Climate Change Impacts on SHA Health Strategies

Introduction

Kenya, a nation of 53 million people, stands at the forefront of the global climate crisis, where rising temperatures, erratic rainfall, and extreme weather events are reshaping public health landscapes. The 2025 long rains season alone displaced over 200,000 people across 14 counties, including Taita-Taveta and Garissa, while droughts affected 4.4 million in ASALs, exacerbating food insecurity and vector-borne diseases like malaria (3.5 million cases annually) and chikungunya (7,000 regional cases) (NDMA June 2025, WHO 2025). These impacts compound the dual burden of non-communicable diseases (NCDs) such as diabetes (9% prevalence) and hypertension (24%), with climate-sensitive conditions accounting for 23% of global deaths and disproportionately affecting vulnerable populations (WHO 2023). The Social Health Authority (SHA), operational since October 1, 2024, under the Social Health Insurance Act of 2023, replaces the National Health Insurance Fund (NHIF) to drive Universal Health Coverage (UHC) by 2030. By September 2025, SHA has registered 26.7 million Kenyans (50% of the population), disbursed KSh 8 billion to frontline services, and covered 4.5 million treatments without out-of-pocket costs. SHA’s health strategies, integrated with the National Climate Change and Health Strategy (2023–2027) unveiled at COP28, emphasize resilience through preventive care, surveillance, and adaptation. This article explores climate change impacts on SHA’s strategies, detailing vulnerabilities, adaptive measures, challenges, and future directions, grounded in Kenya’s medical situation, government reports, and recent analyses.

Climate Change Impacts on Health in Kenya

Climate change amplifies Kenya’s health vulnerabilities, with projections of 1.7°C temperature rises by the 2050s and 3.5°C by century’s end, intensifying extreme events and disease transmission (World Bank Climate Risk Profile 2021, updated 2025). Key impacts include:

Extreme Weather Events and Displacement

• Floods and Droughts: The 2025 El Niño floods displaced 200,000, destroying health facilities and increasing waterborne diseases like cholera (2,000 cases in Nairobi, Kisumu, Migori, and Kwale) and leptospirosis (WHO March 2025). Droughts in northern Kenya affected 4.4 million, leading to malnutrition (26% stunting in children under 5) and heat-related illnesses, with temperatures exceeding 40°C causing 150 deaths (NDMA June 2025).
• Health System Strain: Floods damaged 30% of facilities in ASALs, disrupting SHA’s 8,813 contracted sites (56% national coverage), and increased maternal mortality (530 per 100,000 live births) due to inaccessible ANC (UNICEF 2025).

Vector-Borne and Infectious Diseases

• Malaria and Chikungunya: Warmer temperatures expand mosquito habitats, with malaria cases rising 20% in coastal and highland areas, and chikungunya affecting 7,000 regionally, including Kenya, causing joint pain and fever (LSHTM August 2025). Mpox (Clade Ib, 1,200 cases by February 2025) highlights zoonotic risks from habitat disruption (CDC 2025).
• Respiratory and Heat-Related Illnesses: Urban air pollution, worsened by wildfires and dust storms, contributes to 13% of cardiovascular deaths, with Nairobi’s PM2.5 levels 5 times WHO limits (Climate Risk Profile 2021).

Food Insecurity and Malnutrition

• Crop Failures: Erratic rains reduced maize yields by 20%, affecting 80% of rural households reliant on agriculture, leading to 11% underweight children and micronutrient deficiencies (e.g., 21% anemia in pregnant women) (MoH 2023). Pastoralists in Turkana lost 30% of livestock to drought, increasing poverty and mental health issues (10% depression prevalence).

Mental Health and Vulnerable Populations

• Psychosocial Impacts: Displacement and loss contribute to 20% PTSD among flood-affected communities, with women and children (35% of population) most vulnerable (BMC Public Health 2023, updated 2025 scoping review).

A 2025 scoping review in Climate journal analyzed 263 studies (2000–2024), finding 60% focused on vector-borne diseases and 25% on malnutrition, with ASALs underrepresented despite 52% JEE score for IHR capacities (Gerard et al., Climate 2025).

SHA’s Health Strategies and Climate Adaptation

SHA’s strategies, aligned with the National Climate Change and Health Strategy (2023–2027) unveiled at COP28, integrate adaptation through its three-fund model:

• PHCF (Tax-Funded): Allocates KSh 21 billion for community-level resilience, funding 107,000 CHPs for early warning and screenings at levels 1–4 (community units, dispensaries, health centers).
• SHIF (Contribution-Funded): Supports surge capacity at levels 4–6 for outbreak treatments, with KSh 45–70 billion revenues enabling bi-weekly payments to 8,813 facilities (56% national).
• ECCIF (Government-Funded): Fully covers high-cost climate-sensitive care (e.g., KSh 28,000/day critical care for heatstroke), subsidizing 1.5 million indigent households.

Key Adaptation Measures

• Surveillance and Early Warning: CHPs integrate with KNPHI’s Early Warnings for All (EW4All, launched May 2025), sending vernacular SMS alerts to 26.7 million registrants. In the 2025 floods, 70% early cholera detection prevented 30% more cases (WHO March 2025).
• Resilient Infrastructure: SHA’s KSh 194 billion UAE loan (2024) upgrades 500 facilities for flood-proofing, including solar power in 29 counties under NESP (August 2025).
• Community Resilience: PHCF funds hygiene kits and nutrition supplements for 100,000 households, reducing malnutrition by 15% in Makueni (MoH 2025).
• Net-Zero Healthcare: Kenya’s COP26 commitment to net-zero by 2030 includes SHA’s clean energy pilots, solarizing 200 facilities to cut emissions by 10% (ScienceDirect January 2025).

The 2024–2029 Climate Change and Health Strategy (launched 2025) prioritizes vulnerability assessments and National Adaptation Plans, with SHA’s PHCF allocating 20% for climate-resilient primary care (ATACH Community July 2025).

Impacts of Climate Change on SHA Strategies

Climate impacts strain SHA’s operations but also drive adaptations:

• Increased Demand: Floods and droughts raised SHA claims by 20% in 2025, with ECCIF covering 500,000 outbreak treatments (MoH 2025).
• Equity Challenges: ASALs (4.4 million drought-affected) saw 30% more service denials due to facility damage, but CHP outreach increased rural enrollment by 20% (NDMA 2025).
• Positive Adaptations: EW4All reduced response times by 30% for mpox, saving KSh 1 billion (WHO 2025). Solar upgrades ensured 89% facility uptime during power outages.

A 2025 Medium article notes Kenya’s strategy aligns with WHO’s Global Action Plan, but domestic funding (one-third of US$62 billion plan) lags (Nigeria Health Watch June 2025).

Challenges for SHA in a Changing Climate

SHA faces multifaceted challenges:

• Funding Shortfalls: KSh 4 billion monthly deficit (claims KSh 9.7 billion vs. collections KSh 6 billion), with 5.4% informal uptake, strains adaptation (MoH 2025).
• Infrastructure Vulnerabilities: 30% facility damage from floods, with 60% downtime in ASALs due to power and supply disruptions (Frontiers in Health Services 2025).
• Coordination Gaps: Devolution causes overlaps, with 45 counties signing IPAs but ASALs lagging (NDMA 2025).
• Public Trust: GeoPoll 2025 (n=961) shows 13% optimism, with 70% negative X sentiment citing NHIF scandals and KSh 104.8 billion system issues (OAG March 2025).
• Data Limitations: Only 52% IHR compliance hinders predictive modeling (JEE 2023).

Practical Guidance for Stakeholders

To adapt SHA strategies:

1. Community Vigilance: Use Afya Timiza app for CHP reports; register via *147# for alerts.
2. Facility Resilience: Counties apply for UAE loan upgrades; prioritize solar in ASALs.
3. Advocacy: Support ZTWG for increased ECCIF funding (10% for climate-sensitive care).
4. Personal Preparedness: Enroll in SHA (26.7 million registered); stock hygiene kits.
5. Report Gaps: Contact 0800-720-531 for service disruptions.

Future Outlook

SHA targets 80% coverage by 2028, requiring 10 million informal contributors. Planned adaptations include:

• HNAP Integration: Full rollout of 2024–2029 strategy, with 20% PHCF for resilience (ATACH July 2025).
• Infrastructure Boost: 500 flood-proof facilities by 2027 via UAE loan (MoH 2025).
• Digital Enhancements: DHIS2-EW4All linkage by FY2025/26 for predictive alerts.
• Net-Zero Goal: Solarize 1,000 facilities by 2030, cutting emissions 10% (ScienceDirect 2025).

WHO’s Global Plan projects 20% fewer climate-health deaths by 2030 with such strategies.

Conclusion

Climate change profoundly impacts SHA’s health strategies, intensifying outbreaks, displacement, and NCD burdens, but SHA’s PHCF surveillance, ECCIF funding, and 2023–2027 strategy position it for resilience, covering 4.5 million treatments amid 2025 floods. Challenges like funding gaps and coordination require multisectoral action, but as PS Mary Muriuki stated at the October 2025 Conference, health and climate are intertwined. With scaled investments and community engagement, SHA can adapt, ensuring UHC for all Kenyans by 2030 in a warming world.

BWANA CHAIRMAN MAISHA MAGIC PLUS SEASON 1 EPISODE 42 SUNDAY 28TH SEPTEMBER 2025