Cancer patients have raised concerns over the new Social Health Authority (SHA) system, saying delays, unclear approvals, and rigid payment terms are worsening their suffering and disrupting treatment.
Speaking before the National Assembly’s Departmental Committee on Health, representatives of the Kenya Network of Cancer Organizations (KENCO) described the system as chaotic, leaving thousands of patients stranded despite being fully paid-up members.
KENCO Executive Director Phoebe Ongadi said the shift from the National Health Insurance Fund (NHIF) to SHA has introduced new barriers for patients seeking chemotherapy, radiotherapy, and follow-up care.
“SHA has increased emotional distress more than the disease itself,” Ongadi said. “Patients live in constant fear—wondering when their treatment will be approved, when their financial year begins, or when they’ll be told to pay out of pocket.”
She highlighted the case of Mary Nafula, a fully registered member whose SHA account was declared expired midway through treatment despite paying her annual premiums twice in three months.
Prisca Githuka, KENCO Vice Chairperson, said, “This kind of confusion is breaking patients emotionally and financially. It shows how the system is failing the very people it was meant to protect.”
KENCO officials also criticized SHA offices in hospitals for lacking trained staff and information, forcing patients to travel to Nairobi for clarifications.
“Patients are simply told their accounts have expired, with no explanation,” Githuka said. “These offices must be empowered to serve patients effectively.”
The group urged the government to allow flexible premium payments, saying the current annual lump-sum model is unrealistic for most cancer patients in the informal sector.
“We are not refusing to pay,” Githuka said. “But paying the full annual amount at once is too burdensome. A monthly or quarterly option would be fairer.”
Peter Kinyanjui, a cancer survivor and matatu operator, supported the idea, noting that informal workers would comply more easily if allowed to pay monthly, as they did under NHIF.
“My colleagues are willing to pay, but the one-off annual payment is too high,” he said. “If payments were monthly, many more would join and sustain the scheme.”
KENCO also raised concerns over the Primary Health Care Fund and the Emergency, Chronic, and Critical Illness Fund (ECCIF), stating that they remain largely unfunded, undermining early diagnosis and access to care.
“On paper, these funds exist, but in reality, the coffers are empty,” Ongadi said. “Patients are told to transition to new coverage tiers after exhausting limits, yet no money is available. This defeats the purpose of Universal Health Coverage.”
The organization shared data showing that Kenya records about 44,700 new cancer cases annually, with over 29,000 deaths each year. Breast, cervical, prostate, oesophageal, and colorectal cancers are the most common, with 70 percent diagnosed at late stages.
Committee Chair Dr. James Nyikal (Seme MP) commended KENCO for its evidence-based advocacy, noting that the issues raised mirrored the committee’s own findings.
“What you have presented is consistent with what we have witnessed across the country,” Dr. Nyikal said. “We will incorporate your recommendations into our report and pursue further dialogue with the Ministry of Health and county governments.”
He said most challenges stem from gaps in information flow and fund management at hospitals.
“Both patients and service providers lack information,” he said. “We will work with the ministry and counties to correct these systemic weaknesses.”
KENCO also called for cancer survivors and patients to be included in policy-making bodies, such as the Benefits Package Tariff Advisory Panel, to ensure reforms reflect real patient experiences.
“We live through these policies every day,” Githuka said. “Our inclusion would ensure reforms are grounded in reality.”
Dr. Nyikal welcomed the proposal and said it will be relayed to the Health Ministry for consideration, though legislative action may extend into early next year due to Parliament’s recess.
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