One week after the government began rolling out the Social Health Insurance Fund (SHIF), chronically ill patients are still being turned away from health facilities for lacking insurance.
Meanwhile, the Kenya Union of Clinical Officers (Kuco) raised concerns that their members working in public hospitals have not been paid since July, with some even sleeping at work and eating with patients. The union criticized the SHIF rollout, calling it chaotic and disorganized. Kuco Secretary General George Gibore expressed frustration with the working conditions of intern clinical officers across the country.
“As the transition from NHIF to SHIF unfolds, clinical officers – who provide over 70 percent of all clinical services in Kenya – remain indispensable to our healthcare system,” Gibore stated.
He also criticized the Social Health Authority (SHA) for not following proper procedures and undermining the foundation of healthcare delivery, as well as violating the Social Health Insurance Act. According to Section 32(2) of the Act, healthcare providers or facilities wishing to work with SHA must apply through the relevant accreditation body. Part V (3) of the social health regulations stipulates that SHA must list all licensed and certified healthcare providers and facilities submitted by the accreditation body to ensure quality of care.
However, Gibore pointed out that despite this legal framework, SHIF, in collaboration with the Ministry of Health, started operations without first onboarding clinical officers and facilities accredited by the Clinical Officers Council.
“This unlawful oversight has left clinical officers and their facilities in limbo, effectively sidelining over 1,000 healthcare facilities owned by clinical officers, including 834 facilities that were already serving Kenyans under the NHIF scheme,” he said.
He added that this exclusion is causing a breakdown in healthcare services, depriving Kenyans of access to care, and exposing patients to unnecessary suffering.
Clinical officers have raised the issue with the Principal Secretary for Medical Services, who instructed SHA to empanel healthcare providers and facilities registered under the Training, Registration, and Licensing Act, No. 20 of 2017.
“Despite our efforts – such as holding meetings with SHA in August and following up with written communication on 10th September – the situation remains unresolved,” Gibore added.
“SHA’s continued negligence raises serious questions about its commitment to ensuring that Kenyans have access to vital healthcare services,” Gibore stated.
He added that the situation had worsened, highlighting the plight of clinical officer interns who were posted for internships on April 1 but had not received their stipends or medical cover. This, he said, had pushed many interns into degrading conditions, such as sleeping in hospital wards alongside patients and relying on meals intended for patients.
“Some interns are left to depend on their families, well-wishers, or fundraising efforts to cover medical expenses, despite working 11-hour shifts, seven days a week,” he lamented.
Meanwhile, BSc clinical officer interns, who began their internships two months ago, were in a state of uncertainty. They were posted without formal terms, pending a court ruling expected on 17 October. These interns, along with others in healthcare, represent 27 percent of the workforce.
“Failing to support them is not only detrimental to their well-being but also jeopardizes Kenya’s ability to meet its healthcare obligations and achieve Universal Health Coverage,” Gibore emphasized.
Additionally, the Non-Communicable Diseases Alliance (NCDA) has urged the government to revise the cost of dialysis and other expenses related to managing chronic illnesses. Some NCDA members suffering from chronic kidney failure had faced difficulty accessing services, particularly dialysis, at hospitals.
“They are experiencing major challenges, and some of the private hospitals they have visited for services have asked them to top up so that they can be attended to,” said Gideon Ayodo, the programme manager, during a media sensitization workshop in Nairobi.
