Senators Pledge Action Against SHA Over Delayed County Health Funds Amid Nationwide Healthcare Strains
Nyeri, Kenya – In a firm stand against mounting financial hurdles crippling county-level healthcare, members of the Senate Standing Committee on Information, Communication and Technology have vowed to summon the Social Health Authority (SHA) to account for chronic delays in remitting vital health funds to devolved units. The commitment emerged during a recent oversight tour across Meru, Nyeri, and Isiolo counties, where lawmakers scrutinized revenue management systems and uncovered deep-seated issues in fund disbursements that threaten essential medical services nationwide.
The three-day assessment, led by Committee Chair Allan Chesang, zeroed in on Nyeri County's innovative Health Fund and its digital revenue platform, Nyeri Pay. Established under the Nyeri County Health Services Fund Act of 2021, the Health Fund operates independently from the county's own-source revenues to safeguard uninterrupted healthcare delivery. It channels 80 percent of generated health revenues back to local facilities, with the remaining 20 percent supporting Levels 1 through 4 hospitals. A dedicated oversight committee, chaired by the head of the county's Level 5 Hospital, ensures transparency and prevents commingling with other budgets. This pre-SHA mechanism has proven resilient, but national bottlenecks are now exposing its vulnerabilities.
Nyeri Governor Mutahi Kahiga laid bare the dire consequences of the delays during the committee's visit. He explained that collections under the Health Fund funnel into a single account to streamline processes and curb holdups, yet SHA's sluggish payouts have left the county in a bind. Specifically, SHA owes Nyeri Sh230 million, while the legacy National Health Insurance Fund (NHIF) still holds back Sh289 million in arrears. These shortfalls have forced hospitals to postpone procurement of critical drugs and supplies, halting routine operations and leaving patients in limbo. Kahiga highlighted a particularly harsh ripple effect: county employees face ongoing payroll deductions for health contributions, only to be denied coverage when claims falter, creating what he termed "double jeopardy." He called on the National Treasury to introduce waivers, enabling staff to access care despite the logjam.
The situation in Nyeri underscores broader national woes tied to SHA's rollout following the NHIF's dissolution. Under the Social Health Insurance Fund (SHIF) Regulations of 2025, verifiable claims must clear within 90 days, but actual payouts occur monthly on the 14th. Documentation pitfalls plague the process, with claims often rejected for lacking signatures, featuring erroneous patient data, or missing complete medical records. Providers, in turn, delay resubmissions, exacerbating backlogs. SHA's current settlement rate hovers at a modest 59 percent overall: faith-based facilities lead at 64.56 percent, followed by national referral hospitals at 61.71 percent, county hospitals at 59.62 percent, and private providers at 56.55 percent. These figures paint a picture of inefficiency that cascades into everyday hardships, from stockouts in rural dispensaries to overburdened urban clinics.
Committee Chair Chesang did not mince words on the urgency. After probing Nyeri's systems, he declared that the panel's immediate post-tour priority would be to "push SHA until they start paying counties." He framed the matter as a collective national crisis demanding swift resolution, assuring Governor Kahiga of the committee's full backing. Chesang also pressed for distinctions between the Health Fund and general own-source revenues, emphasizing that such clarity could unlock smoother integrations.
Fellow senators echoed the call to action with pointed critiques and solutions. Nominated Senator Beatrice Ogolla praised Nyeri's ring-fencing of health funds as a model for fiscal discipline but warned that sustainable progress hinges on "an intention to hire the right people with the right skills." She advocated for robust capacity-building initiatives to equip local teams for digital and administrative demands. Nominated Senator Miraj Abdillahi flagged a practical oversight: revenue systems must withstand power outages to avoid disruptions in service continuity. Nyeri Senator Wahome Wamatinga zeroed in on a technical snag plaguing Nyeri Pay, the county's digital collection tool launched in April 2018 for Sh16.9 million. This platform catapulted annual revenues from Sh600 million in fiscal year 2018/2019 to Sh1.45 billion, but its vendor contract ended in March 2025 amid operational glitches. A ensuing court battle over source code access has stalled integration with the Integrated Financial Management Information System (IFMIS), leaving the county hamstrung. Wamatinga urged Nyeri's legal team to weave this access denial into their suit, arguing it undermines full system sovereignty.
On the national front, Health Cabinet Secretary Aden Duale recently fielded similar concerns before the National Assembly's Health Committee, defending SHA's framework while outlining corrective strides. He attributed most delays to procedural lapses, insisting that "verification and adjudication are mandatory before any payout." To tackle the pileup, SHA has kicked off a sweeping arrears verification drive and rolled out sensitisation sessions for providers on proper claim filing. The authority has onboarded nine case management officers, with ambitions to scale to 15 headquarters staff, 47 county-level claims managers, and an equal number of quality assurance specialists. Relationship managers now oversee claims at county and national tiers, tracking progress end-to-end.
Duale spotlighted early wins under SHIF, including Sh79.2 billion collected via user-friendly tools like the "Lipa Pole Pole" installment payment platform. He addressed perceptions of bias in reimbursements, noting that private hospitals often receive higher rates due to their broader service scopes, advanced specializations, and superior documentation, not preferential treatment. To bolster access and affordability, the government has forged alliances with key players: Aga Khan University Hospital and Nairobi Hospital for expanded specialized services, alongside pharmaceutical giants Roche, Pfizer, and Johnson & Johnson to slash treatment costs. Duale affirmed ongoing dialogues with the Council of Governors to furnish bank details for expedited transfers, vowing a "transparent, efficient, and equitable" path to universal health coverage.
Nyeri's fiscal profile adds context to these battles. The county draws Sh6.5 billion in equitable share allocations from the national government for fiscal year 2024/25, with the Commission on Revenue Allocation pegging its untapped potential at Sh4.3 billion. It manages 54 revenue streams across ten departments through three bank accounts, backed by ten ICT personnel. All sub-counties link via a wide-area network equipped with backup generators, yet the vendor dispute and SHA delays cast long shadows over this progress. Governor Kahiga noted steady revenue climbs but lamented persistent integration barriers, reinforcing his push for judicial relief on the source code front.
As the Senate committee compiles its findings, the stakes could not be higher. Delayed funds not only strain county budgets but erode public trust in Kenya's devolved health architecture, potentially derailing the SHIF's promise of inclusive care. Lawmakers' resolve signals a potential turning point, but execution will test whether vows translate into tangible relief for frontline facilities and the millions they serve. With partnerships blooming and staffing ramping up, the coming months could redefine resilience in Kenya's healthcare landscape, provided accountability keeps pace with ambition.