SH9,500 PER SESSION

Counties make Sh1 billion from patients seeking dialysis services

Questions abound as to whether they should charge at all, yet they incur no costs in running the machines or buying reagents

In Summary

• Forty-nine county hospitals have been fitted with about 200 machines.

• The programme was worth Sh2.3 billion and counties are expected to have made more than that when the lease ends in 2022.

Nyeri Governor Mutahi Kahiga and Angelica executive director Mary Matu after the county received two more dialysis machines at the Nyeri County Referral Hospital from MES Angelica Medical Supplies on Monday last week.
LIFELINE: Nyeri Governor Mutahi Kahiga and Angelica executive director Mary Matu after the county received two more dialysis machines at the Nyeri County Referral Hospital from MES Angelica Medical Supplies on Monday last week.
Image: EUTYCAS MUCHIRI

Counties have made at least Sh1 billion charging the public for dialysis since 2015.

Patients pay Sh9,500 for each dialysis session using the machines bought through the managed-equipment scheme.

The devolved units now face questions over the high charges, yet they incur no cost in running the machines or buying reagents as these are taken care of by the national government.

 

A report seen by the Star shows that as of December last year, at least 54,507 weekly dialysis sessions have been carried out across the country since the MES project was initiated.

Patients need at least two weekly sessions. The counties claim the charges from the National Hospital Insurance Fund. Uninsured patients part with cash, while the insured who require more than two sessions per week pay for the extra sessions.

“Assessments have shown a significant increase in utilisation of services provided through the MES arrangement,” an assessment says.

It was conducted for the government by business advisory firm PKF Consulting.

The machines are serviced by the manufacturers, who also train the operators and supply the reagents.

Counties do not pay for the lease as was initially planned, and their share is now paid by the Treasury through a conditional grant.

Before the dialysis programme was rolled out, Kenya had only four public dialysis centres at the Kenyatta National Hospital, the Nakuru Provincial General Hospital, the Jaramogi Oginga Odinga Teaching and Referral Hospital in Kisumu, and Coast General Hospital in Mombasa. Collectively, they had had about 20 old machines.

 

Currently, 49 county hospitals have been fitted with about 200 machines.

The programme was worth Sh2.3 billion and counties are expected to have made more than that when the lease ends in 2022.

Contacted for comment, Health CS Sicily Kariuki confirmed counties have a free hand charging for use of the equipment.

“Only the counties piloting universal health coverage do not charge because they get direct allocations. However, we need standardisation of charges across the country,” she said.

Counties also charge Sh10,000 for a night in the intensive-care units, which were installed through MES and fully serviced by the national government.

The PKF report shows the 12 counties which received ICU equipment had served 3,258 patients by the end of last year.

Before the MES, only eight counties in Kenya had ICU facilities.

Mammogram and other radiography sessions are charged at Sh600 per session. At least 2.4 million general X-ray examinations had been conducted using the MES equipment until December 2018.

“There was a 78 per cent increase in the average monthly X-ray scans between the pre-MES period and 2016, and a further increase between 2016 and 2017,” the report says.

For instance, 636,748 ultrasound examinations and 37,018 digital dental X-ray examinations had been conducted by 2018, and 15,034 patients were operated in MES theatres over the same period.

CS Kariuki suggested that counties lower charges to the public since they incur no costs on the facilities.

“The uptake of mammography services is very low. Although there are cultural barriers around it, Sh600 is too high for such a diagnostic service. It has to go to zero to keep breast cancer at bay,” she said.

“Also, the tests to diagnose cervical cancer should be free.”

Under the MES scheme, 98 hospitals — two in each county and four national hospitals — benefitted from the specialised medical support.

The support constituted theatre equipment, sterilisation equipment, renal dialysis facilities, ICU items, X-ray and other imaging equipment.

(Edited by F'Orieny)