NAIROBI, Kenya, Feb 15 – Health Cabinet Secretary Susan Nakhumicha has announced plans for a comprehensive recategorization of health facilities as the government works to roll out the new health insurance.
The initiative comes ahead of the anticipated rollout of the Social Health Insurance Fund (SHIF) and aims to rectify misclassifications that have led to facilities being assigned inappropriate levels.
Appearing before the National Assembly Departmental Committee on Health, Nakhumicha attributed the confusion in classification to political interference and corruption within the health sector.
She cited instances where hospitals were upgraded or downgraded without meeting the necessary criteria, resulting in mismatches between the assigned level and the actual capabilities of the facility.
Nakhumicha highlighted specific cases, such as a hospital in Kakamega County being upgraded to a level four status despite lacking essential facilities like a theater. Similarly, a facility in Kangemi, Nairobi County, was erroneously upgraded to level four when it should have remained a health center.
“I have for instance visited Kakamega county where a hospital has been upgraded to a level four hospital yet it has no single theatre while Kangemi, Nairobi county, a hospital was upgraded to level four yet it is just a health center,” she said.
The revelation emerged during investigations into alleged collusion between the National Hospital Insurance Fund (NHIF) and healthcare providers in fraudulent claims amounting to billions of shillings. It was disclosed that over 2000 health facilities had been improperly classified, leading to the disbursement of public funds to ineligible institutions.
Robert Pukose, chair of the Health committee, raised concerns over NHIF’s role in disbursing payments to incorrectly categorized hospitals, resulting in financial losses.
He called for accountability from both the Ministry of Health and NHIF regarding their oversight of the classification process.
“This committee needs to be told why the ministry of Health and NHIF has allowed the operation and payment of wrongly categorized hospitals,” he posed.
David Kariuki, CEO of the Kenya Medical Practitioners and Dentists Council (KMPDC), informed MPs that a collaborative inspection by various health bodies had identified the irregularities in facility classification.
“We are going to continue working with the limited resources we have and ensure that within the next six months the recategorization of hospitals will be complete,” he said.
Currently, health facilities in Kenya are categorized from Level One to Level Six, with each level corresponding to different tiers of healthcare services.
The recategorization initiative seeks to ensure that facilities are accurately classified based on their infrastructure, services, and capacity to deliver healthcare to the public.