Questions raised about SHA deal after Ruto move on Adani projects

In the wake of President William Ruto’s cancellation of the Adani JKIA and Ketraco deals, questions have emerged about the fate of contracts related to the new Social Health Authority (SHA) and associated consortium.

The scrutiny comes at a crucial time as the country transitions from the National Health Insurance Fund (NHIF) to a new healthcare system worth hundreds of billions of shillings.

Kenyans on social media platforms have been demanding that the government severs its links to the Adani Group in the new health scheme.

But the chairman of the Social Health Authority, Abdi Mohammed, while speaking to The Standard, distanced the authority from the controversial dealings, explicitly denying the existence of contracts with a consortium of three companies – Safaricom, Apeiro Limited, and Konvergenz Network Solutions.

“We don’t have a contract with Konvergenz, we don’t have a contract with Apeiro, neither do we have a contract with Safaricom,” Mohammed said in one of his responses.

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Abdi also said that the existing contract under discussion, and on which SHA has anchored its platforms, was actually inherited from the defunct NHIF and involves service providers of the Hospital Incident Command System (HICS).

“The digitisation contract being alluded to is between the Ministry of Health and Safaricom PLC, Apeiro Ltd, and Konvergenz Network Solutions,” he explained, drawing a line between SHA’s operations and the broader healthcare digitisation plan.

This distinction becomes particularly significant given the scale of the transition and the chaotic nature of its implementation, which has left many Kenyans suffering.

At the centre of the controversy is a consortium led by Safaricom, which includes Apeiro Ltd and Konvergenz Network Solutions. Apeiro Ltd holds the largest stake at 59.5 per cent, while Safaricom and Konvergenz Network Solutions hold 22.6 per cent and 17.9 per cent, respectively.

The arrangement has raised eyebrows, particularly due to Apeiro’s recent registration and its connections to international corporate entities and figures within President Ruto’s inner circle.

Safaricom itself, in a statement released on 21 September 2024, confirmed its involvement in the health scheme.

“Guided by our purpose of transforming lives and driven by our commitment to use technology to address some of Kenya’s pressing challenges, we have led a consortium of companies (‘The Consortium’) to advance the ambitions of the Ministry of Health to ensure that every Kenyan has access to quality healthcare,” the statement said, adding:

“We will achieve this ambition through the implementation of an Integrated Healthcare Information Technology System (‘IHTS System’). The Consortium includes: Apeiro Limited and Konvergenz Network Solutions Limited, and will invest KES 104,808,136,478 over a ten-year period to implement, maintain, and support the IHTS System. The investment will be recovered over the said ten-year period, with monthly instalments set to commence from February 2025 upon the successful implementation of key milestones on the project. This project structure allows the Ministry to deploy a comprehensive digital health solution without incurring any upfront capital expenditure (CapEx) or operational expenditure (OpEx).”

The statement went further to list six components of the said IHTS, with the fourth highlighting Safaricom’s connection to SHA. It states: “Comprehensive technology for health insurance to support digitisation of the Social Health Authority to curb fraud and improve efficiency, transparency, and accountability in healthcare financing.”

Fraud prevention

The statement seemed to echo an earlier one released by the Ministry of Health, signed by PS Harry Kimtai, which granted the consortium the authority to manage SHA’s digitisation programme.

“To support the implementation of the UHC blueprint, the Ministry of Health has awarded a contract for the implementation of an Integrated Healthcare Information Technology System (‘IHTS System’) to a consortium led by Safaricom PLC. The consortium includes global patient care digitisation firm Apeiro Limited (Apeiro Digital) and enterprise technology firm Konvergenz Network Solutions Limited (KNS).”

On the mandates, the statement also indicated that the consortium would work with SHA. The fifth, and last of the services, states: “Health Insurance Platform (HIP): Improving efficiency. The HIP will allow for the authentication of claims in real-time, fraud prevention, and automation of all activities of the Social Health Authority. This will also allow both public and private sector health providers to integrate with the Social Health Authority.”

Safaricom’s IT employees later presented a master plan titled “Healthcare Information Technology for UHC” to Standard journalists, detailing how the consortium’s infrastructure would dovetail into Social Health Authority’s digital strategy. PS Kimtai also accompanied the team.

The presentation came weeks after the National Assembly Committee on Health, led by Robert Pukose, cleared the Ministry of Health’s decision to award the tenders for the Integrated Information Technology System for Universal Healthcare to this consortium.

On Friday, Mohammed emphasised that SHA is part of a comprehensive  health digitisation agenda that extends beyond the authority.

“This initiative encompasses various healthcare stakeholders, including KEMSA, regulatory bodies such as KMPDC and PPB, the Nursing Council, and 17 other regulators, as well as healthcare providers, hospitals, and healthcare workers’ devices,” he insisted.

He also blamed the link to Adani Enterprises on alleged cartels that had been benefitting from the defunct NHIF. “Healthcare digitisation is one of the key pillars in the delivery of Universal Health Coverage as it increases efficiency, enhances data portability, and minimises fraud. SHA is probably being dragged into the alleged Adani deals by the cartels who were benefitting from NHIF at the expense of citizens,” said Mohammed.

The new healthcare system encompasses three major funds: the Primary Healthcare Fund, with a government allocation of Sh50 billion; the Social Health Insurance Fund, expected to raise Sh148 billion annually through member contributions; and the Emergency, Chronic, and Critical Illnesses Fund, requiring Sh75 billion yearly.