The shift from Kenya's National Health Insurance Fund (NHIF) to the new Social Health Insurance Fund (SHIF) has left many beneficiaries seeking clarity on how this transition will unfold.

The government is currently implementing new reforms and benefits packages under SHIF, aiming to provide comprehensive coverage to all Kenyans. This new model promises significant advantages, particularly for vulnerable populations, including access to screenings, certain transplants, essential medications, and vital medical equipment that were previously difficult to obtain under NHIF.

Starting July 1, all members are required to register for SHIF to take advantage of these enhanced benefits. The Social Health Authority (SHA) will oversee three main funds under SHIF: a primary health care fund for primary health care needs, a social health insurance fund for curative care, and an emergency chronic and critical illness fund for managing medical emergencies.

"We want to prevent and promote wellness. We are focused on preventive, promotive, curative, rehabilitative, and palliative care through primary health care," stated Timothy Olweny, Chair of the Social Health Authority, in an interview with Spice FM.

Under NHIF, the chronic and illness fund faced numerous implementation challenges, particularly for critical emergencies. Despite the government's constitutional mandate to annually disburse these funds, several obstacles hindered their full implementation. Olweny highlighted that a significant issue was the exhaustion of coverage under NHIF for many beneficiaries.

To address these challenges, SHIF introduces a second fund specifically for those with chronic and critical illnesses. Unlike NHIF, which was equivalent to one of SHA's funds, SHIF encompasses broader benefits and aims to fulfill its initial mandate more effectively.

Beneficiaries must initiate new registrations to access SHIF benefits, with a focus on households rather than individuals. Those in formal employment will pay a flat rate, while those on contracts will contribute a fixed proportion of their income.

"Those in formal employment are going to pay a fixed proportion of their income as opposed to those in informal employment," added Olweny.

NHIF members will have a streamlined registration process, leveraging existing data within the health scheme system. Additional information can be provided using a USSD code, and biometric data will also be collected. The Ministry of Health is expected to announce further details in due course.