County governments in Kenya have raised serious concerns over the Social Health Authority’s (SHA) handling of healthcare services, warning that delayed reimbursements and unilateral decisions by the Ministry of Health are straining public hospitals and disrupting patient care.
Speaking at a symposium in Naivasha, Council of Governors (CoG) Chair Ahmed Abdullahi, also Wajir Governor, revealed that public hospitals now face a cumulative debt of Sh32 billion due to delayed claims, with counties struggling to sustain services. Abdullahi criticized the Ministry’s unilateral closure, downgrading, or regrading of hospitals, saying, “How do you downgrade my hospital without consulting me?”
Governors warned that upgrading hospitals from Level 5 to Level 6, while intended to improve services, carries financial and operational consequences for counties. Abdullahi emphasized that counties risk losing revenue from premier facilities unless adequately compensated.
Mombasa Governor Abdulswamad Sheriff Nassir added that there is no formal mechanism for appealing rejected claims, leaving counties dependent on central decisions. Titus Munene, CEO of MEDS, noted that counties provide medical supplies even to the most remote facilities, highlighting the extensive resources invested by local governments.
In response, Health Cabinet Secretary Aden Duale said the Ministry is reviewing SHA packages, engaging with cancer patients, survivors, and other stakeholders to ensure sustainable healthcare delivery.
The dispute reflects ongoing tensions between national and county governments over devolved healthcare management, as counties continue to grapple with mounting debts, strained resources, and operational challenges under the SHA framework.
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