JAMILA’S MEMO: SHA struggles to deliver as system faces major hurdles

Five months after the roll out of the social health insurance scheme, Social Health Authority (SHA), the system has faced numerous and constant challenges.

These challenges are so bad that there are worries that the health financing may ground to a halt. There have even been concerns that the transition to SHA was rushed, with the government pushing for the roll out before putting in place important transitional frameworks.

The transition was almost like forced bottle feeding. A lot of energy was used to force Kenyans to shift to SHA. A lot of energy was used to pass bills that led to the formation of SHA. In fact, it is ironic that just recently the same legislators who passed the bills, were asking questions about the contents, a clear sign that they just rushed to pass them without understanding what was in them.

I now wonder, after all the noise, the many statements, the push to roll it out, where is the energy on SHA now that there are challenges? Where are the voices of leaders who will speak out now that things are not working?

All we are hearing is register for SHA, it will benefit you…at almost every public function attended by government officials, the chorus is the same, register for SHA, it will work for you…A few days ago, I even heard a Senator, spreading the SHA message at a funeral!

But very few are admitting that the health care system has major challenges.

Waswahili husema, Chema Chajiuza, Kibaya Chajitembeza. If SHA was as good and as beneficial as we are being told, its benefits would have been clear for all to see; but the negatives overwhelmingly outweigh the positives.

I fear, SHA may be going the CBC route. The impression we are getting is maybe, just maybe no one thought SHA through, end to end.

This lack of thinking does not apply to figures though. I mean, we thought of how much the transition from NHIF to SHA would cost, but it was discovered along the way the cost for the SHA system shot from Ksh.55 billion to a whooping Ksh.104 billion. But, efficiency seemed to end there.

Patients have been going through a really tough time, or should I say they have been going through SHA, as they struggle to get medical services.

Kenyans don’t need to know what is going on in the back end, they just need services, that’s it…huduma za matibabu. They cannot get services if the OTP, One Time Password is not working…they cannot get services if clinical officers who mainly run the primary care networks are currently on strike, protesting exclusion from SHA.

For many Kenyans seeking medical services, this is a nightmare.

And when sector players express their concern about the system, they are dismissed. In fact they have been told that those complaining are fewer than the hospitals in the SHA stable. Basically the message is, we do not need you.

Currently private hospitals in rural and urban areas have halted SHA services. There are over 600 hospitals and health centers under the RUPHA stable; those are not few…

In my opinion, SHA is a screaming demonstration of lack of leadership. Those in charge need to take it seriously that there are huge problems; that will not go away just by insisting that the system works…If it did and the rest of us are blind or negative to it then why are we seeing issues every day? That is my memo…