More SHA hitches exposed as patients storm Health ministry offices
Health Cabinet Secretary Deborah Barasa (centre) addresses journalists on the state of healthcare in the country at Afya House in Nairobi on January 15, 2024, flanked by Kenya Medical Supplies Authority Chief Executive Officer Dr Waqo Ejersa (left) and Director General for Health Dr Patrick Amoth.
Tempers flared at the offices of the Ministry of Health on Wednesday as frustrated patients, including men and women with young children, stormed the boardroom to express their dissatisfaction with the quality of health services under the Social Health Authority (SHA).
Despite paying monthly premiums, the patients complained that they were unable to access timely treatment due to system failures, resulting in them spending a lot of money on transportation to and from hospitals on a daily basis, some for more than a week now.
Leading the charge was Grace Njoki Munai, who accused Kenyatta National Hospital (KNH) of neglect after waiting seven days without treatment due to persistent system failures.
"We are waiting at the gate. We've been walking all the way from Kenyatta Hospital for treatment since last Wednesday, but their system is not working. Patients in hospitals are being discharged without treatment. We've come here to protest against this neglect,' said Ms Njoki.
Diana Akoth, a mother holding her three-day-old newborn, recounted her ordeal at Afya House following complications from a caesarean section.
She revealed that the hospital kept referring her from one department to another, citing technical problems with the SHA system.
"The hospital has taken me from one office to another, from one department to another. In some places, they claim that the OTP (one-time password) has not been sent. We are many patients outside Kenyatta Hospital, still hanging on to the hope of receiving treatment, but we can't until the SHA is approved," she said, appealing to SHA to help them as they are going through hard times.
“We have been to the NHIF offices (referring to the SHA offices), the ICT department and all the other offices on these floors. They are not helping us. When we send money, the systems work, but when it comes to service delivery, that's when the system starts to break down," the visibly angry patient shouted.
Others echoed her frustration. A father from Kibwezi recounted his struggle to get treatment for his son, who had swallowed a coin two days ago.
"My child hasn't eaten since the incident, but I'm still waiting for the SHA to approve treatment," he lamented.
The incident came minutes after an earlier statement from the ministry expressing confidence in the new health insurance scheme, noting that many Kenyans were accessing medical services under the SHA.
The team stormed the Ministry of Health offices nearly 15 minutes after a press conference on the state of Kenya’s healthcare called by Cabinet Secretary Deborah Barasa ended.
Significant progress
The press conference, also attended by Director General of Health Dr Patrick Amoth, SHA chief executive officer Robert Ingasira, his Kenya Medical Supplies Authority (Kemsa) counterpart Ejersa Waqo, as well as other senior ministry officials,
"Significant progress has been made in improving health services under the Social Health Authority (SHA). Benefits include eight kidney transplants, 8,300 dialysis sessions and the management of 21,000 oncology cases," said Dr Amoth.
The Nation then visited KNH to assess the progress of the health insurance implementation, and patients at the Level 6 facility painted a grim picture of the health crisis.
Patients in the billing area clutched white papers as they queued for hours, hoping for their turn to be served.
Many complained about the slow or dysfunctional SHA system.
KNH CEO Dr Evanson Kamuri acknowledged what he said was a “slight lapse in patient care” and insisted that the SHA system was now fully operational.
“The recent system downtime experienced over the last two days temporarily disrupted some services, causing delays in patient clearance and administrative processes. . . to address the backlog, additional personnel have been deployed across all affected departments with extended working hours,” Dr Kamuri said in a statement.
On Sunday, Mr Ondanga Hamisi travelled all the way from Mumias in western Kenya to visit his son, who had been admitted to KNH.
Grace Njoki and Diana Akoth (seated) storm Health Cabinet Secretary Deborah Barasa’s media briefing at Afya House in Nairobi on January 15, 2024, over Social Health Insurance Fund system hitches. They claimed hundreds of patients were stranded at Kenyatta National Hospital despite paying SHIF premiums.
He'd booked a hotel, confident he'd only need it for one night - his son was due to be discharged the following day, Monday.
But for the past three days, Mr Ondanga has been forced into a routine. He leaves his hotel room at 6am and makes his way to KNH. Since Monday, he has been pacing the corridors of Kenya's largest referral hospital, waiting with bated breath for a signal from the Malipo Centre staff to begin his discharge process.
On Monday, he was handed a ticket number 38, under the pre-authorisation category. This meant he had to present a bill so they could work out how much he should pay and what the SHA would cover.
"The system was inefficient," says Mr Ondanga, clearly frustrated. "There were moments when it worked and hours when it didn't. At 5pm we were told to come back the next day. That meant I went home without any treatment. Fortunately, the hospital allowed us to come here as soon as possible.
By 7.30am on Tuesday, Mr Ondanga was among hundreds of people queuing up at the billing area, clutching their tickets like lifelines. This time his number had risen to 40. But by the evening, he hadn't been seen and had to trudge back to the hotel, praying that Wednesday would be better.
"My patient was discharged on Monday," he says, "so now, on top of the extra hotel bills, I'm going to have to pay out of pocket for the extra days he was in hospital."
When Nation catches up with Mr Ondanga around 3pm on Wednesday, he's still waiting, along with hundreds of others. The SHA system, he explains, is moving at a snail's pace.
A source at KNH, speaking on condition of anonymity, reveals that this system breakdown is becoming a regular occurrence.
"It's not just here," says the source. "The system is unreliable in other hospitals as well. One moment it's working, the next it's slow, and sometimes it's completely down. Patients can still access emergency services, but delays are inevitable for those who need SHA authorisation.”
The billing area is a scene of chaos.
Hundreds of people clutching white papers are milling around the counter, their patience wearing thin.
As frustration mounts, some decide to pay cash to avoid the headache. To prevent the situation from spiralling out of control, the guard manning the entrance allows only one person to enter the area.
Meanwhile, in the mortuary area, other families are feeling the weight of the system's inefficiency.
The family of Frederick Ongalo, for example, has been coming to the hospital for the past week, trying to get permission to bury their loved one. They've made some progress: they've paid Sh89,000 and the SHA has confirmed that it will pay Sh170,000. But it's still not enough.
"If you asked me last Friday, that was my story. But six days later, my life is a constant loop of coming here early in the morning, walking the corridors, waiting for my turn, only to go home and try again the next day," Ongalo tells the Nation.
Back in Kisumu, preparations for the funeral are underway.
The family had planned to remove the body from the mortuary on Friday morning, in time for the burial on Saturday. But now it's uncertain.
"It's a maybe situation now," says Ongalo. "We started this process early to give ourselves time, but the system is failing us. We can't afford to pay in cash. I've seen other families here who have been forced to do just that, just to get clearance and take their loved ones with them.
If his ticket number isn't called by tomorrow, he says, their funeral plans for Saturday will have to be postponed.
The Nation has established that some families, who had originally planned to obtain clearance from the hospital and take their loved ones to a nearby mortuary, have been forced to change course.
Frustrated by the continuing delays in the SHA system, they have decided to leave the body in the hospital morgue and not return until the clearance process has been fully resolved.
A representative of the SHA, who also requested anonymity because he was not in a position to speak on behalf of the authority, acknowledged the ongoing downtime and assured Nation that the issue was being "resolved" after being escalated to the Digital Health Authority.
However, the problem remains unresolved and many people are still unable to access social health services.
The sad revelation comes barely a week after Deputy President Prof Kithure Kindiki acknowledged the hospital's century-long legacy of providing essential health services during a tour of the facility, highlighting key achievements under the UHC initiative, including improved coverage of critical illnesses such as kidney and heart disease, and improved service delivery under the SHA.
"Despite the challenges, KNH continues to lead the way in healthcare delivery. Today's visit demonstrates the government's focus on transforming the health sector as part of our national development agenda," Prof Kindiki said then.
The Deputy President said it is the government's intention to ensure that every Kenyan has access to medical services, noting that it has now been more than two months since the SHA launched registration drives, adding that while the numbers are increasing, they are not good enough.
"Every citizen should register with SHA to benefit from Taifa Care. It offers a superior package as evidenced by the impressive stories of patients, especially those with critical illnesses. For cases such as kidney transplants and heart conditions, patients have personally informed me that the process of accessing services is fast," he said.
However, a report by the Rural and Urban Private Hospitals Association of Kenya (Rupha) painted a bleak picture.
The December report found that 29.3 percent of hospitals reported problems accessing the system, up from 17 percent in November. Technical problems, delayed payments and inadequate training have hampered the functioning of the system.
"The findings reveal stagnation in the SHA transition, with ongoing technical and financial challenges crippling healthcare facilities' operations. Downtime, delays in pre-authorisation and errors require urgent intervention," said Dr Brian Lishenga, chairperson of Rupha.
Despite the government's assurances, growing frustration among patients and providers highlights the urgent need for solutions to stabilise the SHA and restore confidence in Kenya's healthcare system.
