Funding gaps, debts dominate Kenya Health Summit 2025

KENYA—Kenya’s Healthcare Federation (KHF) has held its inaugural Health Summit 2025, which brought together prominent government leaders and key healthcare stakeholders from across the nation.

The event, held on February 17, was attended by the Deputy President, county governors, and senior officials from the Ministry of Health, providing  an in-depth overview of the progress and challenges facing Kenya’s healthcare sector.

Officials reported that 19.5 million Kenyans have registered under the new Social Health Authority (SHA) scheme, with approximately 4 million individuals transitioning from the previous NHIF registry.

Of these registered individuals, 3.8 million are actively contributing to the scheme, paying an average premium of around Ksh 1,000(US$7.72) in the informal sector and Ksh 880 (US$6.80) overall.

Of the registered individuals, 3.8 million are actively contributing to the scheme, paying an average premium of approximately Ksh 1,000 (US$7.72) in the informal sector and Ksh 880 (US$6.80) overall.

The summit also addressed the necessity of transitioning 8,571 Universal Health Coverage (UHC) staff to county management, a move aimed at decentralizing healthcare services.

Meanwhile, the Kenya Medical Supplies Authority (KEMSA) reported that stock availability is 53%, with a refill rate of 65% following backorders.

However, KEMSA is currently facing cash flow challenges, with total debts amounting to Ksh 6.1 billion owed to counties, the Ministry of Health, and development partners.

Additionally, KEMSA is managing delayed payments to suppliers totaling Ksh 1.8 billion (US$13.89 million).

As of the date of the summit, the pending financial obligations included Ksh 2.43 billion ( US$18.76 million) in unpaid bills, Ksh 2.14 billion (around US$16.52 million) in pending deliveries, and nearly Ksh 4 billion (about US$30.88 million) in awarded tenders.

This brings the total pending obligations to approximately Ksh 8.55 billion (US$66.02 million).

Over 5,665 healthcare devices have already been delivered, with more expected by March 2025.

The Social Health Authority’s Enterprise Resource Planning (ERP) system, including its claims processing engine, is nearing completion and promises to enhance operational efficiency soon.

Counties expressed concerns about the Ksh 12.5 billion (US$96.52 million) in outstanding debts owed collectively by the NHIF and SHA, emphasizing that a significant portion—approximately Ksh 7.5 billion (US$57.91 million)—remains unresolved.

They called for rapid operationalization of funds, such as the Public Health Primary Healthcare Fund and the Emergency, Chronic, and Critical Illnesses Fund, to address these financial gaps.

Another major topic discussed was the withdrawal of U.S. government funding, which the ministry noted affects 41,547 healthcare workers and has created a gap of around Ksh 13.5 billion( US$104.28 million) in HIV commodities.

 Currently, 1.4 million Kenyans living with HIV are on antiretroviral therapy, but reduced funding could potentially lead to 58,495 new infections by 2030.

Other public health concerns include tuberculosis, which results in approximately 23,500 deaths annually (with 20,000 linked to HIV), and malaria, which is responsible for around 12,000 deaths based on 2022 data. 

On a positive note, vaccine and immunization coverage remains robust at 77%, and the country is gradually shifting from donor to government funding.

U.S. contributions currently account for Ksh 24.9 billion (US$192.27 million) of Kenya’s Ksh 79.8 billion (US$616.21 million) healthcare budget.

During the summit, the Cabinet Secretary for Health announced the establishment of a Benefits Advisory Panel and a comprehensive review of healthcare packages.

Improvements include an increase in ICU reimbursement from Ksh 4,480 (US$34.59) to Ksh 28,000 (US$216.22) per day and an enhancement in oncology support, now set at Ksh 550,000 (US$4,247.10) per household annually.

The need for accreditation and contracting with overseas providers was also emphasized, with the current package offering Ksh 500,000 (US$3,861.00) all-inclusive.

County governors called for clearer communication strategies, suggesting a single point of contact within the Ministry of Health to streamline the flow of information.

They also expressed concerns regarding rising teenage pregnancies and recommended biometric verification for schoolchildren to ensure accurate data.

A new means-testing algorithm is in development, designed to integrate data from several government agencies to better tailor insurance premium financing for households with irregular incomes.

Regarding digital health, the Digital Health Authority revealed plans to procure 28 new systems—including ERPs and electronic records management systems—at a total cost of Ksh 104 billion (US$803.08 million).

However, governors stressed the need for greater transparency in claims tracking and requested access to the Social Health Authority’s claims dashboard within two weeks.

The summit concluded with a directive from the Deputy President, who set a firm deadline of February 28, 2025, indicating that all counties must access the claims dashboard and resolve community health promoter allowance issues by then.

An additional Ksh 3 billion (US$23.16 million) will be allocated to both the Emergency, Chronic, and Critical Illnesses Fund and the Primary Healthcare Fund, along with Ksh 1.8 billion (US$13.89 million) for maternity services.

Furthermore, all level 2 and 3 facilities are scheduled to receive internet connectivity within the next quarter, supported by a Ksh 2.8 billion (US$21.62 million) budget.

With 6,821 healthcare providers enrolled—58% from government-run facilities and 42% from the private sector, including 487 faith-based, NGO, and community-based facilities—claims data was also reviewed at the summit.

Since the SHA’s launch, Ksh 21.6 billion (US$166.79 million) out of Ksh 21.8 billion (US$168.33 million) in claims have been verified.

Private facilities submitted higher claims, totaling Ksh 10.5 billion (US$81.08 million), compared to government-run facilities, which submitted Ksh 4.5 billion (US$34.74 million), indicating a need for further training in claims submission for public facilities.