The Rural Private Hospitals Association of Kenya (RUPHA) has cautioned that President William Ruto’s recent unveiling of the Social Health Authority (SHA) indigent cover may have sidestepped critical legal procedures required under the Social Health Insurance Act, 2023.
Over the weekend, Ruto revealed that Sh4.4 billion had been committed to support 2.2 million vulnerable Kenyans, equivalent to around 558,000 households. He also commended leaders and donors who pledged funds to sponsor additional households.
“There are many people of goodwill. We have a friend from Kenya who has contributed and promised to pay for 113,000 Kenyans. MPs have also stepped up, and I urge MPs to use Constituency Development Funds (CDF) to support those unable to pay from their constituencies,” Ruto said.
“These leaders have taken on the responsibility of paying for other Kenyans. We shall carry this burden together and will not relent until every citizen unable to pay has been covered, making healthcare truly universal,” he added.
While RUPHA chairperson Brian Lishenga welcomed the spirit of the programme, he pointed out that the rollout was not aligned with the law. He explained that the Act requires the National Assembly and county governments to set aside funds for indigents, which has not been done.
“Kenya is estimated to have at least five million indigents. The cover launched today targets 2.2 million households, which is still far below what is envisaged,” he said.
Lishenga also noted that the law demands a proper means testing exercise to identify vulnerable groups such as widows, orphans, people with disabilities, the elderly and other disadvantaged groups before they are enrolled.
“The National Treasury has not yet carried this out, and there is no evidence that the National Assembly has appropriated funds for what was launched today. Most counties have neither identified indigents nor allocated funds to be remitted to SHA,” he added.
During the launch, SHA activated a sponsorship portal where contributors could support households. The platform listed the President’s personal contribution of Sh4.4 million and highlighted a Sh900 million donation from an anonymous benefactor.
Other pledges included Refugee Point, which covered 150 people, Mombasa Cement with 2,500, and UNHCR with 22,155.
Some counties and leaders also came on board. Cheptiret Kipchamo Ward in Uasin Gishu is supporting 291 households, while Mombasa, Baringo and Lamu counties each enrolled 20,000. Political leaders who pledged support include Japheth Miriti (Sh5.5 million), Naisula Lesuuda (Sh1.9 million), Janet Jepkemboi (Sh2.4 million), Phelix Odiwuor (Sh2.3 million), and David Gikaria (Sh3.6 million).
Governors George Natembeya (Sh23 million), Ochilo Ayacko (Sh5.6 million), Irungu Kang’ata (Sh117 million) and Abdulswamad Shariff (Sh3.6 million) also contributed, alongside MPs Mwangi Kiunjuri (Sh2.8 million), Irene Njoki (Sh1.9 million) and Kimani Ichung’wah (Sh3.4 million).
Despite the goodwill, RUPHA insists that the scheme can only succeed if funding is legally secured every financial year.
“SHA regulations mandate that the National Treasury deducts and remits funds, while county finance chiefs do the same. This is the only way to ensure continuous medical cover year after year. While we welcome the initiative, Parliament has not fulfilled its role. We expect the National Assembly to allocate funds as stipulated, while SHA and counties should identify needy households across Kenya,” Lishenga said.
