The Ministry of Health has challenged county governments to enter into public private partnerships so as to benefit more from the Social Health Authority (SHA) funds.
Medical Services Principal Secretary Harry Kimtai said billions of shillings in claims are often made by private hospitals since many people prefer them because of quality services offered as compared by the public hospitals.
The Fifth Nation Digital Summit
Speaking at the 5th Nation Digital Summit in Kwale County on Thursday February 20, Mr Kimtai stated that out of Sh16 billion released to hospitals recently, Sh11 billion were claims by private facilities while the rest went to public institutions.
“This shows that many people prefer private hospitals because people will always go where they can get quality services,” he said.
The Summit is organised by Nation Media Group, and this year’s theme is Shaping Africa’s Future for Sustainable Prosperity.
Murang’a Governor Irungu Kang'ata expressed the challenges encountered under the new Social Health Insurance Fund (Shif) system which replaced the National Health Insurance Fund (NHIF).
At his county, residents were enrolled into the Kang’ata care programme through which the county facilitated payment of treatment at public hospitals then claimed funds from NHIF.
The Chairman, Nation Media Group Dr. Wilfred Kiboro during the 5th Nation Digital Summit in Diani in this photo taken on 20th February 2025.
Photo credit: Kevin Odit/ Nation Media Group
However, the governor said since the establishment of Shif, the programme has run into several challenges affecting its intended objectives of free healthcare to the masses.
For instance, he said the modality whereby SHA allows people to only pay one month's contribution then access services has left the county at a loss.
“NHIF used to tell people to pay three months' contributions in order to access benefits but Sha allows one month contribution. This means that once a person pays for the one month, they get services but when the county goes to make a claim it's found that the person's account is inactive so we cannot be paid,” he said.
Another challenge he stated is that under NHIF, they used to contribute Sh500 per person but now the county has to pay Sh700 per person under Shif.
Dr Kang'ata said this has caused extra expenses that have even drawn the attraction of private insurers who can offer the same service at a lower cost.
He however expressed optimism that the Ministry will soon sort out the challenges encountered so far, including stability issues of the portal.
“The money we're getting from Sha is little compared to NHIF. We suffer in restocking medicine and other medical requirements. I hope these are teething problems and the national government, as time goes by, they'll sort out these issues,” he said.
PS Kimtai gave an assurance that the government already took note of the issues and most of them are already being sorted out.
On the issue of the portal stability, he explained that it was being rolled out in phases but the rollout will soon be complete and it's speed is going to increase by the end of the month.
He also disclosed that the time taken for approvals is going to be minimised as doctors will be allowed to authorise payments.
“Under NHIF we had many doctors in terms of human resource. They would make a request and this would go to the system, get reviewed and given a go ahead. This is changing; the doctor will authorise and at the Sha level we'll only need to audit. Immediately a request is made it takes no more than 30 minutes. We'll be more meticulous at the level of processing claims.
“For instance we used to have many claims of knee surgeries but now we'll ask, how many knee surgeries can you do in a day,” he stated.
The PS added that the government intends to digitise all public health facilities by September 30, in order to enhance efficiency.
