Elijah Wachira, the Acting Chief Executive Officer of the Social Health Authority (SHA), has instructed all healthcare providers across the nation to continue utilizing the hospitals’ insurance claims management system for patient admissions and discharges while the new provider portal is under development.
This announcement arrives amid rising concerns for dialysis patients who previously relied on the National Hospital Insurance Fund (NHIF) for critical services at private hospitals.
The transition to the Social Health Insurance Fund (SHIF) has created confusion that threatens the well-being of many Kenyans.
One affected patient, seventy-six-year-old James Kanyori, expressed his frustration while seeking dialysis treatment at a private facility in Nakuru.
Despite his urgent need for the lifesaving procedure, Kanyori faced obstacles as the hospital hesitated to provide care, which was once covered under the now-defunct NHIF scheme.
Lacking the means to pay out of pocket, he left the facility empty-handed.
“I am being told to go find money, but I have no source. I’m a 76-year-old man, and without this service, I will die,” he lamented.
Similarly, Florence Nyandieka, who brought her husband for treatment, struggled to pay the sh. 8,500 required for one dialysis session.
In a desperate bid to cover the costs, she sold two of her goats.
Her husband requires dialysis twice a week, leaving the family in a precarious financial situation.
“I sold my goats, but if this continues, I don’t know what else I will sell; the government is making us suffer!” she said.
The Kenya Renal Association has also voiced concerns over the chaotic implementation of the SHA, indicating that dialysis patients are in a precarious position.
“We urge that the situation be handled with greater sensitivity for our patients,” stated Jonathan Wallah, President of the Kenya Renal Association.
In light of the current difficulties, hospitals are instructed to revert to the previous Hospital Insurance Claims (HIC) system for admitting and discharging patients.
A letter from Wachira to healthcare providers emphasized that this system will remain active during the rollout of the SHA and will operate alongside the forthcoming provider portal, which is intended for claims verification and processing.
The challenges surrounding the SHA rollout were echoed by Treasury Cabinet Secretary John Mbadi, who acknowledged funding shortages impacting the initiative.
“We face challenges in fully supporting this program, but the government has made a deliberate decision to proceed and address these issues as they arise,” he explained.
As uncertainty continues, thousands of dialysis patients anxiously await clarity on how the new SHA health insurance provider will affect their access to essential services.
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