SHIF Woes: More than Half of Kenyans Seeking Medical Services Don't Utilise New Health Cover, Report

 

Health Cabinet Secretary Deborah Mulong speaking at a past event.

More than half of Kenyans visiting hospitals pay out of their pockets to access services. Education is Your Right! Don’t Let Social Norms Hold You Back.    This is according to a new survey conducted by the Rural and Urban Private Hospitals Association of Kenya (RUPHA). RUPHA established that 55% of patients visiting about 94% of hospitals pay cash to access medical services. 

The revelations come a month after the launch of the Social Health Insurance Fund (SHIF), which saw the government transition all National Hospital Insurance Fund (NHIF) members to the Social Health Authority (SHA). 

Why Kenyans pay for medical services despite SHIF rollout The report cited issues with non-registration among Kenyan households and their beneficiaries.  It also highlighted that some of the services where patients were forced to pay exits what SHIF can cover.

 “This high rate of out-of-pocket payments highlights a significant challenge within Kenya's health insurance system, particularly for outpatient services and patients who are unregistered or not fully covered under the current SHA framework,” read the report in part.  The association pointed out that the most affected patients are those seeking outpatient services at health facilities at level 4 and above. 

Patients are required to obtain referrals from lower-level facilities, which is a long process forcing the majority to opt for out-of-pocket payments. Another factor leading to out-of-pocket payment for medical services is Kenyans' lack of awareness about the new SHIF cover. 

"Other patients express privacy concerns or discomfort with the Proxy Means Testing process. "When actual costs exceed SHA reimbursement limits, patients are often left to pay the difference. Expanding SHA coverage for high-cost treatments could help reduce this financial burden," the report continued in part. 

by  Wycliffe Musalia