Government officials have set tough conditions for hunger-stricken families in Turkana County, demanding that they register with the national health insurance before getting relief food.
This comes after it emerged that only 110,000 out of more than 1.2 million people in the county had registered for the Social Health Insurance Fund (SHIF), which is administered by the Social Health Authority (SHA).
Turkana Central Deputy County Commissioner Thomas Siele said on Tuesday that he had received 600 bags of relief food, but that only SHA members would be eligible for rations.
Turkana Central Deputy County Commissioner Thomas Siele, Deputy Governor John Erus and Health Executive Joseph Epem at Kanam Kemer Sub-county Hospital on March 24, 2025. Mr Siele told residents that they will have to prove that they have registered with SHA before benefiting from relief food from government.
Photo credit: Sammy Lutta | Nation
The government, he said, cannot struggle to feed people without medical cover only for them to fall sick later.
"Before going to the chief's office to be given food, first register for SHA because that will be the condition from Tuesday," Mr Siele said.
“We want to ensure that all people have registered. We don't want to feed people who in a few days we will learn that they are sick and unable to pay for their medication, and the only hope is elected leaders like deputy governor through fundraising.”
SHIF, one of President William Ruto’s pet projects in Kenya’s quest for universal health coverage, has been rocked by a myriad of challenges, including claims of corruption, system glitches, delayed reimbursements to health providers, low enrolment, and reduced member benefits compared to the defunct National Health Insurance Fund (NHIF).
These challenges have seen many Kenyans being denied medical services while others are forced to pay out of pocket.
There is also growing opposition to the insurance, with health providers the latest to warn of a withdrawal of services weeks after the Rural and Urban Private Hospitals Association of Kenya (RUPHA) resumed services.
Despite the challenges, Dr Ruto, former Health Cabinet Secretary Deborah Barasa and the entire ministry have rejected calls to abandon the plan, with the President insisting that SHIF will work as he urges Kenyans to register.
“SHA is the biggest programme we have in the Republic of Kenya, maybe it will take time to be perfect but believe you me, and it is going to work. We have tried. We tried as Jubilee but we failed. This time we will succeed,” Dr Ruto said on March 2.
The president’s call is being echoed by government administrators in the villages, with Mr Siele telling Turkana residents that the can only get relief food if they registered for the insurance.
"We need to return to someone we are feeding. If one wants to live a healthy life where he or she can easily access medication, SHA is very important. There is a way the government can pay for you if you are vulnerable, there is a way you will also cater for your bills, while for the salaried, we are automatically deducted SHA contributions," he said.
While supporting the new condition, County Health Services Executive Joseph Epem said he hoped to hold a meeting with all deputy county commissioners and sub-county administrators because SHA registration had been a challenge for the county.
"SHA is very helpful especially for low-income earners even though people are opposing it. I recall a case where a cancer patient from Turkana sought treatment at a private hospital in Eldoret. The bill was Sh375,000 and SHA catered for Sh250,000," he said.
“If it had been a public health facility, the bill would have been paid in full by SHA. If the patient would not have registered for SHA, it would have been a huge burden to the family that a funds drive would have been the only option.”
The advantage of SHA is that all health facilities would receive more funding if more people registered.
"Out of a population of more than 1.2 million people, only 110,000 people have registered. With the current figures, the whole county is eligible to get about Sh8.2 million from SHA. The more the registered people, the more funds individual facilities will get," Dr Epem said.
To motivate community health promoters to enrol as many people as possible, the county plans to ensure that each hospital spends 30 percent of its allocation on primary health care.
"This means that if the hospital, with the support of CHPs, enrols more people, their benefits will be greater. The money will also help facilities to buy drugs that are not found at Kemsa, to employ security guards, and ensure they have functional boards," the county official said.
He urged Mr Siele to ensure that before any relief food is distributed, there should be a SHA registration desk so that beneficiaries can easily register before being given food.
"Talk to other deputy county commissioners to also emulate you," he told the DCC.
But religious leaders and some residents questioned the new directive, urging the government to address the challenges rocking the insurance scheme before forcing them to register.
Mr Daniel Loyomo questioned why SHA should be forced on people when its effectiveness in solving the country's health crisis has not been proven.
"This is manipulating the most vulnerable people to embrace something that they don't have information about. We don't need restrictions on relief food. If it is about forcing people, let it be," Mr Loyomo said.
Another resident, Mr Kevin Emojo, said that they would not tolerate manipulation and blackmail because SHA registration is not linked to relief food, which has been in existence for decades.
And as county authorities struggled to increase SHA numbers, religious leaders in the county criticised the insurance, saying it was not working.
Bishop John Mbinda of the Catholic Diocese of Lodwar on March 25, 2025.
Photo credit: Sammy Lutta | Nation
Bishop John Mbinda of the Catholic Diocese of Lodwar said that there seem to be some gaps that are yet to be addressed.
"It will be in the interest of Kenyans that this SHA issue is sorted out. If it is not working yet NHIF was working, perhaps it would be better if we went back to NHIF as we prepare for a proper transition to SHA. This will help us solve the stalemate," he said.
He blamed the SHA's ongoing problems on the lack of a strong and effective opposition to check the government.
"There seems to be a State capture of other arms of government because there are no checks and balances. When other arms of government are compromised, it means that the policies that they make may not be good for citizens. We need a strong voice that speaks for the Kenyan poor and not the rich that are enjoying and rejoicing, we want an opposition that can directly speak to the State and be able to correct issues as they are," he added.
Neglected elderly people in remote villages are among the worst-hit by the prolonged drought, which the county government estimated in December last year to have directly affected at least 714,000.
Some elderly people at Karoge village in Turkana South Sub-county on December 7, 2024 receive relief food from Cornerstone Ministries International church in partnership with Turkana Home of Mercy.
Photo credit: Sammy Lutta | Nation
Mr Adukon Lochuch Kaaman, 69, a resident of Karoge village in Turkana South Sub-county, is among them. All his life, he has relied on pastoralism as the only source of livelihood, he tells Nation.Africa .
“During my youthful days we would migrate to places with pasture and water whenever drought hit us," he recalled.
Previously what qualified residents like Mzee Kaaman to receive relief food rations was their level of vulnerability and national identification card for records.
Mr Kaaman’s village is ravaged by drought and a deepening economic crisis as charcoal burning, the main economic activity, is affected by the reduced number of indigenous trees.
"I was strong and I drank milk whenever I wanted from my livestock before the drought swept them away. But now I am weak and I can no longer cover long distances in search of pasture and water," Mr Kaaman said.
"With the village located along the main highway from Lodwar to Lokichar, many humanitarian agencies and well-wishers don't prioritise us as they always focus on remote and hard-to-reach villages," he added.
His neighbour, Mr Korobe Lowoto, 71, is very weak and can't get out of his manyatta to beg for food.
"If my neighbour's grandchildren don't visit me with food like boiled white maize that I can't even comfortably chew, I will starve," Mr Lowoto said.
"We were not even aware of SHA, and most elderly people have not registered."
