Health SHAnanigans

The history of the Social Health Authority (SHA) is rooted in its mission to make healthcare accessible and affordable for all Kenyans. Over the past few months, this initiative has significantly impacted underserved communities, especially in informal settlements like Mukuru kwa Ruben, where access to quality healthcare has long been a challenge. At Ruben Health Centre FBO, we have witnessed firsthand the transformative role SHA plays in bridging healthcare gaps and empowering our community.

According to the Kenya National Bureau of Statistics, only 46% of Kenyans have access to healthcare within a 5-kilometer radius, while nearly 12% of the population faces catastrophic health expenditures annually. Universal Health Coverage (UHC), a key pillar of Kenya’s Big Four Agenda, aims to ensure that all citizens can access essential healthcare services without financial hardship. Despite these efforts, the journey toward achieving UHC remains fraught with challenges, particularly for those in low-income brackets.

Our nutrition department has observed a remarkable increase in the number of patients seeking our services—from 80 in December to 131 as of 23rd January 2025. Many of these patients are coming to us from the Ruben Health Centre, the government health facility situated less than a kilometer from ours, due to the requirement for SHA registration, which many of them do not have. This surge highlights the dual-edged nature of SHA’s impact: while it ensures more structured healthcare delivery, it also poses challenges for those unable to meet the requirements.

Barriers to Healthcare Access for Low-Income Kenyans

For families in informal settlements like Mukuru kwa Ruben, the challenges of accessing healthcare are numerous:

  • Cost barriers: Many cannot afford the fees associated with healthcare services or insurance registration.

  • Lack of awareness: Misinformation and a lack of understanding about health insurance programs like SHA deter many from enrolling.

  • Documentation issues: Vulnerable groups, such as teenage mothers and informal workers, often lack the necessary identification documents required for registration.

  • Overcrowded public facilities: Public health centers face staffing shortages, long queues, and insufficient resources, leaving many underserved.

Despite these hurdles, Ruben Health Centre FBO’s maternity unit has been a shining example of SHA’s potential. Since incorporating SHA in October 2024, the unit has not only provided crucial maternal care but also contributed significantly to our revenue streams. To date, we have successfully covered 232 claims electronically and an additional 33 manually, resulting in reimbursements totaling KSh 3.8 million. This achievement underscores the efficiency and effectiveness of integrating SHA into our operations.

Furthermore, our maternity unit has taken an active role in health education by registering patients for SHA. This proactive approach ensures that more community members understand the benefits of SHA and gain access to the healthcare services they need. However, challenges persist. One notable issue is the ineligibility of teenage mothers who lack identification documents, making them unable to register for SHA. Nevertheless, as a community-focused institution, we prioritize service over bureaucracy. Rather than turning these vulnerable mothers away, we ensure they can still deliver safely at our facility, reaffirming our commitment to serving the Mukuru kwa Ruben community.

Ruben Health Centre FBO’s Role in Bridging Healthcare Gaps

Ruben Health Centre FBO is committed to bridging the healthcare gap through innovative solutions:

  1. Subsidized healthcare services: Offering affordable services to community members who cannot meet the financial requirements of public or private facilities.

  2. Health education programs: Raising awareness about nutrition, maternal health, and the importance of health insurance programs like SHA.

  3. Support for vulnerable groups: Ensuring teenage mothers and undocumented individuals receive the care they need, regardless of their eligibility status.

  4. Strategic partnerships: Collaborating with government and non-governmental organizations to enhance service delivery.

The journey has not been without its struggles, but the support from Ruben Centre’s management has been instrumental in making our achievements possible. Their unwavering dedication and vision have enabled us to overcome challenges and continue delivering quality healthcare to those who need it most.

We would like to extend our heartfelt gratitude to the Government of Kenya and our generous donors for their unwavering support. Their contributions have enabled Ruben Centre to continue providing critical healthcare services and programs that empower the people of Mukuru kwa Ruben. This partnership strengthens our collective effort to create a healthier and more equitable society.

As we reflect on our progress, we remain inspired by the resilience of our community and the transformative potential of programs like SHA. With continued support and innovation, Ruben Health Centre Nutrition Unit will keep working toward a healthier, more empowered Mukuru kwa Ruben.


By: Benson Kagwima & Gregory Barake

Ruben Centre