru mentioned a meeting with Health CS Susan Nakhumicha to discuss the rollout. She noted the integrated health information system for facilitating health service delivery has not been implemented in all health facilities, partly due to the lack of infrastructure such as electricity and internet connectivity.
“The Ministry of Health will cover all costs related to the rollout and maintenance of the Integrated Health Information System,” Waiguru said, adding that the ministry should also ensure the payment of Sh8 billion owed to counties by the defunct NHIF.
“The Ministry of Health, in collaboration with county governments, will conduct a public campaign on the rollout of SHA registration,” she added.
Last week, Public Health PS noted that counties have designated just half of the needed treatment hubs for the SHA rollout, indicating that the devolved units are not fully prepared for the shift. Under SHA, Kenyans must first visit a facility within their chosen hub when seeking services, with the possibility of referral to higher hospitals.
PS Mary Muthoni reported that 160 primary care networks have been successfully established, with 41 in progress. One Primary Care Network (PCN) consists of several dispensaries, health centers, and at least one Level 4 hospital serving as the referral facility. The goal is to establish approximately 315 PCNs across 47 counties.