SHA abolition battle: Charles Owino explains why Ruto’s health authority cannot simply be scrapped

The fight over Kenya’s Social Health Authority (SHA) has become a new political fault line ahead of the 2027 General Election. The government is challenging opposition promises to abolish SHA if they win power, while the opposition criticizes the health financing system. SHA is established by an Act of Parliament, meaning a future president cannot simply scrap it through a political declaration.

SHA is a body corporate with perpetual succession, established to register beneficiaries, manage funds, contract healthcare providers, and make payments. Opposition leaders have called for scrapping SHA, but this would involve amending or repealing the legislation governing the system. The legal position is nuanced, as a future Parliament could amend or repeal the legislation.

SHA was established after the Social Health Insurance Act was enacted in 2023, replacing the National Hospital Insurance Fund (NHIF) framework. The transition has become closely associated with President Ruto’s Universal Health Coverage (UHC) agenda. Opposition figures, including Wiper leader Kalonzo Musyoka, have criticized SHA and positioned it as part of the broader case against the Ruto administration.

Ruto, in response, has questioned the opposition's alternative and challenged the proposal to scrap SHA. The debate over SHA's future could significantly influence how the government and opposition campaign on healthcare in 2027.