NAIROBI, Kenya – Cancer patients across Kenya are still paying out of pocket for life-saving treatments like chemotherapy and radiotherapy, despite being enrolled in the national health insurance system, a coalition of advocacy groups has revealed.
The Kenyan Network of Cancer Organizations (KENCO) and the Cancer Survivors Association of Kenya (CSA) have raised concerns that private and faith-based hospitals, which are part of the Social Health Authority (SHA) program, are struggling to access the SHA’s new IT system.
This glitch prevents hospitals from verifying patient insurance coverage, forcing them to charge patients directly for treatments.
At least 55 private and faith-based comprehensive cancer centers have been enlisted by the SHA.
However, according to the lobby groups, many facilities report being locked out of the system due to frequent login issues and incomplete patient records.
“Many hospitals are unwilling to risk offering services on credit without being certain that they’ll be reimbursed,” said Phoebe Ongadi, KENCO’s executive director. “Patients are suffering the consequences, as most have fully paid their National Health Insurance Fund (NHIF) premiums, but this isn’t being reflected in the SHA portal.”
The situation has sparked outcry among cancer advocates, as the delays in treatment could prove fatal for many patients.
Cancer is the third leading cause of death in Kenya, with over 44,700 new cases and 29,300 deaths annually.
Prisca Githuka, chairperson of the Cancer Survivors Association, warned that many patients diagnosed in advanced stages rely on immediate treatment for survival.
“The transition to SHA was meant to improve access to care, but it’s only created barriers,” she said.
The advocacy groups are calling on the government to reinstate full access to cancer services at all registered facilities and ensure that no patient is turned away or asked to pay out of pocket.
They are also pushing for the resumption of SHA coverage for overseas cancer treatments, which were previously accessible under NHIF for patients needing specialized care unavailable in Kenya.
“We petition the government to provide transparent information on oncology packages, premiums, and coverage options,” the groups said in a joint statement, emphasizing the need for civil society engagement in public awareness efforts.
The cost of cancer treatment in Kenya remains prohibitively high. A single chemotherapy cycle can cost upwards of KSh30,000, and most patients need at least six cycles.
Radiotherapy, often necessary in addition to chemotherapy, costs at least KSh6,000 per session, with 30 or more sessions required in most cases.
In response to the growing criticism, Medical Services Principal Secretary Harry Kimtai on Tuesday warned healthcare providers that still charge patients for services.
He announced that the government has contracted 7,000 health providers nationwide and would soon publish a list of facilities approved under the SHA program.
“As long as you’ve signed a contract with us, you’re expected to serve Kenyans without discrimination,” Kimtai said.
He also disclosed that the government had recently disbursed KSh1.5 billion to settle outstanding payments and would release an additional KSh3 billion this week, with a commitment to settle all claims within 90 days.
Despite the government’s assurances, KENCO and CSA remain firm in their demand for immediate action to safeguard the lives of cancer patients.
“The delays are putting people’s lives at risk. SHA must act now to prevent further harm,” the groups urged.
The Kenyan Network of Cancer Organizations (KENCO) and the Cancer Survivors Association of Kenya (CSA) have raised concerns that private and faith-based hospitals, which are part of the Social Health Authority (SHA) program, are struggling to access the SHA’s new IT system.
This glitch prevents hospitals from verifying patient insurance coverage, forcing them to charge patients directly for treatments.
At least 55 private and faith-based comprehensive cancer centers have been enlisted by the SHA.
However, according to the lobby groups, many facilities report being locked out of the system due to frequent login issues and incomplete patient records.
“Many hospitals are unwilling to risk offering services on credit without being certain that they’ll be reimbursed,” said Phoebe Ongadi, KENCO’s executive director. “Patients are suffering the consequences, as most have fully paid their National Health Insurance Fund (NHIF) premiums, but this isn’t being reflected in the SHA portal.”
The situation has sparked outcry among cancer advocates, as the delays in treatment could prove fatal for many patients.
Cancer is the third leading cause of death in Kenya, with over 44,700 new cases and 29,300 deaths annually.
Prisca Githuka, chairperson of the Cancer Survivors Association, warned that many patients diagnosed in advanced stages rely on immediate treatment for survival.
“The transition to SHA was meant to improve access to care, but it’s only created barriers,” she said.
The advocacy groups are calling on the government to reinstate full access to cancer services at all registered facilities and ensure that no patient is turned away or asked to pay out of pocket.
They are also pushing for the resumption of SHA coverage for overseas cancer treatments, which were previously accessible under NHIF for patients needing specialized care unavailable in Kenya.
“We petition the government to provide transparent information on oncology packages, premiums, and coverage options,” the groups said in a joint statement, emphasizing the need for civil society engagement in public awareness efforts.
The cost of cancer treatment in Kenya remains prohibitively high. A single chemotherapy cycle can cost upwards of KSh30,000, and most patients need at least six cycles.
Radiotherapy, often necessary in addition to chemotherapy, costs at least KSh6,000 per session, with 30 or more sessions required in most cases.
In response to the growing criticism, Medical Services Principal Secretary Harry Kimtai on Tuesday warned healthcare providers that still charge patients for services.
He announced that the government has contracted 7,000 health providers nationwide and would soon publish a list of facilities approved under the SHA program.
“As long as you’ve signed a contract with us, you’re expected to serve Kenyans without discrimination,” Kimtai said.
He also disclosed that the government had recently disbursed KSh1.5 billion to settle outstanding payments and would release an additional KSh3 billion this week, with a commitment to settle all claims within 90 days.
Despite the government’s assurances, KENCO and CSA remain firm in their demand for immediate action to safeguard the lives of cancer patients.
“The delays are putting people’s lives at risk. SHA must act now to prevent further harm,” the groups urged.
