Mercy Mwangangi to face Senate over Sh9 billion SHA debt to counties

The Senate has moved to hold the Social Health Authority (SHA) to account over delayed payments amounting to billions of shillings owed to county health facilities, delays that are now threatening to paralyse healthcare services across the country.

The Senate Public Investments and Special Funds Committee has resolved to summon SHA Chief Executive Officer Mercy Mwangangi to explain the authority’s failure to settle the arrears inherited from the now-defunct National Hospital Insurance Fund (NHIF).

The committee wants a clear breakdown of the outstanding balances, a payment schedule, and the current status of remittances to all 47 counties.

“This committee will invite the SHA CEO to provide a status report, payment schedule and balances to all county hospitals,” said committee vice chairperson Eddy Oketch.

Governors have intensified pressure on SHA, pushing for the over Sh9 billion owed to counties to be converted into a direct settlement of debts counties owe to the Kenya Medical Supplies Authority (Kemsa), which currently stands at around Sh4 billion.

The governors argue that such a move would ease the burden on counties while ensuring an uninterrupted supply of medical commodities.

“We are proposing a debt swap. Let the money that NHIF or SHA owe the facilities be given to Kemsa so that services are not interrupted,” said Makueni Governor Mutula Kilonzo Jnr, who chairs the Council of Governors’ Legal Affairs Committee.

Mutula revealed that SHA is yet to clear more than Sh9 billion in pending remittances to counties, an obligation that was transferred from NHIF after it was restructured into SHA.

At the same time, counties owe Kemsa nearly Sh4 billion.

He noted that while only Mombasa and Makueni do not have outstanding bills with Kemsa, most counties are being denied medical supplies due to the debts, worsening the health crisis.

Mutula painted a bleak picture of the challenges faced by counties in delivering health services, citing severe drug shortages, lack of personnel and inadequate equipment as major obstacles to implementing universal health coverage.

“We are facing many challenges because of the budget. The health function has not been properly costed, and that is why we have budgetary challenges to fully perform this function,” he said.

In Makueni County, he noted, 38 per cent of the total budget is directed towards the health sector, with 2,200 of the county’s 3,900 workers employed in the department. However, despite this investment, the system remains overwhelmed.

“I have 242 health facilities in Makueni. Out of that, about 150 have only one nurse, one nurse attending to more than 2,000 patients every month. It is hectic,” he added.

The staffing crisis is not unique to Makueni, as counties across the country continue to struggle with acute shortages of nurses, medical officers, and specialist doctors, including neurosurgeons.

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The situation is worsened by constant stockouts, cases of pilferage, and inefficiencies within Kemsa that have undermined service delivery.

With Kemsa unable to maintain a steady supply of essential drugs and medical equipment, several counties have resorted to sourcing from private suppliers to keep facilities operational.

To address internal mismanagement and curb losses, Mutula said his administration is digitising hospital inventory systems to improve transparency and reduce theft of medical supplies.

Senators at the session voiced concern over the worsening state of county health services and committed to pushing for a review of resource allocation.

They called on the national government to devolve more funds to counties, pointing out that the national Ministry of Health continues to control over Sh100 billion despite having limited operational responsibilities.