The government’s use of complicated language and academic approaches in the rollout of the Social Health Authority (SHA) has created major communication gaps, leaving ordinary Kenyans unable to understand how the new health system works, according to Rural & Urban Private Hospitals Association of Kenya Chairperson Brian Lishenga.
Speaking during an interview with Radio Generation, Lishenga explained that some university postgraduates had produced a paper analysing the failures in communicating SHA reforms, and their findings pointed to a key problem: overly technical language that shut out the public.
“One of the criticisms was technocratic language and I agree,” he said on Thursday, noting that the official reform documents were written in language that was difficult even for educated Kenyans to understand.
He described the documents as “tough to read” and said they were not written for public consumption.
“You have to be in the sector or somewhere in the vicinity to know what these guys are talking about,” he said.
He added that up to now, there has been no proper explanation to ordinary citizens about what “means testing” actually is.
Lishenga questioned how such technical terms could be communicated in simple ways in rural areas.
“I don’t know how you go to the village and explain to, you know, your grandmother, proxy means testing. See, that’s very technical language,” he said.
The RUPHA Chairperson noted that the use of this language was a symptom of a deeper issue, adding that the entire approach to SHA design was highly academic and not grounded in everyday realities.
“The technocratic language was a problem, okay, but it was a symptom of a deeper issue. Deeper issue was the approach was highly academic,” he said.
Lishenga explained that proxy means testing, which was used in designing the health programme, is not meant to include poor households but rather to filter out those who are not considered poor.
“Proxy means testing is used to explain, even give you the correct reason why the people develop the model. It is used for excluding, yes, non-poor households. That is its purpose,” he said.
Lishenga added that the tool was originally designed to narrow down the number of beneficiaries in social programmes by selecting those considered well-off for exclusion, effectively reducing government spending.
“The design is not for inclusion of poor households. The design of proxy means testing is to exclude in and poor households when you are designing social programs,” he said.
“At the end of proxy means testing is to minimize government exposure on expenditure on public goods,” he added, stressing that this approach was ill-suited to a health system meant to expand coverage to vulnerable populations.