- The SHIF authority should be compelled to publish regular and comprehensive financial reports, detailing income, expenditure, and outcomes achieved.
- This is key in ensuring that stakeholders can scrutinise the management of funds and hold accountable those responsible for any misuse or mismanagement.
The Social Health Insurance Fund (SHIF) holds great promise in advancing Universal Health Coverage (UHC).
It holds the key to ensuring every citizen has access to essential healthcare services despite existing financial hardships.
Under this scheme, the government has assured Kenyans that vulnerable populations will gain access to a broad spectrum of benefits, including screening, dialysis, kidney transplants, essential medications, and vital medical equipment.
Through SHIF, the State is pledging to shift the healthcare paradigm towards preventive and promotive practices.
Under the new healthcare funding plan, Kenyans will now be mandated to contribute 2.75 per cent of their gross salary to the SHIF, which now replaces the National Health Insurance Fund.
Though the percentage has elicited uproar from a section of Kenyans, it is a relief that it will somewhat address unfair disparities that have existed in the payment of National Hospital Insurance Fund (NHIF) premiums.
But even as it emerges as a game changer, the many scandals that have dogged the NHIF in the past highlight a glaring need for enhanced accountability.
Many of the scandals highlighted in several media reports leave one with more questions than answers about whether the health of Kenyans is guaranteed with SHIF or not.
What has been disconcerting is the failure to hold one accountable for reported mess over the years.
We must address these challenges convincingly head-on and implement robust measures to prevent the loss of public funds.
Allegations of corruption, embezzlement and misappropriation of funds that have been in the past hit NHIF should inform strategies and policy decisions that will punctuate the operation of the SHIF.
Fair enough, while efforts have been made to address these shortcomings, systemic reforms are necessary to tame such incidents from recurring.
The state must take proactive steps to restore confidence in the healthcare system and ensure that public funds collected through SHIF contributions are used prudently, judiciously and transparently.
To enhance accountability in Kenya's SHIF and mitigate the risk of further loss of public funds, several measures can be implemented:
The SHIF authority should be compelled to publish regular and comprehensive financial reports, detailing income, expenditure, and outcomes achieved.
This is key in ensuring that stakeholders can scrutinise the management of funds and hold accountable those responsible for any misuse or mismanagement.
The Constitution of Kenya 2010 establishes independent oversight bodies including the Ethics and Anticorruption Commission.
Free from political interference, these oversight bodies should keep their radar on the operations of the SHIF and investigate allegations of corruption or malpractice that might arise.
These bodies should leverage their constitutional powers in taking necessary actions on audit reports and carry out investigations to ensure compliance with regulations and ethical standards at the Social Health Insurance Authority.
As the Ministry works on regulations to guide the implementation of the Act, legal frameworks should include clear provisions for accountability, transparency, and sanctions for misconduct.
This framework should be enforced rigorously to deter wrongdoing and promote responsible stewardship of public funds.
A platform for meaningful engagement with stakeholders, including civil society organisations, healthcare providers, and beneficiaries, should be availed to foster accountability and transparency.
By involving diverse perspectives in decision-making processes, the State can ensure that funds are used to address the most pressing healthcare needs and priorities in the country.
Capacity-building initiatives should be implemented to enhance the skills and knowledge of SHIF administrators and staff in financial management, procurement, and ethics.
Training programs and technical assistance can help improve governance practices and promote a culture of accountability within the healthcare sector.
Technology should be leveraged to make every shilling spent traceable to the beneficiary.
By implementing transparent governance mechanisms, strengthening oversight, and engaging stakeholders, SHIF contributions will be used effectively to achieve the goal of universal health coverage.
It's time to learn from past mistakes and take decisive action to safeguard public funds and promote the health and well-being of the nation.
Samuel Kimeu, Executive Director, Africa's Voices [email protected]