Governors have launched a fresh onslaught on Health Cabinet Secretary Aden Duale with a set of demands and reforms in the health sector.
In a statement issued on Monday, September 29 after the 28th Ordinary Session of the Intergovernmental Budget and Economic Council (IBEC), the Council of Governors (CoG) expressed outrage over continued delays from the Social Health Authority (SHA) in disbursing funds to counties for health services rendered.
The county bosses specifically cited an outstanding Ksh10.3 billion deficit in verified claims which they claim SHA has failed to pay despite follow-ups since 2024.
Owing to the delays, the council claims counties have endured operational constraints in public health facilities, which have been forced to use their own-source revenue or divert development funds to cover basic healthcare costs.
"The Council expressed concern over delayed SHA claim reimbursements to County Governments, which had led to operational strain in public health facilities, accordingly, the Council directed SHA to settle the outstanding Ksh10.3 billion in verified claims and in collaboration with the Council of Governors establish a structured reimbursement framework to ensure the sustainability of County health services," a statement from the CoG read.
During the Monday session, governors called on the health ministry to establish a structured, transparent, and timely reimbursement framework. The Council warned that failure to act would escalate tensions between the two levels of government and jeopardise national health targets.
Besides funding issues, governors also demanded the distribution of digital tablets to 1200 Primary Health Care (PHC) facilities across the country to support real-time claim processing and improve SHA's responsiveness.
Further, the council directed the Ministry of Health to conduct continuous capacity building for county health officials, many of whom have struggled to adapt to SHA's digital claim systems.
In recent months, several counties have reported high rejection rates of claims because of administrative errors, with governors blaming the issue to lack of training and poor systems integration.
Registering Health Facilities
Another critical resolution from the CoG was calls to the Health Ministry to grant counties the right to register health facilities directly, including those offering adolescent and maternal care. The authority to register currently lies with the government, and this has often led to months-long delays in operationalising new clinics and maternity wings.
"The Ministry of Health to grant County Governments registration rights to all health facilities to facilitate maternal healthcare to adolescents below the age of 18 years," the statement added.
The latest demands came just weeks after the governors opposed the Ministry of Health's decision to absorb over 7,000 Universal Health Coverage (UHC) staff to permanent and pensionable terms.
Health Committee Chair and Tharaka Nithi Governor Muthomi Njuki claimed that the decision by the ministry contravenes the previously agreed position between the national and county government in regards to absorption of the staff.
According to Njuki, the absorption of staff should only be carried out once the government has allocated adequate resources in accordance with the approved Salaries and Remuneration Commission (SRC) scale, and after the transfer of payroll to county governments has been agreed.
