SHA glitches, service paralysis and medics strike: Inside looming health sector crisis
The health sector in the country is facing a myriad of challenges putting the lives of millions of Kenyans at risk.
Despite receiving the much-needed airtime including from President William Ruto, the sector has been on its knees for close to a year.
Strike notices, demonstrations, budget shortfalls and glitches have all rocked the Social Health Authority (SHA), also known as Taifa Care, which is barely one year old.
SHA hitches
During SHA’s inception, Ruto talked highly of the programme framing it as a game changer in the country’s health sector. Over three months since the official launch, the programme implementation has been dogged by a handful of challenges including system glitches.
Several Kenyans have lamented facing difficulties with the system including prolonged system downtimes, delays in One-Time Password (OTP) verification, and an inability to track claim approvals.
This was evident when angry patients disrupted a press conference held by Health Cabinet Secretary (CS) Deborah Barasa at Afya House in Nairobi on January 15, 2025. The patients, some with infants, were protesting the Social Health Insurance Fund (SHIF) system glitches and the difficulties they faced in accessing healthcare services despite paying premiums.
Days later, one of those who stormed the conference, Grace Njoki, was apprehended sparking a nationwide uproar.
During a mid-term retreat, Members of the National Assembly also raised concerns over various challenges bedevilling the health sector, vowing to engage various stakeholders to fix the issues.
Service suspension in private hospital
On Thursday, February 20, 2025, the government was hit with another shocker after the Rural and Urban Private Hospitals Association (RUPHA) announced a planned suspension of SHA services in private hospitals citing debts, system glitches and reimbursement challenges.
Addressing the press, RUPHA Chairperson Brian Lishenga insisted that private hospitals could not stomach the issues putting the lives of millions of patients and their staff at risk.
“The relevant authorities have ignored the challenges facing this new healthcare system, putting patients’ lives at risk and threatening the survival of hospitals due to weak service provision,” Lishenga stated.
Ksh30 billion NHIF debt
In their presser, RUPHA also exposed the issue of piling debt. They revealed that the government owes private medical facilities Ksh30 billion which had accumulated since 2017.
They lamented that the debts had compelled many facilities to default, suffer stockout of essential medicines and led to them failing to pay their staff.
In their statement, they called for an urgent review of the SHA reimbursement framework to salvage the health sector. Their data to justify their claims detailed that 54 per cent of hospitals had not received payments from SHA, while 89 per cent of facilities had reported failures in the SHA portal.
Notably, RUPHA disclosed that police officers and teachers are among those who would be highly affected by the directive starting Monday, February 24, 2025.
Budget shortfall
On Wednesday, February 19, 2025, the Ministry of Health yet again exposed a budget shortfall which they noted could affect their operations in the 2025/26 financial year.
Appearing before the National Assembly, the Ministry of Health officials led by Principal Secretary, of State Department for Medical Services, Harry Kimtai, told the MPs that they were financially constrained.
They sought MPs’ help to plug the Ksh59 billion funding shortfall exacerbated by the United States Agency for International Development (USAID) funding freeze.
“The State Department has 42 projects to be implemented in the FY 2025/26. The total allocation to the capital projects/programmes is Ksh27.495 million, comprising Ksh13.36 million under the Kenyan government and Ksh14.129 million under donor-funded support,” stated Health PS Harry Kimtai.
Of the 59 billion, the Ministry noted that Ksh30 billion would go to a public-financed health care system and Ksh5 billion for procurement of essential commodities.
Another Ksh3 billion is to be spent on purchasing essential commodities; blood bags, equipment to separate the different blood groups and cells, among others.
They noted that the USAID freeze had created a Ksh20 billion deficit and that they needed additional money to cover essential medical sectors which would be affected by the directive including the restocking of HIV drugs.
KMPDU ultimatum
The national government received another headache on Thursday, February 20, 2025, after the Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) threatened mass action over interns’ pay.
In a notice, KMPDU gave President William Ruto’s administration a 30-day ultimatum to resolve the ongoing internship wage crisis or face nationwide demonstrations starting March 18, 2025.
KMPDU Secretary General Davji Atellah accused the government of dishonesty and vowed to push for the implementation of the Collective Bargain Agreement.
“The minister was saying that they cannot afford to pay interns this year because of the USAID freeze by U.S President Donald Trump. If Trump is putting the U.S first, the government needs to put Kenyans first,” Davji Atellah said in a strongly worded statement.
“If the wages are to be reduced or changed, it should not start with intern doctors; it should be for all, and should start with the presidency and the ministers. That’s why we’re saying we will not have any discussion about reducing the wages, we will only have a discussion on when to post the interns and where to post them,” he added.
Clinical officers strike
KMPDU’s ultimatum added to an already difficult situation for the government which is currently struggling to secure a return-to-work formula for members of the Kenya Union of Clinical Officers (KUCO) who began their strike on Thursday, February 20, 2025.
KUCO lamented over exclusion from SHA and their members not being recognised by the system. They also cited the failure to implement the pending 2017 CBA.
Rural areas are expected to be majorly hit if the strike persists.
UHC workers demos
Nurses under the Universal Health Care programme (UHC) have also threatened mass action in March 2025.
They are demanding permanent and pensionable jobs, as well as salary harmonization with other healthcare workers.
Among areas which have been hit by their mass actions include Kirinyaga County and the Western part of the country where they have already downed tools.
Despite the challenges, the government has remained bullish insisting that the country is in the right direction to achieving Universal Health Care coverage.
On several occasions they have also dismissed critics, insisting that SHA is working perfectly while Kenyans have continued to raise concerns.
Nonetheless, the government recently the government appeared to soften its stance after DP Kindiki acknowledged the challenges stating, “We need to do a lot of work. If SHA was working, we wouldn’t have Kenyans complaining.”
In response to public outcry, the Deputy President announced that the Ministry of Health was reviewing the Means Testing Tool for SHA contributions to better address Kenyans’ concerns.
The revised tool is expected to be unveiled in the coming days. Health Cabinet Secretary Deborah Barasa reinforced the government’s commitment to improving the scheme, stating, “We are reviewing the benefits tariffs; they will be announced on March 1, 2025.”
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