Kenyans to use NHIF beyond July 1 as new system not ready

The new Social Health Authority is not ready for a full launch next week, the team overseeing the rollout has noted.

The Transition Committee, which is tasked with facilitating the shift, suggested that the NHIF should continue while SHA is launched in phases.

This is because some key components that will support the new health authority are not ready.

The full transition from the National Health Insurance Fund to the SHA was scheduled to start on July 1, 2024.

“The ICT SHA system was piloted in Marsabit. Dry runs revealed that the new system was not ready and challenges are being addressed and a second repeat dry run that encompasses proxy mean testing may be done thereafter,” the team said in its meeting on Friday last week.

“The ICT experts have been requested to report for SHA alternatives on the  ICT system especially on the registration and contribution domain. There is a need for an alternative solution even including recalling the SHA regulations and use of NHIF.” 

The minutes for the meeting, seen by the Star, noted the continued use of NHIF systems past July 1 will have financial implications, because the licences and contracts for the NHIF system need to be renewed.

Section 47 of the Social Health Insurance Fund (SHIF) requires that digitisation and processes be done using a secure, interoperable, verifiable and responsive technology through an information system.

The system supports registration of members, member identification, contributions to the Fund, empanelment of facilities, execution of contracts, notification and pre-authorisation, claims management and settlement of claims.

However, the team noted the progress, including preparation of  key messages by the Ministry of Health and meetings with the media and other stakeholders.

They said the public participation report for the proposed SHA benefit package was received last week and amendments are ongoing.

The digitised ICT template for developing the package has been done. However, the SHA board needs to incorporate the changes suggested by Kenyans and gazette a new benefit package.

“Transition committee needs to make a formal submission and proposal for addressing issues in the alternative plan due to the identified factors that are not ready for July 1 and this includes staggered implementation of the benefit package among others. This will imply communication methodologies including who will make such communications,” they said.

The committee is chaired by KapKirwok Jason and members include 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 on the suggestions.

Council of Governors chair Anne Waiguru said they had a meeting with the Health CS Susan Nakhumicha to discuss the rollout.

She noted the integrated health information system for facilitation of health service delivery has not been rolled out in all health facilities.

 This is partly due to lack of requisite infrastructure such as electricity and internet connectivity in some health facilities.

“The Ministry of Health shall cover all cost pertaining the rollout and maintenance of the Integrated Health Information system,” she said.

Waiguru said the ministry should also ensure that Sh8 billion owed to counties by the defunct NHIF will be paid.

“The Ministry of Health in collaboration with county governments shall conduct a public campaign on the rollout of registration of citizenry to Social Health Authority,” she said.

Last week, Public Health PS also noted that counties have designated just half of the needed treatment hubs that will be the first port of call for Kenyans seeking health services in the rollout that starts next month, meaning the devolved units are not ready for the shift.

In the SHA, Kenyans will be required to first visit a health facility within their chosen hub when seeking services.

The hubs, called Primary Health Care Network may then refer them to a higher hospital within or outside the network.

PS Mary Muthoni said to date, 160 primary care networks have been successfully set up and 41 are in progress.

One PCN consists of several dispensaries, health centres and at least one Level 4 hospital that acts as the referral facility for that network.

The goal is to establish about 315 Primary Health Care Networks across the 47 counties.