NAIROBI, Kenya – A new wave of healthcare reform is set to transform the lives of Kenyans with the launch of the Social Health Authority (SHA) next month.
This ambitious initiative has garnered praise from experts, though they have highlighted areas for improvement in the benefits package released by the Ministry of Health (MoH).
One of the most debated points is the allocation of Sh935 per household per year for eyeglasses.
Public health specialists and health economists have raised concerns, deeming the amount insufficient.
John Kiragu, a prominent public health specialist and member of the Health Economics Association of Kenya (HEAK), emphasized the need for a significant increase in eye care funding.
“Funding should be reviewed to enhance reimbursement rates in the benefits package to between Sh5,000 to Sh8,000, reflecting current market prices for spectacles and their accessories. This will help alleviate suffering among young and poor individuals with uncorrected refractive errors (URE),” Kiragu stated.
URE, a common eye disorder causing blurred vision, affects a significant portion of the Kenyan population.
According to the MoH, 60% of all eye impairment issues in Kenya are attributed to URE, with eyeglasses being the simplest and safest corrective measure.
Experts have also highlighted the substantial economic impact of URE, estimating an annual GDP loss of Sh134 billion for the 16–60 age group.
The current benefits package only covers optical services for those under 18. HEAK has called for the removal of this age restriction, arguing that refractive errors and other eyesight impairments affect individuals of all ages.
“The burden of uncorrected refractive errors extends from early childhood into adulthood and old age, leading to significant annual costs, reduced quality of life, and economic productivity losses,” the association noted.
While the SHA’s coverage of emergency services has been praised, experts have criticized the policy of restricting emergency care to members only.
This, they argue, violates Article 43 of the Constitution, which guarantees emergency care for all Kenyans.
Kiragu suggested a rephrased access rule: “All Kenyans in need of accident and emergency services will be guaranteed emergency care access at any facility in Kenya.”
The requirement for pre-authorization of radiology services has also come under scrutiny. Experts warn that this could lead to dangerous delays during emergencies.
They have proposed excluding pre-authorization for patients needing urgent diagnostic services and suggested an explicit radiology and laboratory package with equivalent tariffs for trauma and emergency cases.
The SHA will replace the National Hospital Insurance Fund (NHIF), aiming to provide comprehensive healthcare coverage for all Kenyan residents.
Starting next month, every household will contribute 2.75% of its income to the SHA fund.
The ministry has assured the public that NHIF services will remain active until the new scheme is fully implemented.
Public Health Principal Secretary Mary Muthoni has urged Kenyans to be patient as the government works on the new health plan.
“Some Kenyans have long suffered with NHIF, which is why President William Ruto introduced this scheme to help ordinary Kenyans access better healthcare,” Muthoni said.
She emphasized that the new Social Health Insurance scheme will ensure that all Kenyans, especially those at the bottom of the economic pyramid, can access health facilities without discrimination.
