Dialysis patients bear brunt of chaotic transition to SHA

Kenya Medical Practitioners Pharmacists and Dentists Union led by Secretary General Davji Atella address the Press on the rollout of Social Health Authority in Nairobi on October 2, 2024. [Collins Oduor, Nairobi]

Patients requiring life-saving procedures in both private facilities and some public hospitals are facing uncertainty due to confusion surrounding the transition to the Social Health Insurance Fund (SHIF).

Reports indicate that private facilities remain wary of SHIF reimbursements, leading many to demand cash payments for dialysis during the transition period.

On Wednesday, several patients across the country reported being forced to pay out of pocket, citing unanswered questions about SHIF.

However, Health Committee Chairperson Robert Pukose assured the National Assembly that no one would be denied services, claiming the transition has been seamless.

Pukose’s remarks followed a query from Funyula MP Oundo Ojiambo, who sought assurance that Kenyans holding NHIF cards would continue receiving services during the transition to SHIF.

Meanwhile, many Kenyans received messages confirming their NHIF details had been successfully transferred to SHIF, but an SMS service requesting profile updates was reportedly inactive, adding to the confusion.

In Nakuru, dialysis patients complained that they were forced to pay for services in cash, despite their consistent NHIF contributions.

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Aggrieved patients gathered at Nakuru’s Nyayo Gardens to express their dissatisfaction, stating that the rollout had not been smooth.

Ruth Moraa shared her shock when her teenage daughter, scheduled for a dialysis session at a private facility, was asked to pay cash.

“I don’t have the money. I took her to Nakuru Level Five Hospital, hoping she would be attended to. There too, I was asked to pay Sh9,500 for the session,” Moraa said.

She explained that the dialysis session was crucial for her daughter’s well-being, and the denial of services left her emotionally devastated.

“I had to borrow money for transport. After failing to be served in two hospitals, my daughter asked if she was going to die. I encouraged her, but my heart is shattered,” she added.

Moraa noted that her daughter was initially receiving treatment under the EDU-Afya comprehensive cover, which had since been discontinued. “The transition from EDU-Afya to NHIF was smooth. The government should have handled SHIF similarly instead of leaving patients in agony without notice,” she said.

Anthony Njui, another patient, explained that he requires two dialysis sessions a week, but paying for them in cash is impossible. “I’ve relied on NHIF because I can’t afford the service out of pocket. Asking me to pay Sh9,500 per session feels like a death sentence,” Njui lamented.

He added that he was registered at a private hospital under NHIF due to congestion at Nakuru Level Five Hospital’s renal unit.

“I can already feel my UREA levels are too high, and I urgently need dialysis. The hospitals say they’re still waiting for formal communication from the government,” said Njui.

Jeremiah Waweru expressed frustration after being asked to pay for lab services related to dialysis in cash at both public and private hospitals.

“My usual private hospital refused to accept NHIF or SHIF. It was the same at Nakuru Level Five Hospital, though cheaper at Sh6,800, which I didn’t have,” Waweru said.

He added that the transition had caught patients unprepared, even though he had paid NHIF premiums until December 2024. “I didn’t expect to be denied services. Everything was fine under NHIF. The transition should have been better planned. Who do I turn to for these huge payments?” Waweru questioned.

David Maguta, another patient, said he had paid his NHIF premiums through February 2025 but could no longer access services. “What will happen to my money? When will the government clearly communicate to hospitals? In Nakuru, private hospitals handle the majority of dialysis patients, and this disruption is a threat to many lives,” said Maguta.

Nakuru County Director for Health, Administration, and Planning, Dr. Joy Mugambi, explained that only two hospitals in the county are equipped for dialysis and are fully booked.

“We have 17 dialysis machines at Nakuru Level Five Hospital and three machines at Naivasha Level Four Hospital. At Nakuru, we can offer 116 sessions per week,” Dr. Mugambi said.

He acknowledged that the SHIF rollout had resulted in an influx of dialysis patients from private hospitals, overstretching public facilities. “No services have been affected for patients scheduled under NHIF. However, those coming from private facilities are being onboarded gradually depending on availability,” Mugambi noted.

In Laikipia, Governor Joshua Irungu directed all county health facilities to continue providing healthcare services during the SHIF transition. During a visit to the County Referral Hospital in Nyahururu, Irungu assessed the hospital’s readiness for the transition.

“We want to assure all patients seeking healthcare services that we will continue to serve them, regardless of their registration status with SHIF,” Irungu said.

In Nyanza, patients at the Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) were able to access services, though some had to pay out of pocket. Several private hospitals in the region also reported not accepting NHIF cards.

A parent at Kisumu’s Doctors Plaza said the facility informed him that they were not accepting NHIF or SHIF. “My daughter was not treated because the facility doesn’t accept NHIF or SHIF,” said Moses Ouko.

Meanwhile, doctors in West Pokot County have threatened to strike next week over grievances, including delayed promotions and poor terms for contracted health workers.

The Kenya Medical Practitioners and Dentists Union (KMPDU) issued a seven-day strike notice, giving the county until October 7, 2024, to address their concerns.

KMPDU North Rift Secretary General, Dr. Kamonzi Mulei, called on the county to meet the doctors’ demands. He claimed that the county had delayed the implementation of agreements signed in July 2017, March 2024, and May 2024.

Governor Simon Kachapin acknowledged the strike notice, stating that efforts were underway to resolve the matter. “We are addressing the promotion issue, and I’m hopeful we will find a resolution,” Kachapin said.

Reports by Kennedy Gachuhi, James Munyeki, Irrisheel Shanzu and James Omoro