The Central Organization of Trade Unions (COTU) in Kenya has urged workers across the country to fully back and enroll in the newly established Social Health Authority (SHA), emphasizing its potential to provide accessible and affordable healthcare for the workforce, particularly low-income earners.
COTU (K) Secretary General Dr. Francis Atwoli, in a press statement released on September 26, 2024, COTU emphasized the need for all workers to enroll in the SHA, which promises to deliver more affordable health insurance compared to the National Health Insurance Fund (NHIF), particularly for low-cadre employees.
According to data from COTU’s Economic and Research Department, SHA premiums under the Social Health Insurance Fund (SHIF) are significantly lower for workers earning between KSh. 15,000 and KSh. 35,000, a wage bracket occupied by a large portion of Kenya’s labor force.
“Low-cadre workers will enjoy the benefits of reduced premiums, which are much lower than those charged by NHIF,” Atwoli noted, showcasing a comparative chart detailing the cost difference. For instance, workers earning KSh. 6,000 would pay KSh. 165 under SHIF, compared to KSh. 300 with NHIF. Those earning KSh. 35,000 would pay KSh. 926 under SHIF, down from KSh. 950 with NHIF.
Lower Premiums for Low-Income Workers
COTU’s Economic and Research Department presented a comparative analysis of NHIF and SHA contributions, indicating that Social Health Insurance Fund (SHIF) premiums under SHA are notably lower for workers earning between Ksh 6,000 and Ksh 35,000. For instance, a worker earning Ksh 15,000 pays Ksh 412 under SHIF, compared to Ksh 600 for NHIF—a reduction of over 30%. COTU highlighted that these lower premiums would benefit a large portion of the workforce, especially low-wage earners, enhancing equity in healthcare access.
Addressing Public Concerns and Misinformation
Despite COTU’s endorsement, the SHA remains a work in progress, and the union acknowledged ongoing concerns and misinformation about the new health system. Atwoli noted that some confusion stems from the legacy of NHIF, which faced criticism for inefficiency and poor governance before its dissolution. However, COTU reassured workers that it will remain actively engaged in the SHA’s governance, advocating for continued reforms to ensure the authority meets its promises.
“As COTU (K) we will work tirelessly to ensure the prudent use of SHA funds, ensuring that all contributions are effectively utilized to guarantee workers received the services they need and deserve,” Atwoli asserted.
COTU has pledged to collaborate with other stakeholders and the public to improve SHA operations where necessary, aiming for greater transparency and effectiveness. The trade union reiterated its belief that workers should not only support SHA but also demand accountability, a step essential to preventing the inefficiencies that plagued the former health insurance system.
Expansion and Broad Coverage Goals
In addition to lower premiums, COTU highlighted the SHA’s goal of expanding coverage beyond the formal sector. SHIF is set to include informal workers and vulnerable groups such as low-income earners, a key point that distinguishes SHA from NHIF.
SHA’s broader coverage will also address maternal and child healthcare, areas that have historically been underfunded or inadequately covered by NHIF. COTU lauded SHA’s risk-pooling mechanism, which is designed to make healthcare costs more equitable and to provide free access to critical services for the most vulnerable populations.
Healthcare Reform in Kenya
Kenya has long struggled with inefficiencies in its public healthcare system, and the NHIF was at the center of many complaints, including allegations of mismanagement and high out-of-pocket costs for basic services. With the introduction of SHA, the government aims to address these long-standing issues by implementing a more inclusive and equitable health insurance scheme.
COTU’s endorsement of SHA, backed by its seat on the SHA board, signals a broader shift in the country’s approach to healthcare financing. The union’s involvement in the oversight and governance of SHA has added confidence among workers that this new scheme will deliver on its promises.
“We cannot continue sitting on the fence and complaining about a dysfunctional healthcare system while,” Atwoli said. “We are not contributing we must all join, contribute and most importantly demand accountability.”
Long Road Ahead for SHA
Despite COTU’s positive outlook, Atwoli was clear that SHA is still in its infancy and requires further improvements. As the system develops, COTU has committed to ensuring that any emerging challenges are addressed promptly, and the necessary reforms are implemented to guarantee worker satisfaction.
Kenya’s healthcare sector has faced numerous challenges in recent years, from underfunding to access inequalities. With the introduction of SHA, there is hope that these issues will begin to be addressed more systematically. COTU’s continued vigilance and advocacy will play a critical role in ensuring that SHA becomes a reliable pillar of social protection for Kenyan workers.
For now, the trade union is calling on all workers to take proactive steps and register for SHA, believing that broader participation will help build a more robust and equitable healthcare system for future generations.
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