Kenya’s Healthcare System in Financial ICU: Can It Survive the Funding Crisis?

Kenya’s Healthcare System Struggles Amid Mounting Debt and Funding Concerns.

Kenya’s healthcare system is facing significant financial challenges as government ministries accumulate massive debts and health service providers struggle with inconsistent funding.The Ministry of Health has acknowledged the crisis and is working with the Treasury to clear arrears, but concerns remain over whether these efforts will be enough to stabilize healthcare services across the country.

SHA Struggles with Low Contributions.

One of the biggest challenges facing the Social Health Authority (SHA) is the low rate of contributions from registered Kenyans. Out of the 19 million enrolled members, only 4 million make their monthly payments. The Ministry of Health has noted that informal sector workers are shouldering most of the burden, urging all registered members to undergo means testing to ensure fair contributions.

Government Ministries Deep in Debt.

The financial strain extends beyond SHA, with several government ministries owing billions in unpaid healthcare costs: – Ministry of Public Service– Sh15.5 billion, including Sh3 billion for civil servants’ medical cover and Sh12 billionunder the Workman Injury Benefit Act (WIBA). – Ministry of Health–Sh8 billion in unpaid services under programs such as Linda Mama, Primary Health Care, and emergency and chronic illness services. – Ministry of Interior and National Coordination– Sh1.6 billion in unpaid premiums for National Police Service officers.

WIBA Claims Under Scrutiny.

Lawmakers have raised concerns about the legitimacy of Sh12 billion in WIBA claims, with reports showing that Sh3.9 billion was processed before April 2021 without formal contracts. SHA Acting CEO Robert Ingasira admitted that these claims were handled based on informal agreements between NHIF and state departments. Documents presented to a parliamentary committee led by Robert Pukose revealed that NHIF only formalized WIBA contracts with two state departments in April 2021. NHIF also subcontracted co-insurers, including Jubilee and Britam, with Sh8.1 billion** still owed to insurers. MPs Demand Clarity on NHIF’s Financial Standing.

Members of Parliament have questioned NHIF’s financial obligations, with Seme MP James Nyikal asking whether NHIF is owed money or if it owes service providers. Nandi Woman Representative Cynthia Muge sought clarity on whether the outstanding amount is a government debt to SHA/NHIF or NHIF’s debt to service providers. Nyeri Town MP Duncan Mathenge challenged the classification of Sh3.9 billion in WIBA claims as NHIF debt, arguing that since civil servants submitted claims directly to the Ministry of Public Service, and NHIF had no contract or financial transactions with the ministry, the amount should not appear in NHIF’s accounts.

Uncertainty Over the Future of Healthcare Services Under WIBA, NHIF provides group life cover, WIBA benefits, and accident insurance for police officers, with compensation structured as salary continuation or lump sums based on an employee’s annual salary. Workers with permanent disabilities receive one year’s salary multiplied by the awarded disability percentage, while officers who die, fall ill, or are injured in work-related incidents are entitled to compensation of up to eight years’ gross salary.

With the Ministry of Health and the Treasury working to clear outstanding debts, the focus now shifts to whether these efforts will stabilize healthcare facilities or if further financial turmoil lies ahead. Will these measures be enough to ensure uninterrupted healthcare services? The coming months will be critical in determining the future of Kenya’s health sector.