Cancer patients forced to pay as promised Sh800,000 SHA benefit remains on paper
President William Ruto delivers the State of the Nation address at Parliament Buildings, Nairobi, on November 20, 2025.
What you need to know:
- President Ruto had announced an increase in the SHA cancer benefits package from Sh550,000 to Sh800,000, effective December 1, 2025.
- However, hospitals are yet to implement this, waiting until the tariff structures for the revised oncology benefit package are gazetted by SHA.
- Cancer patients are trapped between a presidential promise and hospitals that have refused to implement it.
Cancer patients who have depleted their oncology benefits continue to pay out of pocket as the Social Health Authority (SHA) benefit increase promised two months ago by President William Ruto remains unimplemented.
In November last year, during the State of the Nation Address in Parliament, President Ruto announced an increase in the SHA cancer benefits package from Sh550,000 to Sh800,000, effective December 1, 2025, to help patients access sustained treatment without financial strain.
However, hospitals are yet to implement this, saying that until the tariff structures for the revised oncology benefit package are gazetted by SHA, providers cannot operationalise the increase.
Ms Margaret Kanini's SHA cover ran out two months ago, and each vial of medication costs more than she earns in a month.
"My cover was exhausted months ago. For December and January, I am yet to be given drugs. I was told the limit was increased, but at the hospital, they say there is no communication, and I must pay cash. I don't have cash," she says.
Last week, her hospital told her that SHA had yet to load her account. Her oncologist instructed that since she had stayed two months without drugs, she would need a PET scan to check if the cancer had spread before resuming treatment. The medication costs Sh56,320 monthly, an amount the lung cancer patient cannot afford.
"When will the Sh800,000 that was promised become effective? The amount we are currently receiving is not enough. We need the drugs to survive; without them, the cancer cells spread very quickly. The government should do something," she says.
Across Kenya, cancer patients are trapped between a presidential promise and hospitals that have refused to implement it unless it is officially documented.
Health Cabinet Secretary Aden Duale (left) and the SHA Headquarters in Upper Hill, Nairobi. The authority lost Sh11 billion in six months.
Ms Phoebe Ongadi, Executive Director of the Kenya Network of Cancer Organisations (KENCO), says the suffering contradicts this year's World Cancer Day theme: "United by Unique."
"We appreciate the recent presidential directive to increase the oncology benefit from Sh550,000 to Sh800,000. This commitment reflects recognition at the highest level of the immense financial strain faced by cancer patients and caregivers; policy proclamations alone are insufficient if they are not translated into functional systems on the ground," she says.
She insists SHA must gazette the oncology tariffs immediately, communicate clearly to providers and patients, and ensure the increased coverage is reflected.
For Grace Achieng', a cervical cancer patient, the delay is a matter of survival.
"My SHA system still shows a balance, but every request is declined. I have been denied medication and even a PET scan since December. I had to look for money to pay for my January treatment cycle," she says.
Grace's oncologist prescribed a PET scan to determine if her cancer had spread, but authorisation was declined. She was told to pay Sh120,000 cash and had to borrow from friends.
"The government made a promise on national television, but to me, sitting here in pain, unable to afford the scan that could save my life, that promise is meaningless," she says.
Ms Ongadi says the financial burden of cancer care, diagnostics, surgery, chemotherapy, radiotherapy, supportive medicines, and long-term follow-up, quickly overwhelms most households.
"Effective health coverage is vital not just to protect lives, but to protect livelihoods and dignity. Systemic failures plaguing SHA's oncology programme are uncalled for," she says.
Kenco's engagement with patients has revealed a distressful experience. Most people who exhausted the original Sh550,000 limit are still unable to access the additional benefits, with many denied treatment once the previous limit is reached.
The organisation has documented four critical concerns: SHA has not gazetted tariff structures for the revised benefit package, making it impossible for providers to operationalise the increase; system failures and administrative breakdowns persist, forcing patients to pay out-of-pocket; patients entitled to the enhanced benefit continue experiencing treatment interruptions and financial strain; and delayed reimbursements from SHA are straining oncology services, bringing some close to operational paralysis.
"We need to recognise that although each cancer journey is deeply personal and distinct, we are united in our shared fight against this disease and in our pursuit of equitable access to quality cancer care. But how can we claim to be listening when patients are telling us they are being denied benefits that were publicly promised two months ago?" she asks.
Some private facilities have stopped accepting SHA for oncology cases altogether, saying the system has made it financially impossible to continue.
SHA Chief Executive Officer Dr Mercy Mwangangi.
Aden Duale, Health Cabinet Secretary, defended SHA's oncology programme, revealing that the system has paid out Sh7.05 billion to date for cancer care services covering 32,669 patients across 232 contracted facilities.
"At present, SHA has not received verified evidence confirming that patients are being systematically compelled to purchase consumables or medicines that are covered under the SHA benefits package. However, the authority treats such reports with seriousness. Where cases are confirmed, SHA will engage the affected facilities to establish the facts and take corrective action," Mr Duale stated in written responses to Daily Nation.
"SHA is actively financing dialysis and oncology care across the country, covering over 44,000 patients and disbursing over Sh14 billion to date. Whilst some facilities may experience operational or cash-flow pressures, patients should not be charged for services that are covered, and any confirmed violations will be addressed," he said.
Kenco is calling on the Cabinet Secretary for Health and SHA leadership to urgently gazette and implement the enhanced oncology benefit and resolve systemic and reimbursement bottlenecks.
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