Walking through the bustling corridors of Kerugoya County Referral Hospital, I find myself immersed in the rhythm of hurried footsteps, hushed conversation and the occasional wail of a sick child.
Amidst the commotion, my eyes land on a woman and her husband, their hands tightly clasping their daughter as they ascend a ramp toward the billing section.
A few minutes later, I saw the woman again. But something is different. Her face, once lined with worry, now beams with an unmistakable sense of relief.
In a place where despair often lingers, her joyful smile catches me off guard.
Intrigued, I decided to approach her.
After introducing myself as a journalist conducting a spot check on the Taifa Care program under the Social Health Insurance Fund (SHIF), I realised that she is differently abled, she is deaf. Fortunately, her friend is there to help translate.
Her name is Bilha Wambui. With her daughter now perched comfortably on her lap, she begins to recount her ordeal.
Just a few days ago, her six-year-old daughter fell very ill. The local hospital referred them to Kerugoya Referral Hospital, a level five facility, where she was immediately admitted due to the severity of her condition.
As days passed, Bilha watched the medical bills pile up, her anxiety growing with each passing moment.
She had heard the government’s promises that Taifa Care would cover inpatient costs for registered members, but reality struck hard when she was told she had to pay out of pocket.
Confused, she approached the Taifa Care desk. That was when she received the shocking news, though she had registered, she had not paid her premiums.
Her heart sank. How would she afford the care her daughter desperately needed? But then, she felt a glimmer of hope after speaking to one of the agents.
“All is not lost,” they reassured her. “You can pay your premium now, and it will reflect immediately, covering the rest of your stay.”
Bilha did just that. By the time her daughter was discharged after four days, she only had to pay Ksh 2,100 in cash for the first day’s admission.
The remaining three days, amounting to Ksh 16,140, were fully covered.
As she signed her gratitude, she beamed with joy.
“I am very, very happy. I don’t know where I would have gotten the money. I want to thank the government for Taifa Care.”
As I continue my spot check, I venture into the heart of the local market in Kutus, Kirinyaga County, where the aroma of frying fish fills the air.
I meet Kelly Kawira, a fishmonger who doubles as a kiosk owner, her hands deftly turning fish on a jiko as customers stream in.
When I ask her if she knows anyone who has benefited from Taifa Care, she chuckles.
“You don’t have to look far. I am one of them.”
She recounts how, not long ago, she had fallen ill at a time when business was slow. With no extra money to spare, she visited her local dispensary, where she was turned away because she had not registered for Taifa Care and was not under the cover.
She was then advised to register. A Community Health Promoter (CHP) in her area assisted her in signing up for the scheme.
After completing her registration, she returned to the dispensary and received her medication. Bracing herself for a bill, she was stunned when the cashier waved her away.
“Because I had registered for Taifa Care and paid my premium, everything was covered,” she says, smiling.
Her premium amounted to Ksh 850, a sum she initially found steep. But now, she sees its value.
“In fact, I am now enrolling my children. I have already sent for their birth certificates from my rural home.”
Wanting to understand the role of Community Health Promoters in the rollout of the scheme, I meet Leonard Njeru, a 61-year-old veteran in community healthcare and the chairman of the Kutus Health Unit.
His work, he tells me, is not for the faint-hearted. He and his team walk for miles, braving harsh conditions to reach the vulnerable.
They treat patients, educate them on Taifa Care, and help them enrol, reducing out-of-pocket expenses when they visit hospitals.
“I have been doing this job since the days of the old defunct National Health Insurance Fund (NHIF),” Njeru says.
“Taifa Care has its challenges, but in the long run, it can ensure Universal Health Coverage becomes a reality.”
He proudly notes that Community Health Promoters are now better equipped.
“These days, we get medicine, referral leaflets, and even electronic devices to register people. Before, we did not have any of this.”
He acknowledges, however, that technology has its hiccups.
“Sometimes the gadgets fail. But we report the issue, and within no time, they are up and running.”
Later, at a health digitization event in Kirinyaga County, Moses Kuria, a senior advisor to Kenya’s Council of Economic Advisors, urged health workers to remain focused amid the ongoing debates about Taifa Care.
“Let us stay focused until digitization is complete because I know once it is, all these problems will come to an end,” he said.
During his presentation, Kuria emphasized that level 2, 3, and 4 hospitals are his priority since that is where most Kirinyaga residents seek care.
“SHA did not come for the rich; they have private covers and access to good facilities, some even go abroad. Taifa Care was created for the people who voted for us,” he asserted.
“You are not supposed to be charged any money because we are sending more than enough funds to these facilities. Primary healthcare is free for anyone registered under SHIF in all government, private and faith-based hospitals participating in the scheme.”
He declared that if anyone registered under Taifa Care is asked for money at a hospital, they should report the matter to the hospital in charge, the governor, or even the nearest police station.
He also urged Kenyans to ignore politicians criticizing the program, claiming that they have their own private health covers and would not suffer the consequences of failing to enroll in Taifa Care.
On his part, former Health Permanent Secretary Harry Kimtai underscored the government’s commitment to eliminating medical ‘harambees,’ the fundraisers that many Kenyans hold to cover medical bills that plunge them into poverty.
“That is why we decided to implement a program ensuring every Kenyan can receive treatment regardless of their financial situation,” he explains.
Kirinyaga Governor Anne Waiguru echoes his sentiments, highlighting that 41 percent of her constituents are already registered under Taifa Care.
With the hospital now fully digitized and others following suit to operate paperless, service delivery has improved.
She insists that compared to the now-defunct NHIF, the Social Health Authority pays pending bills monthly.
“The county has so far been paid Ksh 75 million out of a whopping Ksh 103 million. This is progress because previously, we were riddled with debt due to non-payment of premiums,” she says.
In addition, she notes that hospitals will soon be self-reliant.
“The more patients register, the more claims are paid, and the more the hospital gets money to improve services to ensure UHC is achieved.”
However, she acknowledges a key challenge.
“The government needs to help equip level four hospitals and below. This will prevent overcrowding at level five hospitals when many cases could be handled at lower levels.”
The journey toward Universal Health Coverage is far from over. But as I leave Kerugoya, I carry with me the faces of Bilha, Kelly and Leonard, faces of resilience, hope and a belief in a healthcare system that, despite its flaws, is striving to serve its people.
The digitization of health services in the country started on October 1, 2024, during the rollout of the Social Health Authority (SHA) and Taifa Care
