Lawmakers reject SHA request for additional Sh77 billion funding

The Social Health Authority’s (SHA) request for an additional Sh77 billion in the next financial year met stiff resistance from the National Assembly Health Committee members.

Some committee members said SHA had not explained its 2024/2025 budget, claiming the authority’s expenditures were shrouded in opaqueness due to lack of transparency.

SHA is seeking Sh61 billion up from Sh4 billion and Sh107 billion for the Emergency, Chronic, and Critical Illness Fund, an increase from Sh2 billion.

It is also seeking Sh100 billion for the Social Health Insurance Fund (SHIF) from Sh82 billion in the 2025/26 financial year. In total, SHA is seeking an addition of Sh77 billion in 2025/26.

Committee chairman, Endebes MP Robert Pukose, accused SHA of failing to utilise the current expenditure despite public outcry over poor healthcare services since the transition from National Health Insurance Fund (NHIF).

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SHA acting Chief Executive Officer Robert Ingasira defended the budget proposal, saying there was a huge variant to be filled.

“Under SHA, we run three funds, namely the Primary Healthcare Fund, the Emergency, Chronic, and Critical Illness Fund, and the Social Health Insurance Fund. There is a huge variant to fill. The primary healthcare fund in the current budget has Sh4 billion, but the proposal for the year 2025/26 is Sh61 billion,” Mr Ingasira defended the budget.

But his presentation was interjected by Dr Pukose, who demanded an explanation of what the current allocation of Sh4 billion was spent on. “We want evidence-based support. Communication is poor; that is why we have a problem even in the utilisation of funds. We need to package information,” said Pukose.

He added, “We have Sh2.1 billion, but expenditure is low. We should not make the government look bad that we wanted Sh61 billion, but it was not given. We have allocated Sh4 billion for the Primary Healthcare Fund but spent Sh375 million. This is the information that we have.”

Ingasira’s budgetary request, according to the committee, was based on estimates and not evidence-based.

“Let’s deal with evidence-based to encourage users and hospitals to spend the money,” said Pukose. “Let them (hospitals) bill us. If there is a deficit, we can increase as time goes.” 

Ingasira said the proposal to increase the budgetary allocation is to enhance what is covered under Intensive Care Unit (ICU). He added that of the Sh4 billion allocation for the Primary Healthcare Fund, at least Sh1.35 billion was spent and exhausted.

But committee vice chair, Igembe South MP Patrick Munene, said Ingasira’s defence was a confirmation that money allocated for SHA is under-utilised. “The CEO should tell us when they are operationalising and rolling out some of these services. They are speaking in terms of generalities,” the MP demanded.

Seme MP James Nyikal said it is worrying that SHA has unutilised funds, yet Kenyans cannot access quality care. “There is a big infrastructural issue. The Primary Healthcare Fund is meant for outpatients. The biggest target is level 2 and 3 hospitals. If we have to have a breakdown, how many level 2 and 3 accounts do you have to which you have sent the money?” asked Nyikal.

Medical Services PS Harry Kimtai pleaded with the MPs to defend budgetary allocation for the department. The total resource requirement for the financial year 2025/26 is Sh426.8 billion against an allocation of Sh172.6 billion.

The allocation comprises Sh145.1 billion in recurrent and Sh27.5 billion in development, with an overall funding gap of Sh254.2 billion. Programme areas for the initial proposal included Sh44.3 billion for national referral services and Sh3.5 billion for infrastructure and equipment.