Several hospitals in the country have spotlighted the Social Health Insurance Fund’s (SHIF) unsustainability, noting an imminent collapse within 12 months unless current pressing challenges in its implementation are resolved.

The warning comes several days after the Auditor General’s revelations that the Social Health Authority system cost the government Sh104.8 billion, yet the State had no control over the fund.

Appearing before the Departmental Committee on Health the Kenya Health Care Foundation (KHF), Rural Urban Private Hospital Association (RUPHA), Kenya Association of Private Hospitals (KAPH) and faith-based hospitals sent caution to legislators.

They stated without increased financial support to the primary healthcare fund, serving 91 per cent of Kenyans through outpatient clinics, SHIF’s sustainability was at grave risk.

Furthermore, the hospitals raised concerns surrounding the Sh900 annual capitation fund to cater for outpatient services, terming it as inadequate compared to the defunct NHIF which stood at Sh1000 for Level I and Level II hospitals.

The hospitals further observed that only a handful of Kenyans in the informal sector were contributing to the fund, which is an additional point in the SHA’s contribution structure.

KHF chairman, Kanyenje Gakombe, illustrated that non-salaried Kenyans only paid for SHIF during periods of illnesses and while visiting hospitals. Once they got treated, they would lapse on their contributions which would affect the fund entirely.

“If we do not address how non-salaried people should make their contributions because they only pay when they fall sick, this SHIF will become very untenable,” he noted

KAPH chairperson, Eric Musau explained hospitals take issue with the fund’s sustainability since only 4 million non-salaried Kenyans, about 21 per cent of total registered members are actively contributing.

“More than 80 per cent of those living in the informal sector are registering as members, they have done that when they need services. Someone comes to the hospital, pays Sh800, gets a benefit of Sh1.8 million and then after treatment, it ends at that. If we do not follow up on this issue, we do not see how this fund will survive beyond 12 months,” he said.

Brian Lishenga, RUPHA chairperson, said SHA’s unpopularity, as per a recent study, stood at 37 per cent. He added that SHA’s timeline for survival was only about a year before the country’s Healthcare system collapsed.

“This fund can only survive for the next 12 months because even the funding the vote was allocated is Sh4.2 billion to cover 20 million Kenyans yet the budget required is Sh18 billion,” he said.