Ministry of Health PS Harry Kimtai has revealed why the government transitioned from the National Health Insurance Fund (NHIF) to the current Social Health Insurance Fund (SHIF) after many Kenyans raised concerns over its effectiveness.

Kenyans have criticised the SHIF system for locking out thousands of patients, hence denying them crucial medical services. 

PS Kimtai noted that the government sought to remove the technical system issues that provided a loophole for corruption.

He added that the State was required to ensure equality for all Kenyans in terms of paying for health services. 

For NHIF, Kenyans paid a minimum of Ksh.500 and the maximum was capped at Ksh.1,700. To address this, Kimtai noted that the government came up with a uniform rate of 2.75 per cent of one's gross income. 

In addition, he noted that every Kenyan would be provided with equal benefits and that anyone seeking to acquire extra benefits should seek private cover. 

"We came to the conclusion of 2.75 per cent of their gross income. There's no cap. That's why it's called SHIF, where everyone contributes to it and the benefits packages are also equal," Kimtai said on KTNNews. 

"You should not say if you're paying more, you're getting more benefits, it is standard. If you like extra benefits, you can pay for private cover."

Contrary to the public's sentiments, Kimtai emphasises that SHIF was not rushed as the State had carried out numerous tests on the system. 

"The implementation of SHA and the system specifically was not rushed, we had developed the system for quite a while, we had also done what we call lab tests and we agreed because it was announced by the CS that 1st of October would be the launch and the rollout of SHA," Kimtai explained. 

Responding to reports of dependents being added to one's accounts without their knowledge, Kimtai acknowledged that it was a system mixup as the government was trying to integrate the data from the Education Ministry with SHIF. 

After receiving complaints, the government instructed Kenyans to add their dependents individually. 

"We wanted to integrate the National Education Management Information System (NEMIS) with SHIF so that you don't have to keep adding your dependents," Kimtai noted. 

"Once you've registered your child, when the child goes to school, any facility it will be almost automatic. We wanted to make it easy for them (parents) but realised it was a problem, as it was not correct, so we opted the parents to add their children as dependents individually."

Following its rollout, SHIF model has been criticised for offering lower benefits compared to private medical insurance schemes.

Under the SHIF model, those seeking maternity care will be reimbursed Ksh.10,000 for normal delivery and Ksh.30,000 for a caesarean section. 

For inpatient services, the scheme provides Ksh.2,240 daily for a maximum of 180 days per household each year

Dental care services are, however, lower, with Ksh.2,000 per household per year, compared to Ksh.10,000 offered by other healthcare providers.

For optical care, beneficiaries receive Ksh.950 for eyeglasses and a limit of Ksh.1,000 per household annually. Other providers, however, offer between Ksh.7,000 and Ksh.10,000 for similar coverage.