Chaos persisted for the second day as systems deployed to support the new Social Health Insurance Fund (SHIF) failed, leaving thousands of patients across the county stranded.
The government disabled the National Health Insurance Fund (NHIF) system on Tuesday and ordered all medical providers and patients to migrate to the SHIF.
However, hitches with the SHIF system saw many patients locked out of services with the Social Health Authority (SHA) that oversees the scheme apologising over the chaos.
Acting SHA chief executive officer Elijah Wachira said the SHIF claims processing system stalled after biometrics failed.
A technical team set up by the SHA’s transition committee to implement the digital shift to SHIF had two weeks ago revealed gaps in the scheme’s Claims Management System (CMS) and warned that it may hamper a smooth transition from the old NHIF.
Many new mothers were on Wednesday unable to leave maternity wards because their NHIF cards had been disabled and they were unable to afford their bills after discharge.
At the Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) in Kisumu, tens of patients were stranded.
In the dimly lit corridors of JOOTRH, a patient, Rose Joan Auma on Wednesday sat motionless, her face twisted in pain as she waited for surgery on her swollen jaw. Her surgery was scheduled days ago, but without a functioning health insurance system, she remains hopeless.
“I haven’t eaten for two days. They keep saying I’ll go into surgery, but nothing happens” she said.
Similar chaos played at the Murang’a Level Four Hospital with tens caught in long queues and being asked to pay cash for services.
Bill Muriuki, the secretary general of KMPDU Central Branch said that the SHIF rollout has faced significant challenges due to a lack of clarity in both its structure and implementation.
According to the staff at JOOTRH, who are not authorised to officially speak to the media, the new system has not been working since October 1 and resulted in delays in admissions, treatment, and discharge of patients.
“A number of our patients have been crowded at the billing department while some have been forced to pay from their pockets,” said an official.
“I am here to settle the bill for my wife who has given birth. I thought I was home and dry by having an up-to-date NHIF card but I have been told that it is now meaningless. I have to pay the Sh32,000 bill,” said Shadrach Muema, a 43-year-old patient at Murang’a Level Four Hospital.
“One of the most critical issues is the absence of clear contractual agreements between SHIF and healthcare facilities as many administrators, who are our members, have raised concerns about who will reimburse their facilities, given that SHA has yet to officially recognize or contract with these institutions” he said.
By Linet Owoko, Angela Oketch, Angeline Ochieng, Leon Lidigu
