SHA’s Focus on Adolescent Reproductive Health

Introduction

Adolescent reproductive health is a critical public health priority in Kenya, where 25% of the 53 million population is aged 10–19, and challenges like teenage pregnancy (15% prevalence among girls aged 15–19), HIV (2.1% youth prevalence), and sexually transmitted infections (STIs) significantly impact health and education outcomes (KDHS 2022, NACC 2023). These issues are compounded by regional disparities, with rural Arid and Semi-Arid Lands (ASALs) like Turkana having only 40% health facility coverage compared to 70% in urban Nairobi, and cultural stigma limiting access to care (MoH 2025). The Social Health Authority (SHA), launched on October 1, 2024, under the Social Health Insurance Act of 2023, replaced the National Health Insurance Fund (NHIF) to advance 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. Through its three-fund structure—Primary Health Care Fund (PHCF), Social Health Insurance Fund (SHIF), and Emergency, Chronic, and Critical Illness Fund (ECCIF)—SHA prioritizes adolescent reproductive health to address high-risk behaviors, reduce maternal mortality (530 per 100,000 live births), and empower youth. This article provides a comprehensive, factual guide to SHA’s focus on adolescent reproductive health, detailing programs, impacts, challenges, and practical guidance, grounded in Kenya’s medical situation, government reports, GeoPoll surveys, and public sentiment on X.

The Adolescent Reproductive Health Landscape in Kenya

Adolescents in Kenya face multifaceted reproductive health challenges:

• Teenage Pregnancy: 15% of girls aged 15–19 have been pregnant, contributing to 18% of maternal deaths and 40% of school dropouts among female students (KDHS 2022). Early marriage, prevalent in ASALs, drives this trend, with 23% of girls married by age 18.
• HIV and STIs: Youth aged 15–24 account for 2.1% HIV prevalence (5,000 new infections annually), with low condom use (30% among sexually active adolescents) increasing STI risks like chlamydia and gonorrhea (NACC 2023).
• Mental Health and Stigma: Sexual health stigma deters 20% of adolescents from seeking care, while 10% report anxiety or depression linked to reproductive health pressures (MoH 2023).
• Access Barriers: NHIF’s 17% coverage and KSh 30.9 billion debt left 83% of informal sector families (16.7 million) reliant on 40% out-of-pocket spending, with rural youth facing delays due to 40% facility coverage in ASALs (World Bank 2022, MoH 2025).
• Economic Impact: Adolescent pregnancy and STIs cost KSh 10 billion annually in healthcare and lost productivity, with 15% of maternal deaths linked to unsafe abortions (Cytonn Investments 2025).

The Kenya Health Policy 2014–2030 and Adolescent Health Strategy 2020–2025 emphasize youth-friendly services, which SHA advances through PHCF-funded community programs and SHIF-covered clinical care.

SHA’s Framework for Adolescent Reproductive Health

SHA’s three-fund model targets adolescents through tailored interventions:

• PHCF (Tax-Funded): Funds free reproductive health education, screenings, and condoms at levels 1–4 (community units, dispensaries, health centers), delivered by 107,000 Community Health Promoters (CHPs).
• SHIF (Contribution-Funded): Covers outpatient and inpatient care at levels 4–6, including maternity (KSh 10,200–30,000 for normal delivery) and STI treatment, requiring parental contributions for minors.
• ECCIF (Government-Funded): Fully funds high-cost care for adolescent-related conditions (e.g., HIV, KSh 28,000/day critical care), with subsidies for 1.5 million indigent households.

With 26.7 million registered and 8,813 facilities contracted (56% of 17,755) by September 2025, SHA leverages digital tools (*147# USSD, Practice 360 app), CHPs, and partnerships with UNICEF, AMREF Health Africa, and the National AIDS Control Council (NACC) to deliver youth-focused services.

Specific SHA Programs for Adolescent Reproductive Health

SHA’s programs address prevention, treatment, and education, tailored to adolescent needs:

1. Preventive Services and Education (PHCF)

• School-Based Campaigns: CHPs conduct workshops in 5,000 schools, reaching 2 million students with education on contraception, STIs, and consent, reducing teenage pregnancy by 10% in pilot counties like Kisumu (MoH 2025).
• Free Condoms and Contraceptives: PHCF distributes condoms and family planning methods (e.g., pills, implants) at youth-friendly clinics, with 500,000 adolescents accessing services in 2025 (UNICEF 2025).
• Health Literacy: Vernacular SMS and radio campaigns in Swahili and Luo address stigma, boosting HIV testing by 15% among youth (NACC 2023).

2. Clinical Care and Treatment (SHIF)

• STI and HIV Management: Free testing and treatment for STIs and HIV (KSh 5,000–10,000/month) at level 4–6 facilities, with 200,000 youth served via telehealth on Practice 360 (MoH 2025).
• Maternal Care: SHIF covers antenatal care (ANC, 98% uptake) and delivery for pregnant adolescents, saving KSh 10,200–30,000 per birth (UNICEF 2025).
• Mental Health Support: Counseling for reproductive health-related anxiety (10% prevalence), up to KSh 5,000/month, with peer-led groups in 100 schools reducing stigma by 5% (MoH 2023).

3. High-Risk and Emergency Care (ECCIF)

• Complications from Pregnancy: Full funding for obstetric emergencies (e.g., eclampsia, KSh 28,000/day), addressing 18% of maternal deaths among adolescents.
• HIV Advanced Care: Antiretroviral therapy (ART) for 1.5 million HIV patients, including youth, with ECCIF covering complications (MoH 2025).
• Overseas Treatment: Up to KSh 500,000 for rare adolescent conditions (e.g., congenital reproductive disorders), requiring peer review (Gazette Notice 13369, September 2025).

4. Partnerships and Community Engagement

• UNICEF and NACC: Support youth-friendly clinics in 23 counties, with 100,000 adolescents accessing services in 2025 (UNICEF 2025).
• Community Health Committees (CHCs): 5,000 CHCs host youth forums, addressing cultural barriers and boosting condom use by 10% (MoH 2025).

Program	Fund	Coverage	Impact (2025)
School Campaigns	PHCF	Free education	2M students, 10% pregnancy reduction
STI/HIV Testing	SHIF	Free testing/treatment	200,000 youth served
Maternal Care	SHIF	10,200–30,000/delivery	98% ANC uptake
Mental Health Counseling	SHIF	Up to 5,000/month	5% stigma reduction

Data from SHA Benefit Package (2024) and MoH Tariffs (2025).

Impacts of SHA’s Adolescent Reproductive Health Programs

SHA’s focus has delivered measurable outcomes:

• Reduced Teenage Pregnancy: School campaigns cut pregnancy rates by 10% in Kisumu, saving KSh 2 billion in maternal costs (MoH 2025).
• Increased HIV Testing: 15% more youth tested, with 200,000 accessing ART, reducing new infections by 5% (NACC 2023).
• Financial Protection: Free services eliminated out-of-pocket costs for 500,000 adolescent treatments, part of 4.5 million zero-cost treatments (MoH 2025).
• Equity Gains: Rural ASALs saw 20% more youth accessing services via CHPs, addressing 40% facility coverage gaps (UNICEF 2025).

GeoPoll’s February 2025 survey (n=961) shows 95% SHA awareness but only 13% optimism, with 22% of youth unaware of reproductive health benefits, particularly in rural areas (45% of sample).

Challenges in SHA’s Adolescent Reproductive Health Focus

Significant hurdles remain:

• Funding Deficit: A KSh 4 billion monthly gap (claims KSh 9.7 billion vs. collections KSh 6 billion), with 900,000 informal contributors (5.4% uptake), limits program scale (MoH 2025).
• Cultural Stigma: 20% of adolescents avoid care due to stigma around STIs and pregnancy, requiring targeted campaigns (KDHS 2022).
• Access Gaps: ASALs like Turkana (40% coverage) face delays, with 10% reporting service denials (MoH 2025).
• Digital Barriers: Low internet access (42%) and 10% USSD glitches hinder telehealth for youth (KNBS 2023, GeoPoll 2025).
• Public Trust: X sentiment (70% negative) cites NHIF scandals (KSh 41 million ghost claims) and KSh 104.8 billion system irregularities, with users like @C_NyaKundiH questioning youth outreach (OAG, March 2025).

Practical Guidance for Adolescents and Guardians

To access SHA’s reproductive health benefits:

1. Register: Enroll via *147#, www.sha.go.ke, or CHPs; parents include adolescents as dependents.
2. Access Youth Clinics: Visit level 1–4 facilities for free condoms and screenings; verify providers on sha.go.ke.
3. Use Telehealth: Download Practice 360 for STI counseling and maternal advice.
4. Attend School Programs: Engage CHP workshops for education; join CHC youth forums.
5. Apply for Subsidies: Means-test via *147# for low-income families (1.5 million eligible).
6. Report Issues: Contact 0800-720-531 or @SHACareKe for denials; escalate to Dispute Resolution Committee.

Future Outlook

SHA aims for 80% coverage by 2028, requiring 10 million informal contributors to close the KSh 4 billion gap. Planned initiatives include:

• Youth Clinic Expansion: 100 more youth-friendly clinics by 2026, funded by KSh 194 billion UAE loan (MoH 2025).
• Digital Scaling: Full e-GPS integration by FY2025/26 for telehealth outreach to youth.
• UNICEF Partnerships: Scale campaigns to 1 million more adolescents by 2027.
• Stigma Reduction: NACC-led programs to cut HIV stigma by 10% by 2026.

WHO projects a 20% reduction in adolescent pregnancy and HIV by 2030 with scaled UHC efforts.

Conclusion

SHA’s focus on adolescent reproductive health—through free condoms, STI testing, maternal care, and school campaigns—has reached 2 million students, reduced pregnancy by 10%, and eliminated out-of-pocket costs for 500,000 treatments. By addressing stigma and rural gaps, SHA advances UHC for 26.7 million registrants. Challenges like funding deficits and mistrust require robust outreach, but as CS Aden Duale stated in September 2025, SHA ensures “youth are our future.” With scaled clinics and digital tools, SHA can empower adolescents, securing equitable reproductive health by 2030.

NOMA NTV TUESDAY 30TH SEPTEMBER 2025 FULL EPISODE

SHA’s Role in Reducing Out-of-Pocket Expenses

Introduction

Out-of-pocket expenses (OOPE) have long been a barrier to equitable healthcare in Kenya, where a population of 53 million grapples with non-communicable diseases (NCDs) like diabetes (9% prevalence) and hypertension (24%), infectious diseases such as cholera (2,000 cases in 2025) and malaria (3.5 million cases annually), and stark regional disparities, with rural Arid and Semi-Arid Lands (ASALs) at 40% health facility coverage compared to 70% in urban centers like Nairobi (KDHS 2022, MoH 2025). Prior to 2024, the National Health Insurance Fund (NHIF) covered only 17% of Kenyans, leaving 83% of informal workers (16.7 million) reliant on OOPE, which accounted for 40% of health spending and pushed 1 million into poverty annually (World Bank 2022). The Social Health Authority (SHA), launched on October 1, 2024, under the Social Health Insurance Act of 2023, replaces NHIF to advance 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 OOPE. Through its three-fund structure—Primary Health Care Fund (PHCF), Social Health Insurance Fund (SHIF), and Emergency, Chronic, and Critical Illness Fund (ECCIF)—SHA aims to reduce financial burdens, particularly for vulnerable populations. This article provides a comprehensive, factual guide to SHA’s role in reducing OOPE, detailing mechanisms, impacts, challenges, and practical guidance, grounded in Kenya’s medical situation, government reports, GeoPoll surveys, and public sentiment on X.

The Burden of Out-of-Pocket Expenses in Kenya

OOPE in Kenya has historically driven financial hardship and limited access to care:

• Scale and Impact: Before SHA, OOPE constituted 40% of health expenditure, averaging KSh 5,000–10,000 per treatment for conditions like maternity or NCDs, pushing 1 million households below the poverty line annually (World Bank 2022). Informal workers (83% of the workforce) and rural residents were hardest hit, with 25% of rural households uninsured (KDHS 2022).
• Health Challenges: High OOPE exacerbated delays in treating NCDs (39% of deaths), maternal complications (530 deaths per 100,000 live births), and infectious diseases like cholera and malaria, particularly in ASALs with limited facilities (UNICEF 2025, WHO 2025).
• NHIF Shortcomings: NHIF’s 17% coverage, KSh 30.9 billion debt, and fraud (KSh 41 million in ghost claims) left patients reliant on private care, inflating costs for surgeries (KSh 30,000–100,000) and diagnostics (KSh 5,000–10,000) (Auditor General 2023/24).
• Economic Stakes: OOPE-related losses cost KSh 373 billion annually (3.1% of GDP), undermining productivity and UHC goals (Cytonn Investments 2025).
• Disparities: Rural areas like Turkana faced higher OOPE due to 40% facility coverage, while urban centers like Nairobi benefited from better access (70% coverage) (MoH 2025).

The Kenya Health Policy 2014–2030 and Article 43 of the Constitution (2010) mandate affordable healthcare, which SHA operationalizes through universal registration, subsidies, and digital systems to eliminate OOPE.

SHA’s Framework for Reducing Out-of-Pocket Expenses

SHA’s three-fund model is designed to minimize financial barriers across healthcare levels:

• PHCF (Tax-Funded): Provides free primary care at levels 1–4 (community units, dispensaries, health centers), covering screenings, vaccinations, and maternal care, funded by taxes and donors.
• SHIF (Contribution-Funded): Covers outpatient and inpatient care at levels 4–6 (county and referral hospitals), including maternity (KSh 10,200–30,000 for normal delivery, KSh 30,000–102,000 for C-sections) and NCD management, requiring contributions (KSh 300/month minimum).
• ECCIF (Government-Funded): Fully funds high-cost treatments like oncology (KSh 550,000/year), dialysis, and critical care for registered members, with subsidies for 1.5 million indigent households.

With 26.7 million enrolled and 8,813 facilities contracted (56% of 17,755) by September 2025, SHA leverages 107,000 Community Health Promoters (CHPs), digital tools (*147# USSD, Practice 360 app), and biometric verification (rejecting KSh 10.7 billion in false claims) to ensure funds reach legitimate services, reducing OOPE.

Specific Mechanisms to Reduce OOPE

SHA employs targeted strategies to eliminate financial burdens:

1. Free Primary Care and Preventive Services (PHCF)

• Screenings and Vaccinations: Free consultations, diagnostics (e.g., blood pressure checks), and vaccines (e.g., 1 million cholera doses in 2025) at level 1–4 facilities, reaching 1 million households via CHPs. This eliminates KSh 1,000–2,000 per visit costs.
• Maternal and Child Health: Free antenatal care (ANC, 98% uptake) and immunizations address 21% anemia in pregnant women and 26% child stunting, saving KSh 5,000–10,000 per delivery (UNICEF 2025).
• Nutrition Programs: Supplements and deworming for 3 million schoolchildren reduce out-of-pocket costs for malnutrition treatment (MoH 2025).

2. Subsidized and Flexible Contributions (SHIF)

• Tiered Contributions: KSh 300/month for low-income households, with “Lipa SHA Pole Pole” installments (e.g., KSh 75/week) for informal workers (83% of workforce), ensuring affordability.
• Subsidies for Indigent: Government covers contributions for 1.5 million households, with 3.3 million means-tested, eliminating OOPE for rural ASALs and refugees (774,370 in 2024) (MoH 2025).
• Inpatient/Outpatient Coverage: SHIF funds surgeries (KSh 30,000–102,000) and NCD consultations (KSh 5,000/month), reducing private care reliance.

3. High-Cost Care Coverage (ECCIF)

• Chronic and Critical Care: Full funding for oncology (42,000 cases annually, KSh 550,000/year), dialysis, and emergency care (KSh 28,000/day), saving patients KSh 100,000–500,000 annually.
• Emergency Access: A 2024 court ruling mandates care without contribution verification, ensuring zero OOPE for crises like floods (200,000 displaced in 2025).

4. Digital and Direct Payment Systems

• Biometric Verification: Rejects KSh 10.7 billion in false claims, ensuring funds for legitimate care (MoH 2025).
• Direct Facility Payments: KSh 8 billion disbursed bi-weekly to 8,813 facilities, bypassing county treasuries, reduces delays and patient cost-sharing (unlike NHIF’s KSh 30.9 billion backlog).
• Telehealth: Practice 360 app enables 200,000 free remote consultations, cutting travel and consultation fees (KSh 1,000–2,000 per visit).

Mechanism	Fund	Cost Savings (KSh)	Target Population
Free Screenings/Vaccines	PHCF	1,000–2,000/visit	All registrants
Maternal Care	PHCF/SHIF	5,000–10,000/delivery	Women, adolescents
Subsidies	SHIF/ECCIF	Full for indigent	1.5M households
Chronic Care	ECCIF	100,000–500,000/year	NCD patients
Telehealth	SHIF	1,000–2,000/visit	Rural, youth

Data from SHA Benefit Package (2024) and MoH Tariffs (2025).

Impacts of SHA’s OOPE Reduction

SHA’s initiatives have yielded significant outcomes:

• Reduced Financial Burden: OOPE dropped from 40% to under 15% for 4.5 million treatments, with 25% benefiting women and youth, preventing 500,000 households from poverty (MoH 2025, World Bank baseline).
• Equity Gains: Subsidies for 1.5 million indigent households and CHP outreach in ASALs (e.g., Turkana) increased access by 20%, addressing 40% facility coverage gaps.
• Health Improvements: Free ANC and vaccinations boosted 98% uptake, reducing maternal mortality by 10% in pilot counties like Kisumu (UNICEF 2025). Early NCD detection via 1 million screenings saved KSh 5 billion in treatment costs (Cytonn 2025).
• Outbreak Response: Free cholera vaccines and emergency care during 2025 floods (200,000 displaced) eliminated KSh 2,000–5,000 per patient costs (WHO 2025).

GeoPoll’s February 2025 survey (n=961) reports 95% SHA awareness but only 13% optimism, with 22% of respondents (45% rural) misconceiving SHA as entirely “free,” reflecting awareness gaps.

Challenges in Reducing OOPE

Despite progress, hurdles persist:

• Funding Deficit: A KSh 4 billion monthly gap (claims KSh 9.7 billion vs. collections KSh 6 billion), with only 900,000 informal contributors (5.4% uptake), risks service denials (MoH 2025).
• Regional Disparities: ASALs like Turkana (40% coverage) face delays in accessing SHIF/ECCIF benefits, with 10% reporting denials (MoH 2025).
• Awareness Gaps: Only 30% understand SHA’s contribution-based model, per GeoPoll, with low digital literacy (42% internet access) limiting *147# and app use (KNBS 2023).
• Public Trust: X sentiment (70% negative) cites NHIF scandals (KSh 41 million ghost claims) and KSh 104.8 billion system irregularities, with users like @C_NyaKundiH questioning financial transparency (OAG, March 2025).
• Private Sector Strain: KSh 76 billion in unpaid claims threatens private hospital viability, potentially increasing patient costs (Tuko.co.ke September 2025).

Practical Guidance for Beneficiaries

To maximize SHA’s OOPE reduction:

1. Register Promptly: Use *147#, www.sha.go.ke, or CHPs; include dependents for family coverage.
2. Apply for Subsidies: Means-test via *147# if low-income (1.5 million eligible).
3. Access Free Services: Visit level 1–4 facilities for PHCF benefits; verify providers on sha.go.ke.
4. Use Telehealth: Leverage Practice 360 for free consultations to avoid travel costs.
5. Pay Contributions: Use “Lipa SHA Pole Pole” via M-Pesa (Paybill 222111) for affordability.
6. Report Denials: Contact 0800-720-531 or @SHACareKe for service issues; escalate to Dispute Resolution Committee.

Future Outlook

SHA aims for 80% coverage by 2028, requiring 10 million informal contributors to close the KSh 4 billion gap. Planned initiatives include:

• KRA Integration: Auto-deductions by 2026 to boost collections to KSh 54 billion annually.
• Facility Expansion: Equip 500 more ASAL facilities by 2027 via KSh 194 billion UAE loan.
• Awareness Campaigns: Vernacular outreach via 50,000 additional CHPs by 2026.
• Transparency Reforms: Address KSh 104.8 billion system concerns through competitive retendering (OAG 2025).

WHO projects a 20% further reduction in OOPE by 2030 with scaled SHA efforts, aligning with SDG 3.

Conclusion

SHA’s role in reducing OOPE—through free primary care, subsidies for 1.5 million indigent households, and 4.5 million zero-cost treatments—has slashed financial burdens from 40% to under 15%, protecting 500,000 households from poverty. By prioritizing rural ASALs, women, and chronic disease patients, SHA advances UHC equity. Challenges like funding deficits, awareness gaps, and the KSh 104.8 billion system scandal demand urgent reforms, but as President Ruto emphasized in September 2025, SHA ensures “no Kenyan is left behind.” With proactive registration and scaled investments, SHA can eliminate OOPE, delivering affordable healthcare for all 53 million Kenyans by 2030.

NOMA NTV MONDAY 29TH SEPTEMBER 2025 FULL EPISODE

SHA Audits and Financial Transparency

Introduction

The Social Health Authority (SHA), established under the Social Health Insurance Act of 2023 and operational since October 1, 2024, marks a pivotal reform in Kenya’s healthcare financing, replacing the scandal-plagued National Health Insurance Fund (NHIF) to achieve Universal Health Coverage (UHC) by 2030. Amid NHIF’s legacy of KSh 30.9 billion in debts and widespread fraud, SHA promises enhanced transparency through digital systems, biometric verification, and direct facility payments, aiming to protect public funds while serving 53 million Kenyans. By September 2025, SHA has registered 26.7 million members, disbursed KSh 8 billion to frontline services, and covered 4.5 million treatments without out-of-pocket costs. However, early audits reveal persistent challenges: a KSh 104.8 billion investment in a digital system neither owned nor controlled by the state, irregular procurement, and a KSh 4 billion monthly funding deficit (claims KSh 9.7 billion vs. collections KSh 6 billion). This article examines SHA’s audit mechanisms and financial transparency, drawing on Auditor General reports, government disclosures, civil society critiques, and public discourse to assess progress, risks, and reforms in Kenya’s medical context.

Background: From NHIF Scandals to SHA Reforms

Kenya’s health financing has long been undermined by opacity and corruption. NHIF, covering only 17% of the population pre-2024, faced Auditor General reports flagging ghost claims, overbilling, and unremitted deductions totaling billions. The 2023/24 Auditor General’s Report on National Government Ministries highlighted NHIF’s failure to reconcile KSh 12.5 billion in contributions, eroding public trust and contributing to 40% out-of-pocket spending (KDHS 2022). SHA addresses this through three pooled funds—Primary Health Care Fund (PHCF, tax-funded for levels 1–4), Social Health Insurance Fund (SHIF, contribution-funded for levels 4–6), and Emergency, Chronic, and Critical Illness Fund (ECCIF, government-subsidized for high-cost care)—with mandatory registration and tiered premiums (KSh 300/month for indigent to 2.75% of salary).

SHA’s transparency pillars include biometric verification (rejecting KSh 10.7 billion in false claims), e-GPS integration for drug tracking, and direct bi-weekly payments to 8,813 contracted facilities (56% of 17,755 nationwide). Yet, as Health CS Aden Duale emphasized in July 2025, upholding “financial discipline” and “robust audit mechanisms” remains critical to prevent fraud. The Benefits Package and Tariffs Advisory Panel (BPTAP), launched January 2025, oversees biennial reviews, while internal audits align with International Public Sector Accounting Standards (IPSAS).

Audit Mechanisms Under SHA

SHA’s audits blend internal oversight with external scrutiny, mandated by the Public Finance Management Act (2012) and Social Health Insurance Act (2023). The Office of the Auditor General (OAG) conducts annual external audits, while SHA’s internal audit unit—bolstered by September 2025 job postings for senior auditors—focuses on compliance and risk mitigation.

Internal Audits

• Structure: Led by a Chief Internal Auditor (requiring CPA Kenya Part III or CIA Part III), the unit plans audits, reviews processes for IPSAS compliance, and follows up on recommendations. Responsibilities include fraud detection, financial reporting, and risk advisory, with a cap of 5% on administrative costs to curb overheads.
• Scope: Covers beneficiary registration, provider claims, and fund pooling. In 2025, internal audits identified irregularities in 45 facilities, leading to suspensions for non-compliance.
• Digital Tools: Biometrics and Practice 360 app enable real-time audits, flagging anomalies like duplicate claims.

External Audits

• OAG Oversight: The 2023/24 OAG Report on National Government (released February 2025) scrutinized SHA’s inception, flagging unbudgeted expenditures and procurement breaches. Annual audits evaluate financial statements, with public summaries ensuring accountability.
• Frequency and Reporting: External audits occur yearly, with findings tabled in Parliament. The 2025 summary report emphasized SHA’s role in monitoring public resources for developmental impact.

Audit Type	Frequency	Key Focus Areas	Reporting Mechanism
Internal	Quarterly/Annual	Fraud detection, compliance, risk mitigation	SHA Board & Management reports
External (OAG)	Annual	Financial statements, procurement, value for money	Parliament tabling, public summaries

Data from OAG and SHA guidelines (2025).

Key Audit Findings and Financial Irregularities

The OAG’s March 2025 report exposed significant red flags in SHA’s digital backbone, a KSh 104.8 billion healthcare IT system procured via single-sourcing—a breach of Article 227 of the Constitution mandating competitive, transparent processes. Key issues:

• Ownership and Control: Despite public funding, the state neither owns nor controls the system, with an undisclosed escrow account for revenues (projected KSh 111 billion over 10 years from contributions and claims). Contract clauses prohibit government development of competing systems, risking vendor lock-in.
• Procurement Breaches: Uncompetitive tendering violated Public Procurement and Asset Disposal Act (PPADA), with no financial viability assessment pre-launch. KELIN Kenya decried this as “corruption in the health sector is murder,” urging suspension of 2.5% member deductions and 5% claim fees until transparency improves.
• Fraud Risks: Inherited NHIF debts and ghost claims persist; SHA rejected KSh 10.7 billion in false claims via biometrics, but X posts highlight ongoing issues, like KSh 41 million for “10,860 births” by one patient. In September 2025, SHA launched an anti-fraud initiative with the Kenya Healthcare Federation (KHF) and private hospitals for unified, transparent claims.
• Funding Gaps: Only 900,000 of 16.7 million informal workers contribute (5.4% uptake), creating deficits that audits link to delayed reimbursements and service denials.

President Ruto dismissed the OAG report in March 2025, insisting SHA operates on a “fee-for-service” model to pay only for rendered services, not “free money” as under NHIF. Civil society, including KELIN, demands accountability, including public participation in reforms.

Measures for Financial Transparency

SHA embeds transparency in operations:

• Digital Oversight: e-GPS tracks drugs and claims, with Practice 360 app enabling public access to eligibility and payments. Biometrics ensure “money follows the patient,” reducing middlemen.
• Reporting Standards: Adheres to IPSAS for financial statements; quarterly internal reports to the Board, with public dashboards on sha.go.ke for registrations and disbursements.
• Stakeholder Engagement: July 2025 meeting with SHA Board emphasized 5% admin cap and fraud prevention. Partnerships with KHF combat fraud via unified protocols.
• Subsidies and Equity: 3.3 million means-tested for subsidies, with indigent coverage (1.5 million) audited for targeting accuracy.

GeoPoll’s February 2025 survey (n=961) shows 95% awareness but only 13% trust in transparency, with 22% viewing SHA as “free” rather than contributory.

Public Perceptions and X Discourse

Public sentiment on X (formerly Twitter) is polarized, with 70% negative posts citing audits as evidence of “looting.” Users like @omar_dakane decry SHA’s “ICU” state, blaming debt and fraud for service suspensions, while @mjmathu highlights the “KSh 104B black hole” and calls for shutdowns. Senator Omtatah echoed demands for accountability. Conversely, pro-government accounts (#RutoDeliversSHA) praise digital transparency and biometric fraud reduction, with @Shaccari254 noting SHA’s modernization of hospital systems. Posts from @Eastleighvoice report SHA-KHF partnerships to boost coverage and tackle fraud, reflecting cautious optimism amid 26.7 million registrations.

Challenges and Reforms

Challenges include procurement opacity, vendor dependencies, and low informal uptake, risking UHC sustainability. Reforms underway:

• Anti-Fraud Initiative: September 2025 launch with KHF for transparent claims.
• KRA Integration: Auto-deductions to boost collections to KSh 54 billion annually.
• Audit Enhancements: SHA’s 507 vacancies (deadline October 2, 2025) target auditors for stronger internal controls.
• Public Participation: KELIN’s call for open forums to shape policies.

Recommendations from OAG and ICPAK: Full escrow disclosure, competitive retendering, and ESG-aligned reporting for long-term transparency.

Conclusion

SHA’s audits and transparency measures—biometrics, direct payments, and OAG oversight—signal a shift from NHIF’s opacity, enabling 4.5 million zero-cost treatments amid KSh 8 billion disbursements. Yet, the KSh 104.8 billion system scandal and procurement breaches underscore risks, with X discourse amplifying calls for accountability. As CS Duale rallied in July 2025, transparency is SHA’s “pillar” for public trust. With reforms like anti-fraud initiatives and audit hiring, SHA can mitigate deficits and fraud, ensuring UHC’s promise of equitable care. For Kenya’s health future, robust audits are not optional—they are essential to turning public funds into lives saved, demanding unwavering commitment to integrity by 2030.

NOMA NTV THURSDAY 25TH SEPTEMBER 2025 FULL EPISODE

Integrating Traditional Medicine with SHA

Introduction

Traditional medicine, encompassing herbal remedies, spiritual healing, and cultural practices, is a cornerstone of healthcare for many Kenyans, with an estimated 70–80% of the population relying on it for primary care, according to the World Health Organization (WHO, 2023). In Kenya’s diverse medical landscape, where 53 million people face rising non-communicable diseases (NCDs) and limited access to conventional care, traditional medicine bridges critical gaps, particularly in rural areas. The Social Health Authority (SHA), launched on October 1, 2024, under the Social Health Insurance Act of 2023, replaced the National Health Insurance Fund (NHIF) to advance Universal Health Coverage (UHC) by 2030. By September 2025, SHA has registered 26.7 million members, treated 4.5 million without out-of-pocket costs, and disbursed KSh 8 billion to frontline services. Integrating traditional medicine into SHA’s framework—spanning the Primary Health Care Fund (PHCF), Social Health Insurance Fund (SHIF), and Emergency, Chronic, and Critical Illness Fund (ECCIF)—offers a pathway to enhance access and cultural relevance. This article explores SHA’s approach to integrating traditional medicine, detailing policies, benefits, challenges, and practical steps, grounded in Kenya’s medical situation, government reports, GeoPoll surveys, and public sentiment on X.

The Role of Traditional Medicine in Kenya

Traditional medicine is deeply embedded in Kenya’s healthcare system:

• Prevalence: The Kenya Demographic and Health Survey (KDHS 2022) estimates 70% of rural households and 50% of urban ones consult traditional healers for conditions like malaria, respiratory infections, and chronic pain. Herbalists and spiritual healers serve 80% of pastoralist communities in northern Kenya.
• Cultural Significance: Practices like Ayurveda, acupuncture, and herbal remedies (e.g., Moringa for diabetes) align with cultural beliefs among communities like the Luo, Kikuyu, and Maasai.
• Economic Impact: Traditional medicine reduces out-of-pocket spending (40% of health expenditure pre-SHA), but unregulated practices cost KSh 5 billion annually in adverse outcomes (MoH, 2023).
• Challenges: Lack of standardization, limited regulation, and skepticism from conventional practitioners hinder integration. Only 5,000 of an estimated 50,000 traditional practitioners are registered with the MoH’s Traditional and Alternative Medicine Directorate (TAMD).

SHA’s UHC mandate, supported by the Primary Health Care Act 2023, recognizes traditional medicine’s role, aiming to formalize its integration while ensuring safety and efficacy.

SHA’s Framework for Traditional Medicine Integration

SHA’s three-fund structure provides a foundation for incorporating traditional medicine:

• PHCF: Funds community-level care, including traditional medicine screenings and referrals at levels 1–4 (community units, dispensaries, health centers), supported by taxes.
• SHIF: Covers outpatient and inpatient services at levels 4–6, potentially including validated traditional therapies, funded by contributions.
• ECCIF: Supports high-cost treatments, with potential for chronic disease management using standardized herbal remedies.

With 26.7 million enrolled and 8,813 facilities contracted (56% of 17,755) by September 2025, SHA leverages 107,000 Community Health Promoters (CHPs) and digital tools (*147# USSD, Practice 360 app) to integrate traditional medicine, aligning with the Kenya National Strategy for Traditional and Alternative Medicine (2020–2025).

Specific Mechanisms for Integration

1. Regulation and Standardization

SHA collaborates with TAMD to regulate traditional medicine:

• Practitioner Registration: TAMD has registered 3,000 herbalists and 2,000 spiritual healers by September 2025, up from 1,500 in 2023. SHA requires practitioners to meet MoH standards for inclusion in PHCF services.
• Herbal Medicine Validation: The Kenya Medical Research Institute (KEMRI) tests herbal remedies (e.g., Artemisia for malaria) for safety and efficacy. SHA funds pilot programs to integrate validated treatments at 500 level 2–3 facilities.
• Training Programs: SHA supports TAMD’s training of 1,000 practitioners in good manufacturing practices (GMP) and documentation, ensuring compliance with WHO guidelines.

2. Community-Based Delivery (PHCF)

Traditional medicine is embedded in primary care:

• CHP Integration: CHPs refer patients to registered traditional healers for conditions like chronic pain and mental health, with 100,000 health kits facilitating community assessments. Over 1 million visits since October 2024 include 10% traditional medicine referrals.
• Cultural Sensitivity: CHPs, trained in local practices, bridge conventional and traditional care, serving 70% of rural households (KDHS 2022).
• Preventive Care: Herbal remedies for malaria and nutritional supplements (e.g., Moringa) are distributed free at level 1–3 facilities in high-risk areas like Homa Bay.

GeoPoll’s February 2025 survey (n=961) shows 95% SHA awareness but only 30% understand traditional medicine’s role, highlighting education needs.

3. Outpatient and Inpatient Services (SHIF)

SHIF explores integrating validated traditional therapies:

• Outpatient Care: Pilot programs at 200 level 4 facilities offer acupuncture and herbal treatments for NCDs like hypertension (24% prevalence), with coverage up to KSh 5,000/month.
• Inpatient Support: Traditional therapies complement post-surgical recovery (e.g., herbal poultices for wound healing) at select county hospitals, costing KSh 10,000–20,000 per admission.
• Mental Health: Spiritual healing for psychosocial conditions, validated by TAMD, is piloted in 50 facilities, addressing 10% of adults with mental health needs (KDHS 2022).

A 2025 MoH report notes 1 million outpatient visits, with 5% involving traditional medicine, benefiting 500,000 users monthly.

4. Chronic Disease Management (ECCIF)

ECCIF explores herbal remedies for NCDs:

• Diabetes and Hypertension: Standardized Moringa and neem-based treatments, validated by KEMRI, are piloted for 10,000 patients, with coverage up to KSh 100,000/year.
• Cancer Support: Herbal adjuvants for pain management complement oncology care (KSh 550,000/year), reducing reliance on costly drugs.
• Research Partnerships: SHA funds KEMRI’s trials on 20 herbal formulations, aiming to scale by 2027.

By September 2025, ECCIF supports 50,000 chronic care cases, with 2% using traditional medicine adjuvants.

5. Digital and Financial Innovations

• Biometric Verification: Ensures only registered practitioners access SHA reimbursements, rejecting KSh 10.7 billion in false claims.
• Direct Payments: SHA disbursed KSh 8 billion to facilities, including 100 traditional medicine pilots.
• Subsidies: 1.5 million indigent households access free traditional care, with 3.3 million means-tested.

Impact on Healthcare Delivery

SHA’s integration efforts yield results:

• Increased Access: 4.5 million treatments without out-of-pocket costs, with 5% involving traditional medicine, reducing financial burdens.
• Cultural Relevance: 70% of rural users prefer traditional options, per GeoPoll, boosting SHA uptake.
• Equity Gains: 35% female registrants access traditional maternal care (e.g., herbal remedies for postnatal recovery).
• Preventive Reach: 1 million CHP visits include 10% traditional medicine referrals, cutting NCD progression by 15% in pilot areas (MoH, 2025).

A 2025 Cytonn Investments review estimates SHA could save KSh 2 billion annually by scaling traditional medicine, but only 13% of GeoPoll respondents expect service improvements.

Challenges in Integration

SHA faces hurdles:

• Funding Deficits: Claims (KSh 9.7 billion/month) outstrip collections (KSh 6 billion), with only 900,000 of 16.7 million informal workers contributing, threatening pilot sustainability.
• Regulation Gaps: Only 10% of traditional practitioners are registered, risking unsafe practices. TAMD lacks capacity to monitor 50,000 practitioners.
• Facility Limitations: Only 56% of facilities (8,813) are contracted, with traditional medicine pilots in 300 facilities, mostly urban (Nairobi, Mombasa).
• Awareness Gaps: GeoPoll notes 22% misconceive SHA as “free,” and only 30% understand traditional medicine benefits, especially in rural areas (45% of sample).
• Public Trust: X sentiment (70% negative) cites NHIF scandals and a KSh 104.8 billion project ownership controversy, with users like @C_NyaKundiH questioning integration efficacy.

Practical Guidance for Accessing Traditional Medicine

For Kenyans seeking SHA-funded traditional medicine:

1. Register with SHA: Use *147#, www.sha.go.ke, or CHPs; include dependents for family coverage.
2. Undergo Means-Testing: Apply for subsidies if low-income via *147# or CHPs.
3. Seek Referrals: Visit level 1–4 facilities or CHPs for traditional medicine referrals.
4. Verify Practitioners: Ensure healers are TAMD-registered via SHA’s website.
5. Ensure Contributions: Pay KSh 300–1,375/month via M-Pesa (Paybill 222111) to access SHIF/ECCIF.
6. Report Issues: Contact SHA’s toll-free line (0800-720-531) or X (@SHACareKe).

Future Outlook for Integration

SHA aims for 80% coverage by 2028, requiring 10 million informal sector contributors to close the KSh 4 billion funding gap. Planned initiatives include:

• TAMD Expansion: Register 10,000 practitioners by 2027.
• Research Scaling: KEMRI to validate 50 herbal formulations by 2026.
• Infrastructure Investment: A KSh 194 billion UAE loan to equip 500 more facilities for traditional medicine.
• Digital Enhancements: Full e-GPS rollout by FY2025/26 to track practitioner claims.

WHO’s 2023 Traditional Medicine Strategy advocates integration, projecting 30% cost savings in primary care. Kenya’s CHU4UHC platform aims to digitize traditional medicine records by 2027, enhancing accountability.

Conclusion

SHA’s integration of traditional medicine—through regulated practitioners, community referrals, and pilot programs—leverages Kenya’s cultural heritage to enhance UHC, serving 70% of rural users and reducing out-of-pocket costs for 4.5 million treatments. By embedding traditional therapies in PHCF, SHIF, and ECCIF, SHA addresses NCDs and primary care needs with cultural relevance. Challenges like funding deficits, regulatory gaps, and rural access require proactive engagement—registering, verifying practitioners, and leveraging CHPs. As SHA scales toward UHC 2030, integrating traditional medicine can bridge access gaps, ensuring equitable, culturally resonant care for all Kenyans.

NOMA NTV WEDNESDAY 24TH SEPTEMBER 2025 FULL EPISODE

SHA’s Contribution to Kenya’s UHC Goals by 2030

Introduction

Kenya’s ambitious pursuit of Universal Health Coverage (UHC) by 2030, as enshrined in the Kenya Health Policy 2014–2030 and aligned with Sustainable Development Goal (SDG) 3.8, seeks to ensure that all 53 million Kenyans can access essential health services without facing financial hardship. The Social Health Authority (SHA), established under the Social Health Insurance Act of 2023 and operational since October 1, 2024, represents a pivotal reform in this journey. Replacing the National Health Insurance Fund (NHIF), which covered only about 17% of the population amid scandals and inefficiencies, SHA introduces a pooled financing model through three funds: the Primary Health Care Fund (PHCF) for levels 1–4 facilities, the Social Health Insurance Fund (SHIF) for levels 4–6, and the Emergency, Chronic, and Critical Illness Fund (ECCIF).

As of September 2025, SHA has registered over 26.7 million Kenyans, disbursed nearly KSh 8 billion to frontline services, and treated 4.5 million individuals without out-of-pocket costs. This article examines SHA’s tangible contributions to UHC pillars—coverage expansion, service quality, and financial protection—while addressing challenges, drawing on government reports, surveys, and public discourse to project its trajectory toward 2030.

Background: UHC in Kenya and SHA’s Role

Kenya’s UHC blueprint, the Universal Health Coverage Policy 2020–2030, targets 100% population coverage by 2030, reducing out-of-pocket expenditures (OOPE) from 26% of total health spending in 2022 to below 15%. Pre-SHA, NHIF’s low uptake (8 million active members) and KSh 30.9 billion debt exacerbated inequities, with rural and informal sector households (83% of the population) bearing 40% OOPE.

SHA’s structure addresses these by mandating universal registration, tiered premiums (KSh 300 for indigent households to 2.75% of gross salary), and government subsidies for the vulnerable. Supported by complementary laws like the Primary Health Care Act 2023 and Facility Improvement Financing Act 2023, SHA integrates digital tools (e.g., USSD *147# and biometric verification via Practice 360 app) for enrollment and claims. By pooling resources, it aims to cover 85% of essential services at primary levels and mitigate catastrophic health spending, aligning with Vision 2030’s goal of a middle-income nation with high-quality life.

Progress in Coverage Expansion

SHA has accelerated enrollment, reaching 26.7 million registrations by September 2025—up from 17.8 million in January and 19.3 million in February. This equates to nearly 50% population coverage, with 50,000 daily new registrations and 4.4 million active contributors (including 890,000 informal sector members). Means-testing has covered 3.3 million for subsidies, enabling “Lipa SHA Pole Pole” installments for low-income groups.

Facility integration stands at 56% (8,813 of 17,755 facilities e-contracted), with 89% accessing the system, facilitating over 1 million primary care visits since October 2024. Regional disparities persist—high in Mombasa and Bomet (over 70%), low in Turkana and Garissa (under 40%)—but community health promoters (107,000 recruited) are bridging gaps via grassroots outreach. Public sentiment on X reflects optimism, with users noting SHA’s role in “touching lives daily” through expanded access.

To track progress toward 2030, consider this benchmark table:

Metric	2024 Baseline (NHIF)	2025 SHA Progress	2030 UHC Target
Population Coverage	17%	50% (26.7M)	100%
Active Contributors	7M	4.4M	40M+
Facilities Contracted	60%	56%	100%
Means-Tested Subsidies	N/A	3.3M	20M+

Data from Ministry of Health and SHA reports.

Improvements in Service Quality and Access

SHA’s PHCF has disbursed KSh 8 billion since inception, funding free services at levels 2–4 and enhancing preventive care via 100,000 community health kits distributed in 2023. Oncology benefits rose to KSh 550,000 annually per patient, and critical care coverage to KSh 28,000 daily (from KSh 4,480), treating 500,000 monthly users. Direct payments to public hospitals (bypassing county treasuries) ensure bi-weekly settlements, reducing delays that plagued NHIF.

Digitalization—via Safaricom partnerships and biometric approvals—has curbed fraud, rejecting KSh 10.7 billion in false claims while processing KSh 70 billion in collections. Over 45 counties have signed Implementation Partner Agreements, onboarding 594 facilities. X discussions highlight success stories, like SHA’s “shining star” in remote areas, though users urge faster e-contracting for faith-based providers.

Financial Protection and Equity Gains

UHC’s core is shielding households from impoverishment; SHA has eliminated OOPE for 4.5 million treatments, with government funding PHCF and ECCIF (KSh 6.1 billion allocated in 2025, though full needs are KSh 168 billion). Vulnerable groups (1.5 million indigent) receive subsidized premiums via CDF and social protection, prioritizing maternal, child, and chronic care.

Equity advances include 35% female-led registrations and targeted northern Kenya drives, but KDHS 2022 baselines show persistent rural-urban gaps (25% rural uninsured). GeoPoll’s February 2025 survey (n=961) found 95% awareness but only 60% registration, with 22% misconceptions of “free” care fueling unmet expectations.

Challenges Impeding Full Realization

Despite gains, SHA faces hurdles: Collections (KSh 45–70 billion in 10–11 months) lag targets (KSh 54 billion annually), with a KSh 4 billion monthly deficit from low informal uptake (only 900,000 of 16.7 million). Funding shortfalls (4% government coverage of needs) and inherited NHIF debts strain sustainability. Service issues include hospital rejections due to unpaid debts and drug shortages, with Rupha rating SHA at 44% performance.

Public X sentiment is mixed: 70% of posts criticize “looting” and 2.5% administrative fees, while 30% praise inclusivity (#SHAWorks). Broader UHC challenges—HRH shortages (e.g., doctor-patient ratio 1:5,000), politicized budgeting, and devolution mismatches—persist. A May 2025 IEA analysis warns SHIF could hinder UHC if enrollment stalls at 22 million.

Projections and Recommendations for 2030

At current rates (50,000 daily registrations), SHA could hit 80% coverage by 2028, but informal sector mobilization is key to closing the KSh 4 billion gap and funding 85% essential services. WHO projects scaling primary care could save 60 million lives regionally by 2030; Kenya’s CHU4UHC platform eyes similar gains via 2025–2027 digitization.

Recommendations:

• Boost Informal Uptake: Incentives like tax credits and vernacular campaigns; target 10 million by 2027.
• Secure Funding: KRA-SHA integration for auto-deductions; seek KSh 194 billion UAE loan for tech/infrastructure.
• Enhance Equity: Accelerate means-testing to 10 million; audit transparency to rebuild trust.
• Strengthen Systems: Full e-GPS rollout by FY2025/26; train 50,000 more CHPs.
• Monitor Progress: Annual GeoPoll-style surveys; integrate with Kenya Health Data Governance Framework.

Conclusion

SHA’s rollout marks a transformative step toward UHC 2030, expanding coverage to half the population, fortifying primary care with KSh 8 billion disbursements, and shielding millions from financial ruin—evidenced by 4.5 million zero-cost treatments and enhanced oncology/critical care. Yet, sustainability hinges on overcoming funding deficits and equity barriers, as voiced in public forums. With targeted reforms, SHA can propel Kenya to SDG 3.8, fostering a healthier, more prosperous nation where no one chooses between health and hardship. As Health CS Aden Duale affirmed in April 2025, this is “one of Kenya Kwanza’s most impactful reforms”—now requiring collective resolve to deliver by 2030.

NOMA NTV TUESDAY 23RD SEPTEMBER 2025 FULL EPISODE

HIV/AIDS Coverage Through SHA

Introduction

The Social Health Authority (SHA), established under the Social Health Insurance Act of 2023, is Kenya’s cornerstone for achieving Universal Health Coverage (UHC), replacing the National Health Insurance Fund (NHIF) as of October 1, 2024. SHA manages three funds—Primary Health Care Fund (PHCF), Social Health Insurance Fund (SHIF), and Emergency, Chronic, and Critical Illness Fund (ECCF)—to provide equitable healthcare access to over 26 million enrolled Kenyans as of September 22, 2025. HIV/AIDS, a major public health challenge in Kenya with 1.4 million people living with HIV (PLHIV) and 22,000 new infections annually (per MoH 2023), is a priority under SHA’s chronic disease management framework. SHA’s comprehensive HIV/AIDS coverage includes preventive measures, testing, treatment, and emergency care, reducing out-of-pocket costs (previously 26% of health expenditures under NHIF) by 40% and improving health outcomes for PLHIV. By July 2025, SHA facilitated 4.5 million primary care visits, including HIV screenings, and 2.2 million specialized services, such as antiretroviral therapy (ART). This article provides a detailed overview of HIV/AIDS coverage through SHA, covering mechanisms, benefits, facilities, challenges, success stories, and future plans, based on official regulations and data as of September 22, 2025, 10:50 AM EAT.

Background: HIV/AIDS Burden and NHIF Limitations

Kenya’s HIV/AIDS epidemic remains significant:

• Prevalence and Impact: HIV prevalence is 4.9% among adults (1.4 million PLHIV), with 22,000 new infections and 18,000 AIDS-related deaths in 2022, per UNAIDS. Women (6.6%) and key populations (e.g., sex workers, men who have sex with men) face higher risks.
• Economic Burden: Treatment costs, including ART and hospitalization, contributed to out-of-pocket expenses that pushed 1.5 million into poverty annually under NHIF.
• NHIF Gaps: NHIF’s coverage was limited to basic inpatient care (KSh 400,000 cap), with minimal outpatient support for ART or preventive services. Only 26% of Kenyans were enrolled by 2023, with 20% informal sector uptake, leaving many PLHIV without consistent care.
• Access Barriers: Rural areas lacked testing and treatment facilities, while urban hospitals like Kenyatta National Hospital (KNH) faced long wait times (1–2 weeks). Only 70% of PLHIV accessed ART under NHIF.

SHA addresses these through progressive contributions (2.75% of income, minimum KSh 300/month), subsidies for 1.5 million indigent households (announced by President William Ruto on September 13, 2025), and a robust HIV/AIDS program integrating prevention, treatment, and emergency care. By July 2025, SHA disbursed KSh 551 billion to providers, with 10,000+ facilities supporting HIV/AIDS services.

HIV/AIDS Coverage Under SHA Funds

SHA’s HIV/AIDS coverage spans its three funds, ensuring comprehensive care from prevention to critical interventions.

1. Primary Health Care Fund (PHCF)

• Funding: Fully government-funded with KSh 10 billion in 2024/25, covering free services at 8,000+ Level 1-3 facilities (community units, dispensaries, health centers).
• HIV/AIDS Services:
• Testing and Counseling: Free HIV testing and pre-/post-test counseling to identify and manage cases early.
• Prevention: Free condoms, pre-exposure prophylaxis (PrEP) for high-risk groups, and prevention of mother-to-child transmission (PMTCT) services, including antenatal HIV testing.
• Screenings: Routine HIV tests and co-infection screenings (e.g., TB, hepatitis B), with 95% of pregnant women tested.
• Health Education: Over 100,000 Community Health Promoters (CHPs) educate communities on HIV prevention, stigma reduction, and adherence to ART.
• Delivery: CHPs conduct door-to-door testing and awareness campaigns, reaching 70% of households by September 2025.
• Impact: 4.5 million primary care visits by July 2025, with HIV testing increasing early diagnosis by 15%, per MoH data.

2. Social Health Insurance Fund (SHIF)

• Funding: Contribution-based (2.75% of income, KSh 300/month minimum), with subsidies for low-income PLHIV.
• HIV/AIDS Services:
• Antiretroviral Therapy (ART): Free or subsidized ART (KSh 2,000–5,000/month market cost) for 1.4 million PLHIV, with outpatient visits (KSh 1,000–2,000).
• Opportunistic Infections: Treatment for TB, pneumonia, and other HIV-related conditions (KSh 5,000–20,000 per episode).
• Chronic Care: Management of HIV-related NCDs (e.g., hypertension, diabetes) with medications and monitoring.
• Diagnostics: Free viral load and CD4 count tests (KSh 3,000–10,000 market cost) to monitor treatment efficacy.
• Delivery: Provided at Level 4-6 facilities (county/referral hospitals), with 180 renal units and 53 cancer centers addressing HIV complications.
• Impact: 2.2 million specialized services by July 2025, with 90% of PLHIV on ART, up from 70% under NHIF.

3. Emergency, Chronic, and Critical Illness Fund (ECCF)

• Funding: Government-funded with KSh 5 billion in 2024/25, covering catastrophic care.
• HIV/AIDS Services:
• Emergencies: Free ambulance services (KSh 5,000–10,000/trip) and ICU care (KSh 28,000/day) for AIDS-related complications (e.g., cryptococcal meningitis).
• Critical Care: KSh 700,000 for kidney transplants for HIV-related renal failure, KSh 500,000 for overseas treatment (e.g., advanced therapies).
• Palliative Care: Free for 800,000 terminal patients, including those with end-stage AIDS.
• Delivery: Provided at Level 2-6 facilities, with pre-approval for high-cost treatments via Afya Yangu.
• Impact: Reduced AIDS-related mortality by 10%, with 10 endoscopy procedures for HIV complications at KUTRRH by October 2024.

4. Subsidies and Inua Jamii Integration

• Means-Testing: Households below KSh 3,252/month pay KSh 300/month or receive waivers, with 1.5 million indigent subsidized by September 2025.
• Inua Jamii: PLHIV, especially women and orphans, benefit from KSh 2,000/month cash transfers, with 90,000 enrolled in SHA by August 2025 for free HIV care.
• Impact: 70% of beneficiaries are low-income, ensuring access for vulnerable PLHIV.

5. Digital Management via Afya Yangu

• Functions: Registration, facility searches, claims submission, and benefit tracking via sha.go.ke or *147# USSD.
• HIV/AIDS Application: PLHIV locate testing/treatment facilities, verify ART coverage, and track claims. CHPs assist non-digital users.
• Impact: 80% of claims processed electronically by mid-2025, streamlining access for 4.5 million primary care visits.

Key Facilities for HIV/AIDS Care

SHA accredits over 10,000 facilities, with key public and private hospitals offering HIV/AIDS services:

• Kenyatta National Hospital (KNH), Nairobi: Level 6, provides ART, PMTCT, and ICU care, receiving KSh 70 million in SHA funds in August 2025.
• KUTRRH, Nairobi: Treated 61 chemotherapy patients with HIV-related cancers by October 2024.
• Moi Teaching and Referral Hospital (MTRH), Eldoret: Offers ART and TB co-infection treatment.
• Coast General Teaching and Referral Hospital, Mombasa: Provides PMTCT and ART for coastal PLHIV.
• Rural Dispensaries: Over 6,000 Level 1-3 facilities offer free HIV testing and PrEP.

Benefits of SHA’s HIV/AIDS Coverage

• Prevention: Free testing and PrEP reduced new infections by 15%, with 95% of pregnant women receiving PMTCT.
• Treatment Access: 90% of PLHIV on ART, up from 70% under NHIF, with 2.2 million specialized services by July 2025.
• Cost Reduction: Out-of-pocket costs dropped by 40%, saving KSh 5,000–50,000 per PLHIV annually.
• Equity: 70% of beneficiaries are low-income, with 1.5 million indigent covered.
• Health Outcomes: Reduced AIDS-related mortality by 10%, per MoH 2025.

Success Stories

1. Kibera, Nairobi: A female sex worker used Afya Yangu to access free PHCF HIV testing in 2025, starting PrEP at Mbagathi Hospital, saving KSh 10,000/month, per a Ministry briefing.
2. Turkana County: A pregnant woman received PMTCT services via SHA in 2025, ensuring an HIV-free newborn, as shared during President Ruto’s September 13, 2025, meeting.
3. KUTRRH, Nairobi: An HIV-positive patient with lymphoma accessed KSh 300,000 SHIF-funded chemotherapy in 2024, per KUTRRH’s October report.

Challenges

• Reimbursement Delays: KSh 43 billion in unpaid dues by August 2025 disrupt HIV services, with RUPHA’s September 2025 go-slow threat.
• Provider Shortages: Only 500 surgeons and 200 specialists serve 54 million, limiting HIV complication care.
• Awareness Gaps: 35% of rural PLHIV unaware of SHA benefits, per GeoPoll 2025.
• Digital Barriers: ASAL regions lack internet for Afya Yangu, though *147# helps.
• Fraud Risks: KSh 20 million ghost claims in 2025 prompted stricter audits.

Reforms and Solutions

• Payment Reforms: KSh 551 billion disbursed by July 2025, targeting KSh 43 billion arrears clearance by 2026.
• Provider Training: SHA plans to train 500 HIV specialists by 2027.
• Awareness Campaigns: CHP-led outreach targets 80% coverage by 2026.
• Digital Fixes: September 2025 Afya Yangu upgrades resolved eClaims bugs.
• Anti-Fraud: Biometric verification cut fraud by 15% in 2025.

Future Outlook

SHA aims to:

• Increase PHCF funding to KSh 15 billion and ECCF to KSh 8 billion by 2026/27, expanding HIV testing and treatment facilities.
• Deploy AI diagnostics via Afya Yangu for HIV monitoring by 2027.
• Subsidize 1.5 million more indigent PLHIV by 2026.
• Expand ART and PrEP access to 95% of PLHIV by 2027.

Conclusion

SHA’s HIV/AIDS coverage, spanning PHCF prevention, SHIF treatment, and ECCF interventions, has transformed care for 1.4 million PLHIV, with 4.5 million primary care visits and 90% ART coverage. Success stories from Kibera, Turkana, and KUTRRH highlight reduced costs and improved outcomes. Challenges like arrears and digital barriers persist, but reforms signal progress. PLHIV should use Afya Yangu, *147#, or CHPs to access benefits, advancing Kenya’s UHC vision by 2030.

NOMA NTV MONDAY 22ND SEPTEMBER 2025 FULL EPISODE