The promise of Universal Health Coverage (UHC) is crumbling in renal units across the country. Desperate dialysis patients in Bungoma and Murang'a are being forced to pay cash for life-saving sessions as hospitals, starved of funds by the Social Health Authority (SHA), suspend credit services.

The situation is dire. In Bungoma, a private facility is charging patients weekly fees for consumables like dialyzers and bloodlines, citing a two-and-a-half-month delay in SHA remittances. For a patient requiring two sessions a week, the cost is a death sentence.

The Debt Crisis

The Rural and Urban Private Hospitals Association (RUPHA) reveals that SHA and the defunct NHIF owe providers over KES 10 billion. "We cannot buy supplies with promises," said a hospital director who sought anonymity. "We have served patients for months without payment. We are now insolvent."

• Tragic Consequences: The cost of these delays is measured in lives. Elizabeth Cheboi, a 66-year-old from Uasin Gishu, reportedly died two days after missing a session because her family could not raise the cash.
• Double Billing? Some facilities are accused of charging patients cash and still claiming from SHA, a practice SHA Chairperson Dr. Abdi Mohammed termed "illegal." He threatened to revoke contracts, but for hospitals, it is a matter of survival.
• County Crisis: Murang'a Governor Irungu Kangata announced that SHA owes his county KES 207 million, crippling the mobile dialysis units that serve rural patients.

System Failure

The transition from NHIF to SHA was meant to be seamless. Instead, it has created a bureaucratic vacuum where the most vulnerable—kidney patients—are suffocating. The government’s UHC dream is quickly turning into a nightmare of "cash first, care later."