Coast Healthcare Workers Demand Repeal of New Public Health Insurance Scheme

• Oct 28, 2024

Healthcare workers in Kenya's Coast region are calling for an immediate halt to the newly launched Social Health Insurance Fund (SHIF), claiming it has failed to deliver on its promises. Represented by the Kenya Medical Practitioners, Pharmacists, and Dentists Union (KMPDU), they argue the fund has left both patients and healthcare providers in difficult situations, as it limits access to necessary treatments and forces many to pay out-of-pocket for services that were expected to be covered.

According to the KMPDU, the SHIF, managed by the Social Health Authority (SHA), has faced widespread rejection among healthcare providers, with many refusing to participate. Coast KMPDU Secretary Ghalib Salim criticized both SHA and SHIF as ineffective, stating they have created a challenging environment for healthcare workers and patients. He pointed to ongoing issues with the SHIF claims portal, even after Health Cabinet Secretary Deborah Barasa’s assurances that technical problems had been addressed.

“We are treating patients but cannot access treatment ourselves under SHIF,” said Salim. “This scheme is inactive, and citizens are paying out-of-pocket to access even basic services.” Salim also highlighted that the SHIF places restrictive limits on services, including allowing only one dental visit per month for Sh950 and restricting dialysis and chemotherapy treatments to once a month.

Coast KMPDU Chairman Niko Gichana echoed these concerns, explaining that the SHIF has complicated healthcare access, especially for healthcare workers. Gichana noted that the previous National Health Insurance Fund (NHIF) offered more comprehensive coverage and warned that the SHIF could lead more doctors to consider employment abroad if unresolved.

Furthermore, Gichana reported that, out of six coastal counties, only Kilifi and Taita Taveta have honored agreements to provide essential worker rights, such as promotions and timely pay disbursements. The union officials emphasized that many doctors have faced delays in receiving promotions and wages, despite a return-to-work agreement signed on May 8. Intern doctors have also been affected, with numerous interns struggling financially due to unpaid salaries since August.

In addition to these issues, healthcare workers have seen significant shifts in their contributions under the SHIF. Under the NHIF, contributions for salaried employees ranged from Sh150 to Sh1,700, while self-employed individuals paid Sh500. The SHIF, however, now mandates that all workers contribute 2.75 percent of their salaries, resulting in much higher monthly payments for many employees. Those earning Sh20,000 must now pay Sh550, while individuals with salaries of Sh50,000 and Sh100,000 will contribute Sh1,375 and Sh2,750, respectively. Higher earners face even steeper deductions, with contributions of Sh5,500 for a Sh200,000 salary and up to Sh27,500 for those earning Sh1 million or more.

Union leaders are calling for the SHIF to be repealed and for the NHIF to be reinstated to provide a more reliable, comprehensive health coverage system for both patients and healthcare providers. They also urged elected officials to address these grievances, cautioning that failure to resolve the issues could further destabilize the healthcare system in Kenya.