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Rural hospitals demand two-year phased transition to SHIF

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The Rural Private Hospitals Association of Kenya chairman Brian Lishenga.

Photo credit: File | Nation Media Group

The Rural and Urban Private Hospitals Association of Kenya (RUPHA) now wants the national government to implement a two-year phased transition period to allow the formalization of primary care networks and a smooth transition of the Social Health Insurance Fund.

This comes a day after a three-judge bench ruled the Social Health Insurance Act (SHA) unconstitutional and later gave a stay of their ruling for a further 45 days.

RUPHA has accused the government of rushing the transition process which has created loopholes in the health sector.

So far they say at least Sh29 billion has accrued in historical hospital debt as well as Sh6.9 billion frozen in the National Hospital Insurance Fund (NHIF).

The reduced NHIF contributions have also raised several concerns as providers say they are falling into debt.

The association, through its chairman, Dr Brian Lishenga, on Saturday, July 13, said several health facilities lack sufficient drugs to offer sufficient healthcare to Kenyans.

 “There are still unpaid dues from the National Hospital Insurance Fund to health facilities. The effect of these catastrophic scenarios is that the health sector is sinking. We have no drugs, we have fallen back many months on rents and salaries for our employees and our businesses routinely grace auctioneers listing in the dailies. Kenya is sick,” said Dr Lishenga

The expiry of the contract between healthcare providers and the NHIF which lapsed on June 30,  2024, has left the Ministry of Health clutching at straws trying to extend an extension of the contract for three more months.

“Providers were expecting a new contract with the Social Health Authority (SHA) incorporating new terms and conditions and better reimbursements. We oppose unilateral contracting as it ultimately harms patients when hospitals cannot bear the burden of one-sided contracts,” said Dr Lishenga.

With the anticipated transitions, 140 healthcare facilities across the country have been reported to be unable to offer services due to a lack of contracts from the National Hospital Insurance Fund and the Social Health Act board.

This means Kenyans are still unable to get treatments such as renal dialysis, cancer treatment and care as well as some facilities are still not able to utilise their theatres.

They are demanding renewal and re-negotiation of contracts under the National Hospital Insurance Fund for two years with new benefits and tariffs. “We want the NHIF board to immediately also issue contracts to over 140 new healthcare facilities and approve others to offer expanded services such as renal dialysis, cancer treatment and surgery,” said Dr Lishenga.

The Rural-Urban Private Hospital Association of Kenya is also demanding all state agencies owing money to the NHIF to release the money so that the fund can be able to make the necessary payments to its providers.

They also want the abolishment of private health schemes like police and teacher’s medical schemes and to redirect all resources to the National Hospital Insurance Fund to alleviate the financial strain.

They believe the above measures will help stabilise the health sector and smooth service delivery in healthcare.