Transition from NHIF to SHIF: Understanding the New Scheme

The ongoing process of restructuring the health finance scheme in Kenya has left many beneficiaries uncertain about the impending transition to the Social Health Insurance Fund (SHIF). As the government continues to implement new reforms and benefits packages in alignment with the new health financial architecture – SHIF, there is a need for clarity and understanding among the populace.

The SHIF, as envisioned by the government, aims to provide comprehensive coverage to all Kenyans. This new model will offer a wide range of benefits to the vulnerable population, including screening, certain transplants, essential medications, and access to vital medical equipment – many of which were previously difficult to obtain under the National Health Insurance Fund (NHIF).

Effective July 1, all members are required to register for SHIF in order to access these enhanced benefits. The Social Health Authority (SHA) has established a primary health care fund to address primary health care needs, a social health insurance fund to provide curative care, and an emergency chronic and critical illness fund to manage medical emergencies.

Chair of the Social Health Authority, Timothy Olweny, emphasized the importance of preventive, promotive, curative, rehabilitative, and palliative care in ensuring the well-being of the population during an interview with Spice FM on Wednesday.

Under the previous NHIF system, the chronic and critical illness fund, which faced challenges during implementation, was primarily intended for critical emergencies. The government, in compliance with constitutional health mandates, was required to disburse these funds annually without fail from the exchequer.