Former Nominated Senator Millicent Omanga has urged the government to take Kenyans’ concerns about the effectiveness of the Social Health Authority (SHA) seriously.
In a statement on Friday, January 31, Omanga emphasized the need for urgent improvements in service delivery, noting that the program has encountered significant challenges leaving many Kenyans feeling shortchanged.
"The voices of Kenyans on the effectiveness of SHA should be taken seriously, and their all feedback used to improve the system for better service delivery. That's how I see it. We should not bury our heads in the sand when it's crystal clear that the implementation of the program has faced a myriad of challenges, and Kenyans are not getting value for their money," she said.
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In October 2024, Kenya transitioned from the National Hospital Insurance Fund (NHIF) to SHA under the Social Health Insurance Fund Act of 2023.
This move was aimed at improving healthcare access and achieving universal health coverage but the rollout has faced significant challenges, leading to widespread public dissatisfaction.
One of the major issues has been system glitches and technical failures.
Many hospitals have reported difficulties in verifying patient status, processing claims, and accessing the necessary user credentials.
For example, in October 2024, the Nairobi Women's Hospital announced that it would only accept cash payments because of unresolved SHA system failures.
“During this transition period, we regret to inform you that our institution is not yet able to process claims or offer services under the new SHA system. Unfortunately, the SHA claiming system is not fully functional, preventing healthcare providers from verifying member status, notifying patients for treatment, requesting approvals, or submitting claims," Group Finance and Strategy Officer Barbara Kiugu said at the time.
Delayed claims processing has also been a major concern with healthcare providers complaining that SHA has not been reimbursing claims in a timely manner.
Additionally, many patients have also struggled with verification issues when seeking medical care.
At Kenyatta National Hospital, for instance, some patients were denied treatment because the SHA system was down, even though they had made the necessary payments.
