The revolution of Kenya’s healthcare by President William Ruto and his Kenya Kwanza ruling administration through the introduction of the Social Health Authority (SHA) and consequently the Social Health Insurance fund (SHIF) is a requirement that is inevitable. Kenyans should find a way to make it work even with the technical and efficiency hitches which have been experienced during the couples of months which has been in action.
Since independence and the inception of the traditional National Health Insurance fund (NHIF), the government of the day is making a major progress in increasing accessibility to healthcare for its people.
This scheme has the potential to provide affordable and complete care service to all Kenyans and especially to the most vulnerable low-income people in the country. With regards to population, Kenya is over 50 million people, and the nation has enormous health problems, and the SHI/SHA Health Insurance Fund is an important step towards universal healthcare.
To begin with, the SHI/SHA Fund or SHA Health Insurance Fund is established to ensure that all Kenyans are catered for under universal health insurance coverage (UHC). This falls in line with the country’s commitment to achieving its Sustainable Development Goal (SDG) of enabling healthy lives and promoting well-being for everyone at every age. The fund is built on the principle of solidarity where all Kenyans pay into a pot that can be drawn by any of the country’s inhabitants to cater for medical services.
One of the most compelling reasons Kenyans should embrace the SHI/SHA healthcare insurance scheme is that it has the potential of making healthcare less costly and easy to access. As it is, many families in Kenya bear a heavy burden of out-of-the-pocket expenditure on healthcare. A survey carried out by Kenia National Bureau of Statistics (KNBS) illustrated that a significant percentage of Kenyans spend sizable portions of their wages on financing health services which at times leads them into deeper financial strain which may result into impoverishment. On the other hand, the SHI/SHA fund, through its pooling system, allows people to pay a very small, usually subsidized monthly contribution, in return for medical services that would otherwise be unaffordable.
The current SHI or SHA model unlike most exists private health care insurance schemes is much more comprehensive and considers the poorest and least served members of society. The model allows for shared responsibility of the private citizens, employers, and the state.
This sort of innovative financing aims at improving the availability and accessibility of health services for population groups that otherwise would not afford them, including most Kenyans. Especially for people living in rural or urban low-income areas, healthcare can be Extremely costly. Often, the SHI/SHA fund provides a mechanism for collective financing of health Services, and through this Fund serve a larger segment of the population. This fund addresses a wide spectrum of health needs, from outpatient care to more specialized treatments; and can assist families and individuals avoid catastrophic expenditure which potentially may lead them into debt.
The SHI/SHA model’s architecture leans on equity, which means that it is sensitive to the healthcare needs of all populations. The fund is established such that everyone, or at least a very large percentage of the population, can contribute according to their earning capacity. This is fundamentally important for reducing the health inequality gap in Kenya. Rural areas where the population faces more challenges in obtaining quality services will greatly benefit from the fund being utilized in this manner.
People who are not able to afford the amount stipulated in the insurance can make use of the subsidies, which ensures that there are no financial barriers for anyone to join the program. Subsidized contributions to these services by the state, especially those for the unemployed and informal sectors, guarantees that the most economically disadvantaged are catered for.
In a much broader scope of health system reforms in Kenya, SHI/SHA Health Insurance Fund plays a critical role. The Government of Kenya, using the Health Policy of 2014 and Kenya’s Vision 2030 as examples, has set plans of providing universal health coverage to all its citizens. The establishment of the SHI/SHA fund is in line with these long-term health system goals.
The SHI/SHA fund may augment the public healthcare system by pooling resources aiming to deal with the high underfunding of infrastructure and the shortage of healthcare workers. With more resources in the system, public hospitals and clinics can be better equipped to serve the nation, especially the rural populations with limited services. Even more, the fund can reduce the pressure from the private healthcare facilities which are often out of reach of most of the population.
The establishment of a universal health insurance fund also puts the government into a better position to bargain for lower prices on pharmaceuticals, medical equipment, and other essential services. It could pave the way for cost savings that can be invested back to the healthcare system in a holistic way to improve the quality of care.
Embracing the SHI/SHA Health Insurance Fund is a key milestone to achieving universal health coverage where every Kenyan’s health needs are attended to. This fund goes a long way in improving health outcomes for all Kenyans by making healthcare affordable, accessible, and inclusive. This fund has numerous benefits ranging from reducing financial burdens, to encouraging preventative health care measures. As Kenya continues its development journey, investment in the health of its citizens using such innovative interventions is not a choice but a requirement for the growth of the country.
As the fund seeks to create more programs and refine existing ones, it will be critical for all citizens to familiarize themselves with the details and understand their role within the fund so that it can truly serve its purpose. In so doing, they will be participating in the building of a healthier, stronger and more sustainable nation.
