Governor Kihika: NHIF-SHIF Transition Strains Healthcare Delivery in Nakuru County

The technical and policy challenges experienced during the transfer and implementation of the National Hospital Insurance Fund (NHIF) and specifically the Linda Mama program to the Social Health Insurance Fund (SHIF) have affected the quality of healthcare service delivery in Nakuru County.

Launched in 2013 under former President Uhuru Kenyatta, Linda Mama program was designed to address high maternal mortality rates linked to poverty by providing free maternity services in public health facilities, with the government reimbursing registered hospitals later.

As of last week, the government owed hospitals over Sh30 billion in unpaid NHIF claims, worsened by delays and low reimbursement rates during the migration to SHIF. To build trust, Sh1.5 billion has been paid, with remaining payments to follow based on fund availability.

According to Governor Susan Kihika, these challenges have restricted revenue flow for hospitals, straining resources and affecting the availability of essential services and drugs, particularly at Nakuru’s Level 5 Hospital, the county’s main referral center, and other lower-level facilities.

“Due to NHIF and Linda Mama delays, and in an effort to counter these challenges, we are more reliant than ever on buffer stock to meet the needs of our patients,” said Governor Kihika while flagging off a consignment of medical supplies valued at Sh21,266,982 from the Kenya Medical Supplies Agency (KEMSA).

The consignment, including essential pharmaceuticals for 216 public facilities ranging from Level 2 to Level 4 hospitals, represents 92 percent of the first-quarter order for the 2024/25 fiscal year, ensuring health facilities remain stocked with critical medicines.

Seventy-five percent of the drugs will be delivered to each hospital, while the remaining 25 percent will constitute the county buffer stock, which cushions health facilities from supply chain shocks before the next order is processed. The buffer stock now supports Level 5 and other county facilities affected by funding shortfalls.

To ensure a continuous supply of medicines, the county is expecting another consignment of drugs from the Mission for Essential Drugs and Supplies (MEDS) worth Sh22,082,528 to be delivered within 2 to 3 weeks. These drugs are for use in Quarter II-from October to December.

For transparency and accountability, the Governor stated that each delivery is labeled for its respective facility, and all staff are required to update stock control cards to track every item. Non-pharmaceuticals valued at Ksh30,670,558 have also been secured for the upcoming festive season, a time when road traffic accidents typically surge, further straining medical resources.

To promote rational medicine use, the Governor explained that certain essential medicines are primarily available at Level 4 hospitals that offer advanced diagnostic services to manage complex conditions effectively, as per government policy. The essential medicine list outlines the medications deemed necessary for basic healthcare services.

“Everyone must be aware of this system to access the appropriate level of care when seeking medical assistance, ensuring that patients receive the treatments they require without unnecessary delays or complications,” she noted while stressing her government’s unwavering undertaking to ensure the availability of health products.

To bolster preventive health efforts, the Governor revealed that the Department of Health is procuring various vaccines and antidotes valued at Sh2,449,972. These include the yellow fever vaccine for international travelers and snake antivenom for managing snake bites.

Suleiman Mbatia
Author: Suleiman Mbatia

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