The Government has temporarily revised its Social Health Authority (SHA) payment policy, to provide relief to informal sector workers who may struggle with lump sum contributions.
Non-salaried individuals will now have the option to pay their SHA premiums monthly instead of the previously scheduled annual lump sum.
Under the gazetted SHA regulations, the transition plan from the now-defunct National Health Insurance Fund (NHIF) to the SHA stipulates that those not on the payroll make a one-off annual payment before receiving treatment at any of the health facilities Contracted.
Initially, the annuity requirement for informal workers was a way to reduce default.
Many in the informal sector have irregular incomes, and government officials have raised concerns that monthly payments would lead to inconsistent contributions, which could weaken the funding base needed to maintain the Social Health Insurance Fund (SHIF), the only fund designed to pool resources for universal health care. . .
This challenge has been familiar since the days of the National Health Insurance Fund, where inconsistent monthly contributions led to significant gaps in the Fund’s resources, impacting service delivery and coverage.
During a roundtable for reporters on Monday, government officials said the temporary measure is an incentive for informal sector workers to sign up for the SHA and that the prorated payment option makes it more accessible to individuals who are struggling or may struggle to afford it. Lump sum.
The scheme requires families to contribute 2.75 percent of their income. For workers, this percentage depends on their income, while for those who do not have a fixed monthly income, contributions are calculated using a means-testing tool that takes into account earnings and assets.
Former NHIF chief executive Samson Kohora, who now heads up member benefits design at the SHA, said: “There is a provision within the regulations that it must be an annual contribution and internally we have a reminder system which aims to ensure that those reminders are sent out, firstly, three months in advance.” From expiration and two weeks before expiration to ensure that we have a way to enforce compliance. We appreciate that there are challenges in collecting the total amount, which is why a member can choose to pay for one month.”
The SHA official added that the authority is developing an insurance premium financing option, which is expected to become operational within three months.
“The initiative aims to reduce the number of people who are unable to cover the full 12-month contribution in advance.”
The new social health system was launched at the beginning of last month and has since included 13 million Kenyans. Salaried individuals have already started remitting their contributions to the Social Health Insurance Fund (SHIF) from October.
For informal workers, SHA contributions will be linked to active payments rather than automatic deductions. This means that their requirements for payment into SHIF will begin after their registration.
However, the transition process was not smooth at all. Despite enrollment numbers, some Kenyans have reported not receiving vital services, and many healthcare facilities are struggling to adapt to the new system.
Technical issues, including frequent system crashes, complicated the process, leading to delays and frustration for both healthcare providers and patients. In some areas, a lack of information has led to residents not knowing about the Social Health Insurance Fund (SHIF) and its purpose.
In Kaikur, located in Kibish Sub-county of Turkana County, many residents are still completely unaware of the new social health system. The individuals the Nation spoke to had “never heard” of the Social Health Insurance Fund (SHIF), and similarly were not enrolled in the previous NHIF programme.
“When you get sick, you go to the dispensary and they give you medicine or you buy it,” said Aleem Longor, an expecting mother. “Sometimes, one has to sell a goat to pay for the treatment.”
Community health promoters play an essential role in educating the masses and encouraging them to enroll, but in this part of the country, even these health promoters are yet to receive information about the scheme. Furthermore, local dispensaries, which are important access points for many residents, are under-resourced and lack the equipment needed to implement SHA-related services.
The Ministry of Health acknowledges these issues, with officials pledging to address these gaps. Health CS Deborah Barasa likened SHA to a baby “who is not expected to be born and is running fast”.
“We support the agenda because it is a national agenda but ultimately it will support every Kenyan at every corner to have access to quality services. We are aware of the challenges we face but as you can see, this is a new system,” said CS Deborah Barasa. “It is still at an early stage.” “We are working on improving and working to have a strong system.”
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