Patients with chronic and critical conditions are now benefiting from the new medical scheme, the Social Health Insurance Fund – implemented across the country from October 2024.
The scheme is designed to meet the needs of patients with life-threatening conditions and the high costs associated with treating them.
Nonetheless, the onboarding process has seen both successes and obstacles.
Eunice Atieno Odinga was in urgent need of surgery for a triangulated hernia—a condition that could have been fatal without timely intervention.
Her husband, Mohammed Vin Chris, had diligently saved with NHIF for over a decade and faced the reality that these savings were insufficient to cover the costly, immediate surgery his wife required.
However, the gradual integration of SHIF allowed Odinga to receive life-saving treatment.
The onboarding process for SHIF is happening incrementally across healthcare facilities, and many hospitals are now adjusting their systems and processes to accommodate patients, especially those who were previously insured by the defunct NHIF.
Kennedy Kabui, the Head of Specialist Services at Ruai Family Hospital (RFH), explained that while the hospital’s onboarding process posed technical and logistical challenges, the transition was critical for meeting patients’ needs.
He emphasised that in RFH facilities, patients can still use their old NHIF cards, thanks to their seamless integration with the new SHA system.
“Migrating patient records and ensuring continuity of care has been a complex but necessary step,” said Kabui.
“Now, the majority of our patients, including former NHIF members, can access treatment without delay or additional administrative hurdles.”
Tony Okoth, Clinical Lead at RFH, shed light on the medical aspects of onboarding and the critical nature of timely interventions.
He noted that Odinga’s case was life-threatening, and the medical team had to act quickly to perform the surgery.
“The availability of coverage for life-saving procedures has made an enormous difference,” he said.
The successful operation is not only saved Eunice’s life but also highlighted the potential of the Social Health Authority to transform patient outcomes on a larger scale.
SHA onboarding process has faced challenges, particularly for patients needing urgent care in facilities that have not yet completed their SHIF integration. Patients often encounter delays and confusion due to unfamiliarity with the new system.
