HEALTH FINANCING
BY
GITARI NORMAN
THE FUNDS
PRIMARY HEALTHCARE FUND
SOCIAL HEALTH INSURANCE FUND
EMERGENCY, CHRONIC AND CRITICAL ILLNESS FUND
HOUSEHOLD REGISTRATION STATUS(AS AT 8TH FEB 2026)
OVERALL SHA CLAIMS SUMMARY-31/12/2025
MID YEAR SHA CLAIMS & PAYMENT SUMMARY
| SHA HALF YEAR FY 2025/ 2026 CLAIMS | |||
FACILITY | Amount Claimed | Amount Paid | Rejected | Outstanding Amount |
KCRH | 176,254,660.00 | 62,120,878.00 | 2,360,320.00 | 111,773,462.00 |
KIMBIMBI | 30,211,009.00 | 3,458,653.45 | 1,446,640.00 | 25,305,715.55 |
KIANYAGA | 12,716,080.00 | 6,446,800.15 | 803,600.00 | 5,465,679.85 |
SAGANA | 5,174,816.00 | 4,476,530.80 | 14,300.00 | 683,985.20 |
Total | 224,356,565.00 | 76,502,862.40 | 4,624,860.00 | 143,228,842.60 |
PHCF VS SHIF PAYMENTS;KIRINYAGA COUNTY
FUND | FY 24/25 | FY 25/26 (Mid Year) | Total |
PHCF | 54,184,081.65 | 89,497,108.45 | 143,681,190.10 |
SHIF | 183,814,398.00 | 76,502,862.40 | 260,317,260.40 |
Total | 237,998,479.65 | 165,999,970.85 | 403,998,450.50 |
PRIVATE INSURANCES
PRIVATE INSURANCE CLAIMS MID YEAR 25/26 | | ||||
INSURANCE/FACILITY | KCRH | KIMBIMBI | KIANYAGA | SAGANA | Total |
APA | 12,350.00 |
| | | 12,350.00 |
BRITAM KYM | 969,600.00 | - | | | 969,600.00 |
BRITAM Corporte | - | - | | | - |
Jubilee Mtiba | 636,020.00 | 3,500.00 | 1,500.00 | 49,720.00 | 690,740.00 |
Jubilee Corporate | 78,450.00 | - | | | 78,450.00 |
MAKL | 2,801,000.00 | - | | 41,010.00 | 2,842,010.00 |
Total | 4,497,420.00 | 3,500.00 | 1,500.00 | 90,730.00 | 4,593,150.00 |
PRIVATE INSURANCES CONT’
PRIVATE INSURANCE PAYMENTS MID YEAR FY25/26 | | | |||
INSURANCE/FACILITY | KCRH | KIMBIMBI | KIANYAGA | SAGANA | Total |
APA | - | - | - | - | - |
BRITAM KYM | 957,380.00 | - | - | - | 957,380.00 |
BRITAM Corporte | 26,600.00 | - | - | - | 26,600.00 |
Jubilee Mtiba | 443,220.00 | 3,500.00 | - | 19,680.00 | 466,400.00 |
Jubilee Corporate | 3,000.00 | - | - | - | 3,000.00 |
MAKL | 2,318,140.00 | - | - | - | 2,318,140.00 |
Total | 3,748,340.00 | 3,500.00 | - | 19,680.00 | 3,771,520.00 |
PAYBILL COLLECTIONS(OOP)
HOSPITAL | Jul-25 | Aug-25 | Sep-25 | Oct-25 | Nov-25 | Dec-25 | Total |
KERUGOYA COUNTY REFERRAL HOSPITAL | 6,718,379.00 | 6,215,159.00 | 7,327,331.00 | 7,574,297.50 | 6,461,247.00 | 6,869,731.00 | 41,166,144.50 |
KIMBIMBI SUBCOUNTY HOSPITAL | 2,413,910.00 | 1,931,710.00 | 2,080,732.00 | 2,340,569.00 | 2,095,390.00 | 2,464,982.00 | 13,327,293.00 |
KIANYAGA SUBCOUNTY HOSPITAL | 1,042,581.00 | 768,099.00 | 886,281.00 | 918,383.00 | 817,853.00 | 861,290.00 | 5,294,487.00 |
SAGANA SUBCOUNTY HOSPITAL | 1,020,120.00 | 933,135.00 | 1,070,722.00 | 1,160,111.50 | 1,011,919.50 | 1,009,095.50 | 6,205,103.50 |
WAIVER
Health Facility | FY24/25 | FY25/26(Half Year) |
KERUGOYA COUNTY REFERRAL HOSPITAL | 11,140,496.00 | 5,978,915.00 |
KIMBIMBI SUBCOUNTY HOSPITAL | 2,601,120.00 | 2,603,430.00 |
KIANYAGA SUBCOUNTY HOSPITAL | 303,855.00 | 170,005.00 |
SAGANA SUBCOUNTY HOSPITAL | 261,275.00 | 61,515.00 |
TOTAL | 14,306,746.00 | 8,813,865.00 |
RECOMENDATIONS
END.
THANK YOU!