New Health Fund

Kenya is embarking on a transformative journey in its healthcare system with the introduction of the Social Health Authority (SHA), replacing the long-standing National Health Insurance Fund (NHIF). This transition marks a significant shift in how health services are financed and delivered, aiming to address existing gaps and enhance healthcare accessibility for all Kenyans. Here’s everything you need to know about this major overhaul.

The New Social Health Authority (SHA)

The SHA, a state agency, is set to manage the Social Health Insurance Fund (SHIF), which is one of three new funds established under the new health regime. The other two funds are the Primary Health Care Fund (PHCF) and the Emergency Chronic and Critical Illness Fund (ECCF). Each fund has a distinct purpose:

Social Health Insurance Fund (SHIF). This is a contributory insurance fund designed to pool resources for comprehensive healthcare coverage.

Primary Health Care Fund (PHCF). This fund is dedicated to supporting outpatient services at community health facilities.

Emergency Chronic and Critical Illness Fund (ECCF). This fund addresses the financial burden of treating chronic and critical illnesses like cancer, diabetes, and hypertension.

President William Ruto has highlighted that the SHA aims to close the gaps identified in the NHIF system and to provide improved services to all citizens, regardless of their economic status. This initiative is part of a broader effort to achieve Universal Health Coverage (UHC), which has been elusive despite previous attempts.

Why the Shift from NHIF?

The NHIF, established 66 years ago, has undergone numerous reforms over the years to address the changing healthcare needs of Kenyans. Despite these efforts, the NHIF system faced criticism for its limitations, particularly in terms of coverage and equity. It primarily relied on contributions from salaried employees, leaving many Kenyans in the informal sector or those who are unemployed without adequate coverage.

The new SHI model seeks to address these limitations by creating a more inclusive and equitable system. By pooling resources from a broader population base, including those in the informal sector, the system aims to reduce inefficiencies and provide better coverage.

What Will Change Under SHA?

Contribution Rates

Under NHIF. Contributions ranged from Sh150 to Sh1,700 for salaried workers and Sh500 for self-employed individuals. Those earning Sh20,000 paid Sh750, while those earning Sh100,000 were deducted Sh1,700.

Under SHA. The contribution rate will be 2.75% of salaries for all workers. For instance, individuals earning Sh20,000 will contribute Sh550, those earning Sh50,000 will pay Sh1,375, and individuals earning Sh100,000 will contribute Sh2,750. High earners will contribute even more, with those earning Sh1 million paying Sh27,500. The minimum monthly premium for those not in formal employment has been reduced from Sh500 to Sh300.

Vulnerable Populations

The SHA introduces a significant improvement by providing coverage for vulnerable populations who are unable to contribute. The government will pay contributions on behalf of these individuals, with the national and county governments covering their costs.

Foreigners

Contributions to the fund will be mandatory for all adults seeking government services. Foreigners staying in Kenya for more than 12 months will be required to contribute to the SHIF, while those staying for less than a year must purchase travel health insurance recognized under Kenyan regulations.

Transition from NHIF to SHA

The transition to SHA officially began on October 1, with the process aiming to be completed within 12 months. The Transition Committee, established in February 2024, is overseeing the shift, including the transfer of assets, liabilities, and responsibilities from NHIF to SHA. The registration process for the new system is already underway, with over a million people enrolled by July through self-registration methods and various registration points.

How to Register

Kenyans can register through a USSD code (*147#), the SHA website (http://sha.go.ke), or by visiting NHIF offices and designated registration centers. Community Health Promoters are also available to assist with registration.

Looking Forward

The introduction of SHA represents a significant step forward in Kenya’s health financing landscape. By expanding coverage and improving equity, the new system aims to make healthcare more accessible and affordable for all Kenyans. With its focus on inclusivity and efficiency, SHA is poised to address many of the shortcomings of the NHIF and move Kenya closer to achieving Universal Health Coverage.