Patients face barriers to accessing level 4, 5, and 6 facilities due to SHA regulations

Nearly a month after the government rolled out the new Social Health Authority (SHA) healthcare system, complaints continue to abound among health seekers across the country.

The Primary Health Care Act, which stipulates that patients must seek care at dispensaries and health centres before being referred to higher facilities, has been termed a stumbling block. Many of these facilities are in poor condition and lack essential services.

At Bokimai Level 2 facility in Kisii County. Esnah Ambela carries her baby as she navigates a steep hill in search of healthcare services, only to face a rude shock at the dispensary: there are no medicines.

Although the Tabata Mission Hospital is better equipped to provide the services she needs, SHA regulations bar her from visiting a facility of her choice for treatment.

The Primary Health Care Act requires that all primary healthcare be sought at Level 2 and 3 facilities before a referral can be obtained. Unfortunately, these so-called Level 2 and 3 facilities are poorly equipped.

"Ukienda hospitali hakuna madawa. Ukienda hospitali kubwa unaambiwa urudi hizi hospitali ndogo ndogo ndio utumwe hio kubwa....hizi ndogo madawa hakuna," Ambela told Citizen TV.

"Hii SHA imekuja hata hatuelewi mahali tutaanzia. Tukikuja hapa hakuna madawa; tunataka services zilitwe hapa," Grace Mukami, another Bokimai resident, said.

Nurses we spoke to, whose identities we cannot reveal, reported receiving gadgets for patient registration, but the facilities are not connected to the national power grid and lack internet connectivity.

They also mentioned that they had not received any training on how to assist patients with registration. For Ambela, the inconvenience is twofold: not only must she bypass better facilities closer to home because they won’t treat her without a referral, but her preferred hospital also requires a peculiar document for registration.

“Patients are stranded; they are told to pay for medicine instead of SHA covering it as it should. We appeal to the government: instead of focusing on Gachagua’s impeachment, let them address SHA issues. Patients are suffering," Samuel Koros, a Kaptaket resident, said.

Festus Korir, another resident, is another frustrated man. His father, who was admitted to Kapkatet Level 4 Hospital, was discharged three days ago, but they are unable to process his discharge.

Despite Mzee Korior being up-to-date with his SHIF contributions, the system fails to reflect his details, and the family is increasingly worried they may have to pay the 100,000 hospital bill in cash.

"We are having a lot of trouble with SHA. It’s difficult to register; the system rejects us. We were sent to a cyber café and told the registration was successful, but when we come here, it doesn’t show in the system," he said.

The government is currently in a standoff with faith-based organizations and other private facilities over the referral system clause, which they argue denies patients the right to choose where they want to seek health services.