Nearly 58 percent of healthcare facilities have not yet transitioned to the newly introduced Social Health Insurance , reflecting ongoing challenges in adopting the new system.
A survey by the Rural Urban and Private Hospitals Association (Rupha) revealed that only 42 percent of privately-owned health facilities have embraced SHA, with 75 percent able to access its services.
The transition has been hindered by factors such as pre-approvals for maternal and emergency cases, pre-authorization, and claims management for surgeries. SHA was rolled out on July 1, 2024, replacing the National Health Insurance Fund (NHIF), which expired a day earlier.
Despite a Ministry of Health directive ensuring continuous service for SHA members, challenges persist. Principal Secretary for Health Harry Kimtai emphasized the importance of uninterrupted patient care, particularly for critical services like dialysis, cancer treatment, and maternity care, urging healthcare providers to honor contracts under SHA’s Healthcare Provider provisions.