President William Ruto’s administration is facing a challenging task in ensuring the delivery of quality and affordable healthcare, which served as a key rationale for the proposed monthly deductions set to generate at least Sh133 billion annually. This move comes amidst concerns over the inadequately equipped state of both public and private hospitals.
As early as March, Kenyans could see a deduction of 2.75 percent from their gross monthly income to finance the Social Health Insurance Fund (SHIF), which pledges a comprehensive package covering primary healthcare, emergencies, chronic, and critical illnesses. The SHIF, slated to replace the longstanding National Health Insurance Fund (NHIF) of over 57 years, even pledges to facilitate overseas treatment when local options are unavailable.
To access these healthcare services, individuals are required to register as SHIF members and make monthly contributions. The government anticipates that this initiative will reduce out-of-pocket health expenditures from about 24.3 percent to below 10 percent.
However, a study commissioned by the Ministry of Health (MoH) and the Kenya Medical Practitioners and Dentists Council raises doubts about the feasibility of accessing these services without substantial investments in infrastructure, equipment, and personnel.
According to the study, conducted last August and published in December, many hospitals lack sufficient healthcare providers and essential infrastructure to deliver the promised services. Out of the 12,384 health facilities surveyed, representing 86.2 percent of all public, faith-based, and private health facilities across Kenya, only two percent provided all 16 basic outpatient services assessed by the MoH.
Moreover, the study highlights deficiencies in maternity services, emergency obstetric care, blood transfusion services, and access to oxygen and ambulances. Less than half of the hospitals offered maternity services, with only a third equipped for emergency obstetric care. Additionally, access to critical care services such as ICU and HDU was limited, with only a small fraction of facilities capable of providing these services.
Furthermore, the study indicates a shortage of essential medicines and pharmaceutical supplies, hindering patients’ access to necessary treatments despite having insurance coverage. Renal services were also notably scarce, with only a fraction of facilities equipped to handle renal failure cases.
The study underscores the need for substantial investments in healthcare infrastructure, equipment, and human resources to meet the demands of the SHIF. It recommends scaling up critical care services, enhancing pharmacy services, and ensuring the availability of essential medicines and non-pharmaceutical supplies in all health facilities.
Additionally, addressing the shortage of healthcare personnel, particularly in underserved areas, is crucial for the successful implementation of universal health coverage (UHC). The study emphasizes the importance of revamping human resources in primary healthcare facilities to ensure adequate staffing levels.
Moreover, the study highlights disparities in the distribution of healthcare facilities across counties, indicating a need for improved access to healthcare services in underserved regions. Accreditation of health facilities with the SHIF will also be necessary to expand coverage and address concerns over delayed claims settlement.
In conclusion, the successful implementation of the SHIF hinges on addressing the identified gaps in healthcare infrastructure, personnel, and service delivery. Without substantial investments and reforms, the ambitious goal of universal health coverage may remain elusive for many Kenyans.
