County leaders have expressed growing frustration over the management of healthcare services under the Social Health Authority (SHA), accusing the Ministry of Health of taking over functions that should be handled at the county level.
The Council of Governors (CoG) says delayed payments of claims have left public hospitals with a cumulative debt of Sh32 billion, undermining service delivery and straining county resources.
Addressing participants at a symposium in Naivasha focused on the Affordable Housing Programme and SHA, CoG Chairman and Wajir Governor Ahmed Abdullahi criticised the Health Ministry and Cabinet Secretary Aden Duale for what he described as excessive interference in county healthcare operations.
“Indiscriminate and unilateral closure of hospitals and downgrading of the same… since SHA, MoH Afya House has become too powerful. It’s like they are running our hospitals from Afya House. Downgrading, regrading… how do you downgrade my hospital without talking to me?” Abdullahi said, highlighting the disconnect between national and county management.
The governors argue that decisions such as upgrading hospitals from Level 5 to Level 6, though aimed at improving care, are being implemented without county involvement, creating financial and operational difficulties.
Abdullahi stressed that counties rely on local revenue from hospital services to fund further healthcare infrastructure, warning that centralising these facilities could hurt funding and planning.
“Literally, it means counties are being asked to hand over their hospitals. It would be nice if we value these hospitals and they give us the money so that we can construct more hospitals, because according to Article 209, own-source revenue comes from user levies and the services you provide. So if your premier facility is taken from you, it has consequences on own-source revenue,” he said.
Another pressing issue raised by the CoG is the slow processing of claims, which Abdullahi says is demoralising hospital staff who have provided services but see their payments denied over minor or unclear reasons.
“It is very demotivating for our staff when they have actually provided service and the claims they have logged in are being rejected under very flimsy reasons,” Abdullahi added.
Mombasa Governor Abdulswamad Sheriff Nassir highlighted the absence of a clear mechanism for addressing rejected claims. “If something is rejected right now, there is no follow-up mechanism. That means there is no appeal. So we depend on one person or a group of people to make a decision,” he said.
Responding from a separate engagement in Nairobi, CS Aden Duale noted that the Ministry of Health is reviewing benefit packages under the SHA. “We have listened to cancer survivors, cancer patients, parents, and leaders.
So there is something we are doing in line with the benefit and advisory panel, and we want to get feedback from you all on how we can make sure we have a more sustainable healthcare delivery for our citizens,” he said.
