Top Tweets for #ErrorbyDesign
https://t.co/pRTsL5pjzS We shall be giving more insights about #ErrorByDesign for the next 1.5 hours. Tune in
A lot has happened since @LHreports @AfUncensored published our #ErrorbyDesign investigation. SHA published a non-response response, we wrote back, government officials attacked our reporting. Join us for an X Space where we unpack our reporting and its aftermath.
How does the SHA proxy means testing determine the sum each Kenyan household must pay for public health insurance?
Watch #ErrorByDesign now on https://t.co/vLr1UVZMzC
#ErrorByDesign, produced by @AfUncensored’s @joy_kirigia and @MukamiPurity, in collaboration with @LHreports and @guardian, investigates how Kenya's Social Health Authority (SHA) AI algorithm is overcharging the poorest while undercharging the richest. https://t.co/ybJOQdbome
@thatQay @_shakenya @Mizani254 @eli_likuyani @wmuchelle It’s exactly my question and I just thought to log in yesterday after watching @AfUncensored documentary on #ErrorByDesign and boom, I found out I have a UTI, got given Cefixime 400g and Paracetamol…I am still befuddled.
It took months of waiting, along with the Ombudsman's intervention, for the Social Health Authority to reply to our Freedom of Information Act requests regarding the data used to build SHA's means testing system.
Watch #ErrorByDesign produced by @joykirigia, @MukamiPurity and @gabriels_geiger
now on https://t.co/qYyuuID78L
I need an explanation @_shakenya I am in the office, working and healthy but on my medical records on SHA, it shows that I have gone to hospital and treated today. I have UTI and being given an antibiotic and paracetamol @Mizani254 @eli_likuyani @wmuchelle and doc is Somali
@AfUncensored For context this was the detailed ROR we sent 12 days before publication of our #ErrorByDesign https://t.co/cFZrRShzP3
REJECTING THE MISLEADING SHA “EQUITY” NARRATIVE
As was expected SHA have responded to the #ErrorbyDesign feature by @AfUncensored .
Here is my take
The statement issued by the @_shakenya (SHA) on means testing is selective, misleading, and divorced from the broader fiscal reality facing Kenyans.
1. The “Punishing the Poor” Narrative is Incomplete and Politically Convenient
SHA argues that NHIF was regressive because lower-income earners paid a higher percentage of income. This argument is mathematically correct— but policy-wise dishonest. It isolates NHIF contributions from the total tax burden, which is where the real inequity lies.
Let me use the line SHA like using to hood wink Kenyans to advance their false narrative:
A Kenyan earning KES 1,000,000/month already contributes approximately:
* KES 350,000 in PAYE (35%)
* Additional indirect taxes (VAT, excise, fuel levies, etc.)
Suppose we even add the 1700 they paid to NHIF.
Their tax contribution is KES 351,700 + all other taxes. This goes to government before he touches it.
The question SHA refuses to answer:
Why is health financing being used to “equalize” inequality created by the broader tax system?
That is not the role of social health insurance.
2. Social Health Insurance is NOT a Redistributive Tax Tool
The core principle of social health insurance globally is:
* Risk pooling
* Government subsidization of the poor
NOT:
* Punitive redistribution within contributors
* Nor experimental “Robin Hood economics” targeting the formal sector
By enforcing a flat 2.75% on income, SHA:
* Converts insurance into a quasi-tax
* Ignores already disproportionate taxation of formal earners
* Overburdens the compliant 17% of Kenyans in formal employment
In the Kenya Kwanza era there is even more lost tax 1.5% for a house the 1 Million fellow for a house he will never get.
3. The Real Crisis: SHA Has Increased Financial Risk, Not Reduced It
While SHA claims “equity,” the lived reality in the health sector is:
* Increased out-of-pocket payments
* Widespread claim rejections
* Delayed or non-payment to providers
* Closure or near-collapse of health facilities
This is not theoretical. it is systemic failure.
A system that:
* Cannot pay providers
* Rejects valid claims
* Forces patients to pay cash
Is not social protection. It is financial exposure.
4. The Means Testing Instrument (MTI) is Technocratic Overreach
SHA defends Proxy Means Testing (PMT) as “global best practice.”
But in Kenya:
* The informal economy is fluid, undocumented, and unpredictable
* Household data is incomplete and unreliable
* AI/DHA-driven assessments are producing real-world harm
The result of this as demonstrated in #ErrorByDesign
* Misclassification of households
* Wrong premium assignments
* Delayed care and denial of services
This is not precision targeting. it is algorithmic guesswork applied to human survival.
5. The Fundamental Policy Error: Overestimating Informal Sector Compliance
Let us be honest as a country: 83% of Kenyans are in the informal sector. These incomes are:
* Irregular
* Seasonal
* Largely untraceable
It is unrealistic to assume that this segment will:
* Consistently declare income
* Pay 2.75%
* Sustain a national insurance pool
6. The Burden Has Shifted — Not Solved
SHA claims NHIF relied on 20% formal sector.
But the reality today: The same formal sector is still financing the system now at:
* Higher rates
* Higher uncertainty
* Lower benefit predictability
This is not reform. This is repackaged dependency on the same shrinking base (now ~17%).
Moreover health providers are the underwriters of SHA with unpaid legacy NHIF debts, mounting SHA debts and exclusion from SHA services despite financing SHA.
7. Health Financing Cannot Be Built on Policy Experimentation
Healthcare is not a space for:
* Ideological experiments
* Political narratives (“Hustler economics”)
* Unvalidated digital systems
It requires:
* Predictability
* Trust
* Scientific and actuarial grounding
8. The Way Forward: Evidence, Not Narratives
We agree that discussion is necessary. But we must ask: Is Government listening?
Evidence such as the #ErrorByDesign analysis has already demonstrated:
* Structural weaknesses in SHA design
* Systemic rejection patterns
* Financial unsustainability
Yet policy continues unchanged.
My POSITION as Dr Simon Kigondu an overtaxed health policy commentator, is CLEAR AND UNEQUIVOCAL:
1. The informal sector (83%) cannot sustainably finance SHA
2. The formal sector (17%) is being overburdened
3. AI-driven DHA systems are causing harm
4. Out-of-pocket expenditure has increased
5. Provider non-payment is collapsing healthcare delivery
CONCLUSION: TIME TO CALL IT WHAT IT IS
The SHA model, as currently implemented, is:
* Economically flawed
* Operationally unstable
* Clinically dangerous
It is time to:
- Acknowledge the failed experiment
- Return to evidence-based health financing
- Engage stakeholders meaningfully
You cannot fix inequality in taxation by breaking healthcare. What SHA has done is not protect the poor — it has weakened the entire system.
Dr Simon Kigondu is a gynaecologist & commentator on health policy.
Hiding Behind AI: How SHA Was Used to Load Health System Costs Onto the Poorest #ErrorByDesign @AfUncensored
https://t.co/76qfNAqQsz
For the first time the Kenyan government actually embraces Ai and what do they do with it? Punish the poor.
#ErrorByDesign
Thank you for watching and supporting our documentary #ErrorByDesign. To read the full package of the project including our methodology, please find them in this link. @AfUncensored @citizentvkenya @johnallannamu @LHreports @guardian https://t.co/PRMKjhTnNW
@citizentvkenya @citizentvkenya @johnallannamu The math is finally mathing- it’s heartbreaking and horrifying So SHA isn't just flawed it’s reverse Robin Hood -overcharge the poor to subsidize the rich. They knew the numbers, and they hit 'implement' anyway yani bila huruma #SHA #ErrorbyDesign
Tonight on The Explainer, @johnallannamu, @MukamiPurity and @joy_kirigia break down the data and accountability issues surrounding SHA's AI algorithm system.
Tune in to @citizentvkenya at 9:00 PM for a detailed look at the findings of our latest investigation #ErrorByDesign and what this mean for Kenyans.
Error by Design: How SHA’s AI System is Failing Kenyans #ErrorByDesign @AfUncensored
https://t.co/Rxqg68gmos
An AI system was used by SHA to calculate the healthcare premiums of Kenyans, but did it unfairly burdened the poorest and favored the wealthy? We dug deeper to uncover the truth behind this system.
Watch #ErrorByDesign by now showing on Youtube.
@joy_kirigia Purity Mukami and Dr. Brian Lishenga are on #TheBigPicture with @MoigeWilliam talking about #ErrorByDesign, the joint investigation by @LHreports @AfUncensored @guardian into how an AI-powered algorithm is overcharging those with the least for their insurance premiums: https://t.co/1e3qxxc0LF
For the first time, we reveal the technology and the politics behind the SHA algorithm system on #ErrorByDesign produced by @joy_kirigia, @MukamiPurity and @gabriels_geiger
Watch now on https://t.co/vLr1UVZMzC
@SpiceFMKE @nduokoh @dennisaseto @EverlyneMungai #ErrorByDesign
@HonAdenDuale can scream that SHA works but let’s be honest - it’s not working for more than 80% of patients, whether paid or not!
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