For the 1,400 men and women who once formed the backbone of the National Hospital Insurance Fund (NHIF), the promise of a new dawn under the Social Health Authority (SHA) has turned into a recurring twilight of uncertainty. In a move that exposes the deep administrative cracks in Kenya’s healthcare transition, the Public Service Commission (PSC) has—for the third time—extended the temporary deployment of these staff for another six months.

The decision, communicated quietly as the previous extension lapsed, leaves these workers in professional purgatory: neither fully absorbed into the new authority nor released to the wider public service. It is a bureaucratic holding pattern that raises urgent questions about the operational readiness of the SHA, a body tasked with delivering President William Ruto’s flagship Universal Health Coverage (UHC) agenda.

A 'Temporary' Solution That Won't End

The latest directive comes from PSC Chief Executive Paul Famba. In a letter dated November 21, 2025, addressed to the Principal Secretary for Medical Services, Dr. Ouma Oluga, Mr. Famba confirmed that the deployment would be extended retrospectively from November 22. This marks the third six-month extension since the transition began in late 2024.

“The Commission has decided and directed that the deployment of all the staff of the defunct NHIF to SHA be and is hereby extended for a further period of six months or until the recruitment exercise at SHA is fully completed, whichever comes earlier,” the letter reads in part.

This extension was triggered by a request from the SHA itself, admitting that its recruitment process—led by CEO Dr. Mercy Mwangangi—is still far from complete. For the staff on the ground, this means another half-year of looking over their shoulders, unsure if they will have a job when the clock runs out again in May 2026.

The Human Cost of Bureaucracy

While the boardroom letters fly between the PSC and the Ministry of Health, the real impact is felt in the corridors of hospitals and the homes of these employees. A distracted workforce is a dangerous liability in healthcare. Staff members, speaking on condition of anonymity, describe a workplace rife with anxiety and low morale.

• Job Security: Employees are unable to plan their financial futures, with banks reportedly hesitant to advance loans to staff on such precarious contracts.
• Operational Paralysis: The lack of permanent confirmation has slowed down decision-making within SHA, as temporary staff hesitate to make long-term commitments.
• Service Delivery: The internal chaos correlates with the external frustration of Kenyans, who continue to face system downtimes and unclear benefit entitlements at health facilities.

“We are working with one foot out the door,” one senior officer told Streamline News. “How can we serve Kenyans effectively when we don’t know if we are unwanted guests in this new house?”

Legal Hurdles and the 'Kenyan Reality'

The delay is not entirely administrative; it is also legal. The transition has been complicated by a ruling from Justice Byram Ongaya of the Employment and Labour Relations Court, who blocked the automatic absorption of NHIF staff into SHA. The court insisted on a competitive recruitment process to ensure fairness and transparency.

However, the implementation of this order has been sluggish. The SHA is caught between the legal requirement to recruit competitively and the practical necessity of retaining the institutional memory held by the former NHIF staff. Without them, the complex claims processing system would likely collapse entirely.

This stalemate hurts the ordinary Kenyan—Wanjiku. When the system fails to authorize a dialysis session or a C-section because the person behind the screen is demoralized or the department is understaffed, it is the patient who pays the price. The government’s assurance that SHA is "fully operational" stands in stark contrast to the administrative glue holding it together: a workforce on borrowed time.

As the clock starts ticking on this new six-month window, the pressure is on Dr. Mwangangi and the PSC to finalize the transition. Kenya’s healthcare system cannot afford to be run by a ghost workforce forever.