The Kenya Legal and Ethical Issues Network (KELIN) and Federation of Women Lawyers (FIDA-Kenya), prominent advocates for health and women’s rights, have today expressed deep concern over the challenges arising from the transition from the National Health Insurance Fund (NHIF) to the Social Health Insurance Fund (SHIF) under the Social Health Insurance Act, 2023. Addressing the press in Nairobi, the two organizations highlighted how systemic gaps in the rollout have disrupted access to healthcare, threatening the constitutional right to health guaranteed under Article 43 of Kenya’s Constitution.
Speaking at a press conference in Karen KELIN offices they noted the transition has been marked by confusion and a lack of clear public awareness, leaving many Kenyans in a precarious position. Reports have emerged of healthcare facilities turning away patients, detaining individuals over unpaid bills, and halting critical treatments for chronic illnesses. Vulnerable populations—including persons with disabilities, minorities, and those living in poverty—have been disproportionately affected by these disruptions, further exacerbating inequalities in healthcare access.
The most pressing issues identified is the lack of preparedness within the health system to accommodate the new scheme. The organizations pointed out that pending claims from the now-defunct NHIF have left healthcare facilities financially strained, forcing patients to pay out of pocket. This has plunged many Kenyans into financial distress, undermining the principle of Universal Health Coverage (UHC) that the SHIF seeks to uphold.
According to KELIN and FIDA-Kenya concerns about the lack of clarity surrounding critical healthcare programs such as Linda Mama and EduAfya, as well as HIV care services. They noted that these programs, which are vital for vulnerable groups, have been inadequately addressed in the transition to SHIF. The ongoing digitalization of health records, while seen as a step forward, was also flagged as a potential risk for marginalized communities who may be excluded due to the digital divide.
The organizations urged the Ministry of Health and the Social Health Authority (SHA) to take immediate action to address these systemic gaps. They emphasized the need for clear operational guidelines and communication strategies to educate the public and healthcare providers about the changes. Public sensitization campaigns, they argued, are crucial for restoring trust and transparency in the healthcare system.
They two bodies called for the swift settlement of NHIF claims to enable facilities to function effectively and ensure a seamless transition to SHIF. They stressed the importance of safeguarding emergency care access as guaranteed by the Constitution, including the need for exceptions and extended time limits where necessary. To address grievances and disputes arising from the new system, they recommended operationalizing the Social Health Insurance Dispute Resolution Tribunal and filling staffing gaps within the SHA.
The transition to SHIF, represents a critical moment for Kenya’s healthcare system. Its success will depend on the Ministry of Health’s ability to address these challenges swiftly and reaffirm its commitment to equitable and inclusive healthcare for all.
KELIN and FIDA-Kenya underscored that the government has a constitutional obligation to protect the right to health and ensure that every Kenyan is treated with dignity and respect.
