9 out of 10 patients still pay medical bills out of pocket: Report
A report by the Rural and Urban Private Hospitals Association of Kenya (Rupha) has revealed that nine out of ten Kenyans still pay for medical services out of pocket, despite the government’s launch of the Social Health Insurance Fund (SHIF).
The report, conducted between the 9th and 12th of this month, highlights significant challenges in the rollout of the Social Health Authority (SHA) and SHIF, despite government assurances of comprehensive coverage.
In Kinangop, Nyandarua County, frustrations are mounting as residents struggle with inadequate access to healthcare.
John Mburu, a resident, said, “I lost my grandfather because he couldn’t get treatment. The SHA card didn’t pay for the surgery he needed”.
Another resident, John Gitonga, criticised the system, saying, “When you go to the health centre, there are no services. We are frustrated with SHA and SHIF. Even citizens don’t understand what it is.”
Jane Nderitu also a resident of Kinangop lamented the rising number of deaths in the area.
“The death rate has increased because of this. The health minister should come and see for themselves. Every day, it’s funerals because of this issue,” she said.
The Rupha report, based on data from over 400 health facilities, cited several issues with SHA, including:
– Challenges in registration and patient verification.
– Limited outpatient benefits.
– Insufficient coverage for medications and services.
– Lack of access to covered medications.
While Rupha notes that the SHA online portal has seen improvements, the Ministry of Health has been urged to address these gaps. Key recommendations include streamlining the Patient Verification and Registration process, making the SHA Contact Center accessible for enquiries, reviewing the outpatient funding model and upgrading the SHA portal
Despite the criticisms, the government maintains that SHA and SHIF offer greater benefits compared to the previous National Health Insurance Fund.
“For kidney patients, we now cover Sh21,000 weekly for two dialysis sessions. For cancer, SHA offers testing and treatment, covering over Sh400,000,” Deputy Government Spokesperson Mwanaisha Chidzuga said.
The Ministry of Health reports that over 14 million Kenyans have been registered for SHA, with ongoing campaigns to increase enrolment.
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