By Emmanuel Mwita, HSC.
Social Health Insurance (SHA) is meant to provide social, and financial protection and equitable access to healthcare for all individuals, especially those who may face barriers due to financial constraints.
However, the failure of the Social Health Insurance system has had a particularly severe impact on young people, worsening existing health inequalities and creating new challenges for their well-being. From higher out-of-pocket medical expenses to limited access to crucial services, the gaps in the system have left many young people vulnerable to preventable health issues.
The recent announcement by private hospitals to suspend SHA services casts more trouble into the already struggling Health insurance. There have been multiple reports of system failure denying patients access to crucial services including emergency services. This has far-reaching effects, especially for young people and women.
One of the most glaring effects of a failed SHA system is the increased financial burden placed on young people seeking healthcare. In Kenya, the informal sector, which accounts for a significant portion of young workers, is often excluded from comprehensive health insurance schemes. Many young people cannot afford private insurance plans leaving them vulnerable to catastrophic health costs. One of the objectives of SHA was to cover such young people who are struggling to pay their monthly contributions. When young people enrolled in social health insurance programs are forced to pay out-of-pocket for medical services it can lead to delays in seeking treatment or forgoing healthcare altogether. For instance, young people with chronic conditions like asthma, diabetes, or HIV may find it difficult to afford regular check-ups or medications, putting them at risk for complications that could have been avoided with early intervention.
Another major consequence of a failed SHA system is limited access to essential preventive and reproductive health services. Young people are particularly in need of sexual and reproductive health services, including contraceptives, counseling, and maternal care. However, when these services are not covered by insurance or are expensive to access, young people may avoid them, resulting in higher rates of unintended pregnancies, unsafe abortions, and sexually transmitted infections (STIs).
The current situation exposes youth to significant barriers to mental health services, which are increasingly important given the rising rates of mental health issues among young people. A failed social health insurance system contributes to the marginalization of mental health care, as young people often cannot afford to access counseling or therapy sessions.
In a recent parliamentary convening in Naivasha Members of the National assembly highlighted these glaring challenges facing SHA and the Ministry of Health was directed to provide a comprehensive report on the implementation status of the policy and steps being taken to address the raised challenges.
To address this, the government and other stakeholders must take urgent and deliberate action to address the financial, structural, system and accountability issues facing SHA to ensure that young people are provided with equitable access to healthcare. By strengthening SHA and ensuring that health services meet the diverse needs of young people, Kenya can foster a healthier and more productive generation.
Emmanuel Mwita is a NAYA youth advocate, Migori
