Navigating Challenges: Why 46% of Health Facilities Are Yet to Adopt Kenya’s SHA E-Contracting Platform
As of January 2025, approximately 46% of health facilities in Kenya have yet to fully adopt the Social Health Authority (SHA) e-contracting platform. This situation raises significant concerns regarding the effectiveness and efficiency of the ongoing transition from the National Hospital Insurance Fund (NHIF) to SHA, which was initiated to enhance healthcare access and quality across the nation.
Current Status of E-Contracting
A recent report titled “Status of E-Contracting” indicates that out of 3,993 health facilities contacted, 1,863 have not signed their e-contracts as of January 6, 2025. This lack of compliance highlights substantial barriers that healthcare providers face during this critical transition period. While some progress has been made—e-contracting completion increased from 50% to 71.4%—the remaining percentage still represents a significant gap in full participation by healthcare providers.
Reasons for Slow Adoption
Several factors contribute to the slow adoption of the SHA e-contracting platform among health facilities:
- Technical Challenges: Many providers have reported difficulties accessing the SHA portal due to system downtimes and technical glitches. A survey indicated that 44% of providers experienced system downtimes, while 28% faced delays in processing claims and accessing patient information.
- Lack of Training: Insufficient training on navigating the SHA portal and managing claims has been a major obstacle for many healthcare providers. The need for comprehensive training programs is critical to ensure that all staff are equipped to utilize the new system effectively.
- Financial Strain: The transition has placed considerable financial pressure on healthcare facilities. Many hospitals reported that payments received under SHA only covered essential payroll costs, leaving operational expenses unmet. This financial strain can hinder their ability to adapt to new systems and maintain quality patient care.
- Patient Verification Issues: A significant number of healthcare providers (100%) reported challenges with patient verification processes, complicating their ability to provide timely and effective care under the new system.
Progress and Improvements
Despite these challenges, there have been notable improvements in certain areas:
- Increased Claim Submission Success: The success rate for claim submissions has risen from 61% to 80%, particularly for inpatient and maternity claims. This upward trend indicates that providers are gradually adapting to the new claims processes.
- Functional Credentials: Approximately 94.3% of healthcare providers reported having functional credentials for accessing the SHA portal, a marked improvement from previous assessments. However, issues with access among credentialed providers persist, indicating a need for ongoing technical support.
Future Directions
To ensure a successful transition to the SHA e-contracting platform, several actions are necessary:
- Enhanced Training Programs: Implementing robust training initiatives for healthcare staff will be crucial in addressing knowledge gaps related to SHA operations and claims management.
- Technical Support Improvements: Providing ongoing technical support and resources will help mitigate access issues and improve user experience on the SHA portal.
- Financial Assistance: Addressing the financial burdens faced by healthcare facilities is essential for enabling them to invest in necessary infrastructure and training for effective participation in SHA.
- Streamlined Processes: Simplifying patient verification and claims submission processes will enhance efficiency and reduce delays in patient care.
Conclusion
The transition to the SHA e-contracting platform is a critical component of Kenya’s efforts toward achieving universal health coverage (UHC). However, with nearly half of health facilities yet to fully adopt this system, significant challenges must be addressed.
By focusing on training, technical support, financial sustainability, and streamlined processes, Kenya can enhance its healthcare delivery system and ensure that all citizens benefit from improved access to quality medical services.
