Kenya’s ambition to provide affordable, comprehensive health coverage through a national insurance system, now known as the Social Health Authority (SHA), has faced persistent challenges. Despite reform efforts, many Kenyans continue to struggle to access needed services, and the system’s finances have been strained by fraud and inefficiencies.

What Is SHA?

The Social Health Authority (SHA) is a state corporation established by the Social Health Insurance Act, 2023 to replace the former National Hospital Insurance Fund (NHIF). Its mandate is to manage public healthcare financing in Kenya and to ensure accessible, affordable, and quality health insurance for all Kenyans.

SHA oversees several funds, including the Primary Health Care Fund, the Social Health Insurance Fund, and the Emergency, Chronic, and Critical Illness Fund, all designed to broaden coverage and reduce financial risk for Kenyans.

SHA Fraud is a Setback

One of the biggest threats to the SHA’s effectiveness is fraudulent claims. In 2025, the authority reportedly nearly lost KSh 10.6 billion to fraudulent payouts , a huge loss in a system that is still trying to expand services. When public funds are diverted through inflated or fake claims, less money remains for genuine patient care.

Fraud often arises when:

• payment systems lack transparency,
• enforcement and auditing are weak, and
• some health providers collude with intermediaries to claim unjustified reimbursements.

Without stronger controls and accountability, public funds are at risk while service delivery remains inadequate.

At the same time, fake hospital registrations and misconduct have been flagged by SHA itself, and the authority has even provided reporting channels for the public to report suspected fraud.

Poor Services

Despite significant contributions by Kenyan workers and employers, many beneficiaries feel that the services they receive are insufficient.

Common complaints include:

• Frequent medicine shortages even basic drugs like paracetamol and antibiotics are often unavailable in many facilities.
• Long waiting times and limited outpatient care , which should be core elements of a functioning insurance system.
• Benefit gaps some members report minimal reimbursement caps that hardly cover actual costs in many clinics.

These frustrations persist even as the SHA expands, highlighting the gap between health financing and effective service delivery.

Not for All

The promise of SHA is universal coverage, but in practice access still varies.

For example:

• Children under five typically receive free care at most public hospitals. a policy that has provided real relief to many families.
• However, not all outpatient services are covered widely, and many Kenyans feel that the contributions they make are not yielding proportional benefits.

Some argue that specific groups — like civil servants — receive more complete access under current rules, while others face limited benefits. This discrepancy affects public perception of fairness in the system.

But Why?

The government reportedly spent KSh 104.8 billion on a billing system intended for public healthcare facilities. Critics argue that such systems should be standardized across both public and private facilities to improve claims tracking, reduce fraud, and increase oversight.

When every facility uses a unified digital billing and claims system, it becomes easier to monitor where funds are going and to flag anomalies before they become huge losses.

Zero Transparency

A recurring problem is weak enforcement of laws and weak accountability for fraud and misuse of funds. Even when irregularities are identified, few responsible parties face consequences. Without robust leadership and commitment to justice, the system will continue to leak resources.

Effective governance could push Kenya closer to a system where basic healthcare is truly affordable and reliably available.

It is Still Little

SHA collects roughly KSh 5.4 billion per month in contributions. While this is a significant amount, it still may not be enough to cover the full cost of comprehensive healthcare, especially if losses from fraud and inefficiencies continue. A more efficient, transparent system could make these funds go further for patients.

Way Forward

Kenya’s Social Health Authority represents an important step toward universal health coverage, but significant reforms are still required. Strengthening fraud prevention, standardizing billing systems, ensuring consistent availability of essential medicines, expanding equitable access to benefits, and enforcing accountability are all critical to the success of the system.

If these issues are addressed, SHA has the potential to evolve into a healthcare financing system that genuinely protects Kenyans from the financial burden of illness and delivers meaningful health outcomes.

I’m often asked, “What book are you currently reading?”
That question pushed me to pause and reflect on what I had actually been reading—and why.

In 2025, my reading was intentional. The central theme was money, not out of obsession, but out of necessity. In the 21st century, money has quietly become one of the most determining factors in how we live, work, and make choices.

I work in the pharmaceutical industry an industry that moves billions of dollars yet many professionals within it struggle to achieve financial security. That contradiction forced me to rethink what I believed about money, value creation, and professional growth. It ultimately shaped my reading choices throughout the year.

I went down the rabbit hole trying to understand why this gap exists and what separates industries and individuals that thrive from those that merely survive. That curiosity naturally led me toward business, strategy, productivity, and systems thinking.

One idea kept resurfacing across almost everything I read:

Money is made by solving a problem that many people need solved.

Put simply: create value, find people willing to pay for it, and repeat.

The books below have significantly shaped how I now think about money, work, health, strategy, and long-term success. What follows are my key takeaways and honest reflections on each of them.

---

Outlive – Peter Attia

I would recommend this book 100% to any healthcare provider.

This is one of the hardest yet most useful books I have ever read. I picked it up after seeing it recommended by a YouTuber as one of the best books they had read that year, and I thought it would be a good addition to my list. It turned out to be far more demanding than I expected.

The book took me months to finish. The opening chapters were especially difficult because of the seriousness of the subject matter and the heavy medical terminology. I often found myself reading at a very slow pace, sometimes pausing for days before continuing. In fact, I finished two other shorter books while still working my way through this one.

Things began to click for me when I reached the chapter on Understanding Alzheimer’s, and later when he introduced the idea of thinking tactically. From that point, the book became less intimidating and more practical.

Outlive helped me better understand diseases associated with old age—cancer, hypertension, diabetes, and neurodegenerative conditions. Peter Attia strongly emphasizes the role of genetics in determining future health outcomes, while repeatedly reinforcing the idea that many of these diseases are preventable. Where prevention isn’t possible, early diagnosis and slowing disease progression become critical.

If you’re not interested in reading the entire book, I’d recommend skipping straight to the sections on exercise, nutrition, sleep, emotional health, and medications. The part where he explains exercise and sustainable weight loss is especially eye-opening.

---

The E-Myth – Michael E. Gerber

One of my customers once asked me:

“Do they teach how to run a pharmacy business in school? Because I keep looking for this drug and no one seems to have it…”

That question immediately came to mind when I started reading The E-Myth. I wondered whether the book might have answers that could help many struggling business owners—and it absolutely does.

Most pharmacy owners are the business. Remove the owner, and the business collapses. What surprised me is that even large businesses with well-defined job descriptions suffer from the same problem.

The challenge arises when:

There’s more work to do than you can possibly get done.

You become the manager, salesperson, marketer, cleaner, accountant—everything.

Pharmacists and pharmaceutical technologists know their technical work very well: handling difficult customers, dispensing prescriptions, patient counselling, organizing the pharmacy, understanding regulations. But when it comes to strategic work—the entrepreneurial work that leads to growth—many struggle.

Michael Gerber explains this through storytelling, outlining the stages of a business: infancy, adolescence, and maturity. From my observation, most businesses are stuck in adolescence because most owners operate as technicians rather than entrepreneurs.

The Entrepreneurial Perspective asks, “How must the business work?”
The Technician’s Perspective asks, “What work has to be done?”

This book is essential reading for anyone interested in building a business that works as a system—not one that collapses when the owner steps away.

---

Slow Productivity – Cal Newport

The concept of this book is simple:

1. Do fewer things
2. Work at a natural pace
3. Obsess over quality

There’s a common belief that running a pharmacy 24 hours a day automatically increases revenue, or that employees must always appear busy for productivity to exist.

For many business owners:

Productivity equals “working all the time.”

But this definition lacks clear goals or performance measures that distinguish between doing a job well and doing it poorly.

Reading Slow Productivity forced me to rethink what we should actually consider as “work” in the pharmacy sector. Although Cal Newport focuses on knowledge work, the principles apply strongly to supervisors and decision-makers.

Consider two pharmacies making daily sales of KES 50,000. Pharmacy A operates from 9am–8pm. Pharmacy B operates from 7am–midnight. Using revenue alone, it makes little sense to say Pharmacy B is more productive—especially when you factor in staffing, cleaning, and operational fatigue.

In both cases, the same result is produced, but the force driving changes in methods is productivity.

The takeaway is simple: balance effort with outcomes. Do fewer things, work at a natural pace, and obsess over quality.

---

This Is Strategy – Seth Godin

At first glance, this book feels like a collection of tweets or old-school blog posts. Over 200 of these reflections are compiled into This Is Strategy.

The book doesn’t tell you what to do. Instead, it gives direction toward why and who you should focus on.

Strategy is not a set of tactics or short-term wins. It’s a philosophy of becoming—being clear about the change you want to make and who you want to change, understanding the systems and games around you, and committing to a long-term path.

Godin emphasizes that tactics change, but strategy doesn’t.

To me, strategy means knowing when to capitalize on an opportunity and when not to. It’s about deciding who you’re serving, what change you want to make, and what you will consistently say no to.

He outlines four pillars of strategy: systems, time, games, and empathy each deeply relevant to running a pharmacy or any service-based business.

---

Million Dollar Weekend – Noah Kagan

Who doesn’t want to make a million dollars in one weekend?

I’ll admit—I fell for the clickbait. But it turned out to be a very interesting read. The book is especially useful for anyone looking to launch a product, whether that’s an app, a supplement, or a service tied to pharmacy operations.

The core lessons are simple and recurring:

1. Find a real problem people have
2. Craft an irresistible solution backed by basic market research

Reading this book helped me realize there is very little pharmacy-related content that people are proud to read, learn from, and share. That gap alone represents an opportunity.

Spoiler alert: I haven’t made a dollar yet.

Noah Kagan explains that most people fail not because of lack of skill or intelligence, but because of fear—fear of starting and fear of asking. I plan to test some of the ideas from this book on a product I’m currently working on and document the process here.

---

The Diary of a CEO – Steven Bartlett

I listened to Steven Bartlett’s podcast consistently throughout 2025, so reading this book felt like a natural extension.

The book is built around 33 laws grouped into four pillars: the self, the story, the philosophy, and the team. He introduces the idea of filling five buckets in order: what you know, what you can do, who you know, what you have, and what the world thinks of you.

Several stories stood out to me, especially those relevant to leadership, brand building, and reputation—areas many pharmacy owners underestimate.

---

The Alchemist – Paulo Coelho

I couldn’t stop reading this book once I started. It left me wondering why it took me so long to pick it up.

I won’t say much to preserve the sense of discovery I experienced, but three lessons stood out clearly:

• Everyone has a unique purpose. Fulfillment comes from having the courage to pursue what truly matters, even when the path is uncertain.
• Growth and wisdom come through experiences, challenges, and failures not just the final achievement.
• Intuition and “omens” guide us when we pay attention. Life often communicates what we need to know if we’re willing to listen.

Conclusion

As I move into 2026, my focus won’t be on reading more books for the sake of it, but on turning ideas into systems, experiments, and better decisions inside the pharmacy.

I’ll continue reading – especially in business and productivity – but with a stronger bias toward execution. Learning without application has limits. The goal now is to consume thoughtfully and create deliberately.

In short: read with intent, act faster, and build more than I absorb.

I have been following these medicines for more than a decade, and I want to highlight a pattern that is becoming increasingly consistent.

Prednisolone, Diclofenac, Cetirizine, Chlorpheniramine, Amoxicillin, Omeprazole.

Let us focus on prednisolone, diclofenac, and omeprazole because of their heavy use in most healthcare facilities.

These are among the most commonly sold medicines in the community pharmacies I have visited, and in many cases, it is the client not the prescriber who requests them.

My aim is not to accuse, but to help us know more, learn more, and at least begin thinking about how we can respond better to what is happening.

I know that many pharmaceutical technologists and pharmacists have dispensed these medicines over the counter without fully exploring why the patient is buying them. The consistently high usage may be a surface indication of a much deeper and growing problem within our community.

When I was an intern in a hospital setting, I remember doing inventory in the main pharmacy. I noticed that medicines such as amoxicillin, cotrimoxazole, antihypertensives, and others came in very large quantities, while a particular brand of omeprazole arrived in only two packets. At the time, I wondered, “There must be very few patients with conditions that require this medicine.”

Later, I realized that although omeprazole was prescribed for short periods usually one to two months it was prescribed far less frequently compared to antihypertensive or antidiabetic medicines.

However, after I started working in the community, I observed a steady increase in the use of both omeprazole and diclofenac over the years.

This raises an important question: what is driving this increased and sustained use?

One explanation could be population growth, leading to higher overall demand. But my bigger concern is the continuous and repeated use of these medicines. Many people do not adhere to recommended dosages, and even among those who follow treatment properly and feel better, the problem often returns after a few months.

This clearly points to issues of poor compliance, inappropriate use, and possible treatment failure.

What stands out is that many people are struggling with pain, gut health, and respiratory problems.

For now, I will set respiratory issues aside and focus on pain and gut health.

Pain

Pain can be a major obstacle to daily life. While everyone experiences pain at some point, chronic pain is different it forces people to rely on painkillers for long-term relief.

The painkiller of choice, unfortunately, is almost always diclofenac.

Its use has become so common that it is widely recommended from one person to another, even for something as simple as a headache. Painkillers, especially potent ones like diclofenac, should not be used without proper diagnosis and monitoring, yet this medicine is being used casually and repeatedly.

Gut Health

For many people who do not prepare meals at home, stomach problems have become a regular occurrence. What starts as a simple stomach upset or diarrhea often progresses, over time, into chronic gastric problems and ulcers.

Food safety standards are frequently ignored. Cooking oil is recycled excessively, hygiene is compromised, and cost-cutting takes priority over quality. Many people eat what is available, not what is healthy, and this gradually takes a toll on their gut health.

Water quality also plays a role. Inadequately treated drinking water may be contributing significantly to widespread gastrointestinal problems.

These are observations and speculations, not conclusions but they are important signals. They highlight areas that deserve closer examination, data collection, and deliberate decision-making.

Conclusion

What is clear so far is that many people are struggling with persistent pain and poor gut health, yet the underlying causes are rarely addressed. Instead, we are repeatedly treating symptoms with the same medicines—often without adequate assessment, follow-up, or patient education.

As pharmacy professionals, we are in a unique position to notice these patterns early. If we pause, ask better questions, and engage patients beyond the sale, we may begin to shift from simply dispensing medicines to genuinely improving health outcomes. These medicines are not the problem on their own but how, why, and how often they are being used should concern us all.

In recent days, there has been a global eruption of interest in the future of AI (robotics) and civilization, largely occasioned by Elon Musk’s statements across interviews and social media.

The economic impact of AI is well understood by a few global leaders such as Jensen, Sam, and Elon. The growing challenge and opportunity for Kenyan businesses is to understand this impact more deeply and learn how to position themselves to benefit from it.

“If I could, I would certainly slow down AI and robotics, but I can’t,” Elon says in an interview on the Katie Miller podcast.

To understand what’s really happening, we must get to the heart of the matter. With this in mind, I prompted ChatGPT to tell me five ways AI can be used in the pharmacy ecosystem.

This is because I don’t like hearing the idea that I will be replaced by a robot. Many people are also not prepared for the idea that they may have to leave the 9–5 jobs they have grown addicted to.

The real question is: what would you do with your free time?

What AI offers feels like paradise something I never imagined would be prescribed to us this way, by the predictions of a rich billionaire.

Tell me, who doesn’t want the following:

• Not having to work
• Being provided with all goods and services one could possibly want
• Or work becoming optional

There would be an abundance of time to venture into meaningful activities, such as spending time with loved ones and travelling to great places.

But before that time arrives, AI can be used today as a companion. We should see it as a tool that makes work easier.

That is why I asked AI to explain how it could be useful in the pharmacy sector.

This is what I got:

AI can support pharmacists with instant, standardized counselling prompts covering dosage, side effects, interactions, and lifestyle advice ensuring every patient receives the same high-quality information, regardless of who is on duty.

AI systems can flag potential drug–drug interactions, duplicate therapies, dosing errors (age, weight, renal function), and allergy risks in real time, acting as a second safety net before dispensing.

By analyzing sales trends, seasonality, disease outbreaks, and prescribing patterns, AI can help pharmacies predict stock needs, reduce expiries, prevent stock-outs, and improve cash flow.

AI can automate refill reminders, adherence nudges, chronic disease check-ins, and health education messages turning the pharmacy into a continuous care partner rather than just a point of sale.

From staff scheduling and workflow optimization to identifying high-margin products and underperforming categories, AI can help pharmacy owners make better decisions faster while freeing pharmacists to focus on patient care.

There is a lot to unpack here, but first, let’s look at the day-to-day operations of a real pharmacy environment:

• Cleaning the store, including dusting shelves
• Billing and collecting cash from patients
• Dispensing medicines and writing prescription labels
• Picking client calls
• Interacting with clients online or through WhatsApp
• Receiving stock from suppliers
• Posting stock into inventory systems, including updating batches and expiries
• Pre-packing medicines and counting tablets
• Clinical monitoring
• Responding to questions from hospital clinicians
• Over-the-counter consultations
• Regulatory compliance
• Pharmacovigilance

So what are the findings when we compare this to what AI can do?

• Most tasks pharmacists perform today are already within AI’s capabilities. This means one pharmacist could potentially do the work of ten, freeing up a significant amount of time.
• Clinicians who consult pharmacists for critical dosing and treatment regimens may eventually bypass pharmacists altogether, since AI can provide faster and more accurate answers.
• Pharmaceutical technologists may still have more hands-on roles, but AI will make their work easier and free up time for other activities.
• Most pharmacy operations will be optimized, but overall, the pharmacy profession appears set to decline.

Way forward

There are many aspects of the profession that pharmacists take pride in designing patient regimens, joining clinicians on ward rounds, discussing medication therapy, and pharmacovigilance. In the coming years, much of this may slowly disappear.

This will leave pharmacists and pharmaceutical technologists with more free time, even for those who remain employed.

However, most employers are uncomfortable seeing staff idle. Employees are often expected to be doing something, even when there is little to do.

So, is it possible to create an environment where professionals can express their skills without the constant pressure of productivity?

The answer remains: it depends.

Some pharmacies remain extremely busy, with staff in a continuous loop of pulling medicines from cabinets and dispensing until the shift ends. Others enjoy long idle hours and get busy only at rush hours.

Crowded pharmacies may remain so for a long time, until the idea of filling prescriptions online becomes widely accepted. That shift is still far away.

So how are pharmacists surviving?

To be honest, I don’t fully understand the logic behind how pharmacists are aligning themselves with the AI effect, but I am observing the following:

• Some are taking up part-time jobs
• Others are doing remote work
• A group is moving into consulting
• Many are enrolling in nursing, public health, or business administration

The future, then, is not really about whether AI will replace pharmacists, but about how pharmacists will redefine their value in a world where thinking, checking, and predicting are no longer uniquely human tasks. Time, once scarce, may become the most abundant resource, and how it is used will matter more than titles, shifts, or job descriptions. Those who wait for clarity may be overtaken by it, while those who engage early, experiment, and adapt may discover that AI does not erase professional identity but forces it to evolve. Whether this transition leads to decline or renewal will depend less on the technology itself and more on how willing we are to rethink what meaningful work looks like in the age of intelligent machines.

I am interested to see how this will look over the next ten years.

In May 2023, I came across a post on X (formerly Twitter) by @RobertAlai, who was looking for Flugone capsules. He mentioned that they work well for him but that he was having trouble finding them in many Kenyan pharmacies.

I was surprised — Flugone is a common medicine for managing colds and flu. I had just cleared my stock and was waiting for the next batch, so I picked up my phone and called three friends who work with major distributors to find out what was going on.

They all gave the same response: Flugone was out of stock, and no one knew when it would be back. Some chemists on the outskirts of Nairobi still had a few packs, but they had hiked the prices.

So, Why Do Drugs Go Out of Stock?

Drug shortages happen more often than most people realize. Even everyday medicines like Flugone or Panadol Cold & Flu can disappear from shelves for months, leaving both patients and pharmacies frustrated.

When a medicine goes out of stock, the first step is to find out:

1. Why it’s out of stock.
2. How long the shortage is expected to last.
3. Whether there are alternatives you can use in the meantime.

Usually, the problem lies somewhere in the supply chain. The importer might be facing regulatory delays, a product could have been recalled or discontinued, or there may be a temporary shortage due to short expiry dates or manufacturing issues.

Your approach should always be clinical — identify the specific cause and respond appropriately instead of panicking or guessing.

A Real Example

In 2024, a shortage of Ventolin inhalers hit the market due to increased demand and shipping delays. Many patients were forced to pay more or switch to more expensive alternatives.

However, pharmacies that anticipated the shortage and stocked up early not only served their repeat patients reliably but also made good profits.

This is a fundamental business principle — when demand exceeds supply, those who plan and source smartly always win.

A Five-Point Approach to Managing Stock-Outs

Here’s a practical approach I’ve used to manage medicine shortages effectively:

1. Stock in advance.
2. Offer an alternative generic.
3. Call other pharmacies for help.
4. Ask the doctor to prescribe something else.
5. Know when to stop looking.

1. Stock in Advance

Stocking well is your insurance policy against frequent stock-outs. Review your purchase history and forecast seasonal demand.

For example:

• Cold and flu medicines move faster during the rainy or cold seasons.
• Over-the-counter (OTC) fast movers peak during festive seasons like Easter and Christmas when most suppliers close for the holidays.

Be tactical — stock just enough to meet demand without overstocking.

2. Offer an Alternative Generic

When possible, switch to medicines with the same active ingredient but different brands.

For example, azithromycin is available from many manufacturers under various brand names. Explain to your patients that the active ingredient is the same — only the manufacturer differs.

However, avoid substituting prescription medicines without consulting the doctor first. Some medicines are urgent, so if substitution isn’t possible, consider sourcing the exact product as the patient waits.

3. Call Other Pharmacies

Maintain a good relationship with neighboring pharmacies. When you’re out of stock, one of them might still have it and can sell to you at trade price.

If you work in a chain pharmacy, make use of inter-branch transfers to balance stock across branches.

4. Ask the Doctor to Prescribe Something Else

If the medicine is unavailable across all channels, contact the prescribing doctor. They can recommend an alternative or adjust the prescription.

Sometimes, it’s easier for the patient to go back to the doctor for a revised prescription.

5. Know When to Stop Looking

Some drugs will never return to the market. For example, Nizoral was discontinued due to safety concerns about liver injury, yet some patients kept searching for it years later.

When you encounter such cases:

• Inform the doctor that the drug has been discontinued.
• Recommend safe, available alternatives.
• Educate the patient so they understand why the medicine is no longer supplied and don’t waste time searching for it.

Final Thoughts

Stock-outs are part of pharmacy life, but how you handle them defines the kind of service your pharmacy delivers.

By anticipating shortages, communicating clearly with patients and doctors, and maintaining strong relationships with suppliers and fellow pharmacists, you can turn a frustrating situation into a moment of trust-building — and even a business advantage.