Kenya’s Social Health Authority faces operational and oversight challenges

KENYA – Kenya’s Social Health Authority (SHA) is currently grappling with significant operational challenges, notably a 9% increase in patient verification issues over a two-month period, as well as heightened scrutiny from lawmakers following a critical audit report.

Rising patient verification issues

A recent survey by the Rural and Urban Private Hospitals Association of Kenya (Rupha) revealed that over 80% of private healthcare providers are encountering difficulties in verifying and registering patients.

This marks a rise from 74% in December 2024 to 83% in February 2025. The primary causes include delays in the delivery of one-time passwords (OTPs), which are essential for patient verification, affecting 63% of providers.

Additionally, 59% of patients lack access to mobile phones, hindering the verification process. Technical issues with the Afya Yangu portal, intended to streamline patient registration, have also been reported by 49% of healthcare facilities.

Moreover, missing dependent data in the SHA system complicates verification for 55% of health facilities, particularly for patients needing to list dependents for coverage.

Despite 93% of providers having the necessary credentials, 62% report problems accessing the SHA portal due to non-functional credentials, automatic lockouts, and internet connectivity problems.

These challenges have led to increased wait times and disruptions in service delivery.

Legislative scrutiny following audit report

The SHA is also under intense scrutiny from Kenyan lawmakers following a damning audit report by Auditor-General Nancy Gathungu.

The report exposed significant issues within the SHA’s integrated healthcare information technology system (IHTS), a critical component for implementing the Social Health Insurance Fund (SHIF), which replaced the National Health Insurance Fund (NHIF).

During a session with the Senate County Public Accounts Committee, senators questioned Ms. Gathungu on why she did not recommend terminating the controversial Sh104.8 billion SHA system contract or prosecuting the officials involved.

Nairobi Senator Edwin Sifuna advocated for the contract’s termination, stating, “We should terminate it and face the consequences later.”

Similarly, Homa Bay Senator Moses Kajwang’ criticized the SHA as a vehicle for misappropriating public funds.

In response, Ms. Gathungu indicated that the decision to terminate the contract lies with the lawmakers, emphasizing that her office’s role is to provide findings and recommendations.

Government’s stance

President William Ruto addressed the negative publicity surrounding the SHA, attributing it to individuals exploiting loopholes to embezzle funds from the former NHIF.

He emphasized the government’s commitment to reforming the healthcare system and ensuring that the SHA fulfills its mandate of providing quality healthcare services to all Kenyans.