Governors push for NHIF-KEMSA debt swap

Governors are now raising an alarm over a crisis threatening healthcare delivery across the country, accusing the Social Health Authority (SHA) of delaying the remittance of billions of shillings owed to county health facilities.
The revelations emerged during a Senate Public Investments and Special Funds Committee meeting with Makueni Governor Mutula Kilonzo Jr, who painted a grim picture of how the delays in the remittance of the funds are affecting service delivery in the devolved units.
The governor further warned that shortages in drugs, staff, and equipment are undermining efforts to roll out Universal Health Coverage (UHC).
“The health function has not been properly costed, and that is why we have budgetary challenges,” he said.
In Makueni, 38 per cent of the county’s total budget is allocated to health. Of the county’s 3,900 workers, 2,200 serve in the health department.
“I have 242 health facilities in Makueni. Out of that, about 150 have only one nurse, one nurse attending to over 2,000 patients every month,” he said.
The situation is mirrored across the country, with many counties suffering acute shortages of nurses, medical officers, and specialists such as neurosurgeons.
With Kemsa unable to consistently supply essential medical commodities, counties have turned to private suppliers to keep hospitals running.
The committee, chaired by Vihiga Senator Godfrey Osotsi, has now resolved to summon the newly appointed SHA Chief Executive Officer (CEO), Dr Mercy Mwangangi, to appear before it.
The development comes amid mounting pressure from governors, who want the outstanding remittances from the defunct National Hospital Insurance Fund (NHIF)— now rebranded as SHA—to be offset against the debt counties owe the Kenya Medical Supplies Authority (Kemsa).
Governor Mutula, who chairs the Council of Governors’ Legal Affairs Committee, revealed that SHA owes counties more than Ksh9 billion, a debt inherited from the defunct NHIF.
“We are proposing a debt swap. Let the money that NHIF or SHA owes the facilities be given to Kemsa so that services are not interrupted,” proposed Mutula.