Governors Demand Control Over Health Facilities, Funds Amid Ksh10.3 Billion SHA Deficit
The Council of Governors (CoG) has intensified its push for reforms in Kenya's health sector, citing significant operational challenges due to delays in fund disbursements by the Social Health Authority (SHA). Following the 28th Ordinary Session of the Intergovernmental Budget and Economic Council (IBEC) on Monday, September 29, the governors issued a statement expressing frustration over an outstanding Ksh10.3 billion deficit in verified claims, which the SHA has failed to reimburse to counties since 2024.
The delays have placed considerable strain on county health facilities, forcing them to rely on their own revenue sources or redirect development funds to sustain basic healthcare services. This financial burden has compromised the ability of public health facilities to operate effectively, prompting the governors to demand urgent action from Health Cabinet Secretary Aden Duale.
The CoG has called for the establishment of a structured, transparent, and timely reimbursement framework to ensure the sustainability of county health services. They emphasized that the failure to address these delays could escalate tensions between the national and county governments, potentially jeopardizing national health targets.
In addition to addressing the funding crisis, the governors proposed several reforms to strengthen the health sector. They urged the Ministry of Health to distribute digital tablets to 1,200 Primary Health Care (PHC) facilities nationwide. These tablets would enable real-time claim processing, improving the SHA's responsiveness and reducing administrative bottlenecks. The council also highlighted the need for continuous capacity building for county health officials, many of whom have faced challenges adapting to the SHA's digital claim systems. High rejection rates of claims due to administrative errors have been a recurring issue, which the governors attribute to inadequate training and poor system integration.
Another key demand is for counties to be granted the authority to register health facilities directly, particularly those providing adolescent and maternal care. Currently, the registration process is managed by the national government, leading to significant delays in operationalizing new clinics and maternity wings. The governors argue that decentralizing this process would enhance access to critical healthcare services, especially for adolescents under 18 years.
The CoG's demands come in the wake of recent tensions with the Ministry of Health over the absorption of more than 7,000 Universal Health Coverage (UHC) staff into permanent and pensionable positions. Health Committee Chair and Tharaka Nithi Governor Muthomi Njuki criticized the ministry's decision, arguing that it contradicts prior agreements between the national and county governments. Njuki emphasized that the absorption of staff should only proceed once adequate resources, aligned with the approved Salaries and Remuneration Commission (SRC) scale, are allocated and the transfer of payroll to county governments is finalized.
The governors' latest resolutions underscore the growing friction between the two levels of government over the management of Kenya's health sector. As counties grapple with financial and operational challenges, the CoG has made it clear that swift action from the Ministry of Health is essential to prevent further disruptions in healthcare delivery and to safeguard the country's progress toward universal health coverage.