Health Principal Secretary Mary Muthoni on Tuesday acknowledged that the rollout of the Social Health Authority (SHA) has faced some initial challenges. However, she assured the public that the government is actively working to streamline the process and deliver a more seamless experience for Kenyans as part of efforts to achieve Universal Health Coverage (UHC).

Speaking at the third Nation Health Summit held at the Kenyatta International Conference Centre (KICC), which concludes today, PS Muthoni emphasized the importance of public engagement in refining the initiative.

“We admit that the SHA rollout hasn’t been perfect. But we didn’t just sit back — we listened to Kenyans, identified the pain points, and took action to address them,” she said.

Aligning with the Summit’s theme of moving towards a healthier population to accelerate Universal Health Coverage, she said that the government’s first step was to enact the four laws that are meant to drive the realization of this dream.

The four laws that came into force in 2023 include the Primary Health Care Act, the Digital Health Act, Facility Improvement Fund and the Social Health Authority.

All these laws, if implemented fully, will be key in ensuring that Universal Health Coverage (UHC) will not fail this time.

“This is the time that UHC must work in the country. We don’t need new policies; we only need to implement them. We can probably amend one or two lines but we don`t need new policies,” she said.

The PS also said that some of the issues that the Health Ministry is trying to ensure that they run seamlessly include finance, human resources for health, and service equity.

“It is not that there has been no money for health, but the budget has always been reallocated for other functions,” she said.

Since health is a devolved function, she asked employers in the counties to ensure that there are enough incentives for people working in healthcare facilities.

Under its newly established Social Health Authority (SHA), Kenya is rolling out social health insurance financed by both tax revenues and individual/household premium contributions.

Kenyans who live in far-flung regions may have fewer specialists compared to those living in urban areas. PS Muthoni said that while the general specialist-to-population ratio is critically low, the ministry now has postgraduate training programs that will help in solving this issue. So far, about 70 specialists are receiving training.

“We are keen on the human resources for health; for the geographical distribution of healthcare, we want to ensure that we have decentralized training and recruitment.  The counties should be able to help us with the implementation,” she said.

“We need to improve our guidelines on sharing medical specialists; should we have a shortage, intercounty sharing of specialists should be encouraged,” she added.

Dr Meshack Ndirangu, Country Director for AMREF, said in one of the panels that for Africa to succeed in ensuring that UHC is implemented, there needs to be rigorous prioritization.

He said that the public needs to have confidence in our health systems.

“When the public looks at SHA, for instance, they should see it as a highly efficient organization do not have any questions about anything,” he said.

“We cannot keep replicating models from elsewhere. We need to look for specific needs that counties have without wasting resources. In Africa, we try to replicate models that do not work for us,” he said.

Giving a global overview of UHC, Leonard Cosmas, who works at the World Health Organization (WHO) as a monitoring and evaluation technical officer, said that the global health regulatory body recognizes that UHC is a complex process.

“We must appreciate the efforts we have seen in different countries. We have seen sustained political will since 2012 when member states passed a resolution to accelerate UHC. We recognize that countries face different challenges, like resource constraints, that can be addressed in different innovative ways,” he said.

He said that when there is political will, there is a likelihood that UHC will be attained.

Based on a global report released in 2023 by the WHO, most countries are off track in achieving UHC. At the time, Kenya was halfway way through achieving the goal, which is usually measured using the UHC service coverage index.

Dr Samuel Kinyanjui, Country Director, AIDS Healthcare Foundation, said during his presentation that Kenya needs to reframe the Health Ministry’s role to achieve UHC so that it can focus solely on regulation and stewardship.

“Kenyans must shift from paying for services and pay for results to restore the trust in accelerating UHC,” he said.

Dr Brian Lishenga, chairperson of the Rural and Urban Private Hospitals Association (RUPHA) said that while there were initial problems in SHA around claims that were technical issues, some of those have slowly been resolved.