Mumias East Member of Parliament, (MP) Peter Salasya has called on the government to reconsider Kenya's newly implemented health Insurance Scheme, the Social Health Authority (SHA).
The First time legislator, urges government instead to consider reverting to the old National Health Insurance Fund (NHIF), citing concerns over the new scheme’s effectiveness.
Speaking in Naivasha on Thursday, January 30, 2025, Salasya raised questions about the implementation of SHA, questioning whether there had been adequate public participation in its launch.
According to him, it seems that the program only benefits public hospitals, which are already overwhelmed and unable to support the growing demand for healthcare services.
“No 1, was there public participation? Because it seems to me there was no participation even with private hospitals because it seems it only supports public hospitals and there are not enough public hospitals and facilities to support the program,” Salasya noted.
The new Health Insurance Scheme has made headlines for controversial reasons since it's roll-out late last year, despite government's promise on universal health coverage through the scheme.
The Social Health Authority pre-authorization portal has on numerous occasions been non-functional, causing significant delays in critical surgical procedures and forcing hospitals to either postpone surgeries or require cash payments from patients.
The system failures come less just a months into SHA's operations, which was intended to streamline healthcare access and affordability but has instead been plagued by inefficiencies and growing dissatisfaction among stakeholders.
Hospitals report pending approvals dating back to late November, none of which have been cleared, leading to a situation where hospitals must choose between sending patients home to await approval or requiring upfront cash payments for emergency procedures.
Hospital administrators have expressed concern about the financial risks of performing procedures without approval, as they may not be reimbursed, effectively forcing them to deny services to SHA-reliant patients or require immediate cash payments.
The Ministry of Health however, claims to have streamlined operations, alleging that outages have been addressed and SHA is running seamless.
Patients, who about a week ago stomped the Ministry's Board Meeting following Frustrations, beg to differ.
The President and leaders affiliated to the ruling Kenya-Kwanza administration on the other hand have continued to campaign for the scheme, urging Kenyans to register and continue contributing, exuding confidence in it's ability to improve health care in the Country.
The implementation has been marred by chaos and controversy, following numerous ignored red flags including multiple postponements, system failures, and the abrupt suspension of CEO Elijah Wachira.
Key red flags included Parliament's concerns over a Sh104.8 billion digital system contract, failed test runs in pilot counties, and insufficient public participation.
The transition from NHIF faced multiple delays from April to October 2024, with critics including Health Committee Chair Robert Pukose warning about potential corruption and questioning the need to replace NHIF's functional IT system.
Despite clear warnings from lawmakers, civil society groups, and healthcare stakeholders, the government proceeded with the rollout, leading to system glitches and service delivery challenges that have significantly impacted healthcare access.
The World Bank's 2023 Digital Health Implementation Guide specifically cautioned against the "big bang" approach adopted by Kenya, recommending instead a phased rollout with robust contingency plans.