Coast medics demand immediate halt of troubled SHIF, term the scheme a failure

Healthcare workers in the Coast region have called for an immediate halt to the newly launched public health insurance scheme, arguing it has failed to deliver on its promises, leaving both medical professionals and patients in challenging circumstances.

The medics contend that the Social Health Authority's (SHA) contracted healthcare providers have largely declined to implement the Social Health Insurance Fund (SHIF), forcing patients to pay out-of-pocket for services that were supposed to be covered.

Represented by the Kenya Medical Practitioners, Pharmacists, and Dentists Union (KMPDU), the union claims that SHIF, overseen by the SHA, is ineffective and faces broad rejection from healthcare facilities.

Coast KMPDU Secretary Ghalib Salim criticised both SHA and SHIF as “white elephants,” noting that they have left healthcare workers and patients alike struggling with an unreliable health insurance framework.

He highlighted persistent issues with the SHIF claims portal, despite Health Cabinet Secretary Deborah Barasa's assurances that the technical issues had been resolved.

“We are treating patients but cannot access treatment ourselves under SHIF. This scheme is inactive, and citizens are paying out-of-pocket to access even basic services,” Ghalib said.

He claimed that the new system restricts essential services, allowing only one dental visit per month at a cost of Sh950, and limits treatments like dialysis and chemotherapy to once a month.

Coast KMPDU Chairman Niko Gichana echoed Ghalib's sentiments, stating that its shortcomings have put healthcare workers and the public in a difficult position.

Gichana noted, “There used to be comprehensive medical insurance for Ministry of Health seconded employees. Now, without proper pre-authorisation, our members are forced to pay out-of-pocket.”

Social Health Authority (SHA).

He also highlighted that out of six counties in the coastal region, only Kilifi and Taita Taveta have upheld agreements to honour doctors' rights, such as promotions and timely salary disbursements.

The union officials noted that many doctors have experienced delayed promotions and wages since the union's return-to-work formula was signed on May 8.

They decried that intern doctors have also been impacted, with many facing financial difficulties due to unpaid salaries since August.

The union urged elected leaders to address these issues and reinstate the former National Health Insurance Fund (NHIF) scheme, which they argued offered more comprehensive coverage for both healthcare professionals and the public.

They cautioned that failing to resolve these grievances could further destabilise Kenya’s healthcare system, with the potential for more doctors to seek employment abroad.

“If our comprehensive medical insurance cover is not restored, we will have no choice but to take the next step,” Gichana warned.

Under the new SHIF, all workers contribute 2.75 per cent of their salaries, a departure from the NHIF system it replaced.

Previously, contributions for salaried employees ranged from Sh150 to Sh1,700 monthly, while self-employed Kenyans paid Sh500. The NHIF had capped contributions at Sh1,700 for those earning Sh100,000 or more.

The SHIF now requires those earning Sh20,000 to contribute Sh550, while individuals with salaries of Sh50,000 and Sh100,000 will pay Sh1,375 and Sh2,750, respectively.

Higher earners face increased deductions, with those earning Sh200,000 contributing Sh5,500, and those with a monthly income of Sh1 million or more paying up to Sh27,500.