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SHA PERFORMANCE REPORT

Q2 2024/2025

By

Gitari Norman

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INTRODUCTION

  • The Social health insurance act, 2023 established the Social Health Authority
  • SHA took over from NHIF on 1st October 2024
  • In Kirinyaga County, 74 health facilities are accreditted by SHA
  • 71 health facilities are operational and actively claiming from SHA
  • E Contracting still ongoing, pending facilities required to update their contract status
  • Reporting template at JICA SAMACH website labelled SHA REPORT
  • Below is the SHA claiming performance report for Kirinyaga County;

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SHA Registration

Comparison with other Counties

Situation;

  • Kirinyaga county led nationally with 27.1% of its population registered into SHA
  • However, the county is fairing poorly in addition of dependants into SHA compared to other counties
  • Addition of dependants during registration is critical in reducing waiting time during service delivery

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SHA CLAIMING

  • HOSPITALS PERFORMANCE

  • There has been significant improvement in claiming for SHA since the transition from NHIF
  • All manual claims that were made to SHA during transition period(OCTOBER) have been submitted for processing.
  • with increased Uptake of SHA, claims volume is also increasing
  • Awaiting inclusion of outpatient services in SHA contract for level 4 hospitals to extend OPD services to clients

HOSPITAL CLAIMS

Facility

Inpatient

Maternity

OPD

RENAL

TOTAL

1

Kerugoya CRH

17,031,940

6,026,960

0

2,992,650

26,213,430.00

2

Sagana SCH

194,880

570,000

1,990

0

766,870.00

3

Kimbimbi SCH

3,326,350

2,100,000

0

0

5,426,350.00

4

Kianyaga SCH

669,520

2,680,000

31,450

0

3,380,970.00

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Level 2 and Level 3 Health Facilities Performance�Kirinyaga North Subcounty

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Findings

  • Only one facility(Nguka health Centre) claimed more than half of it’s facility workload
  • Most facilities have registered significant improvement in the month of December compared to the month of November
  • Facilities unable to claim all deliveries due to lack of ID’s among patient seeking these services
  • Increased community sensitization and registration will be critical in improving claiming rate for services offered.

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Level 2 and Level 3 Health Facilities Performance�Kirinyaga South subcounty

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Findings

  • All facilities are claiming below 50% of their workload
  • Kiamanyeki dispensary had the highest claiming rate
  • Claims for Maternity deliveries affected by lack of ID’s among patients seeking these services
  • Increased community sensitization and registration will be critical in improving claiming rate for services offered.

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Level 2 and Level 3 Health Facilities Performance�Kirinyaga Central Subcounty

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Findings

  • Generally good performance from all facilities in Kirinyaga Central
  • Beyond Zero claimed all clients served in the month of December
  • Good claiming rate for maternity deliveries

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�Level 2 and Level 3 Health Facilities Performance�Kirinyaga East Subcounty�

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Findings

  • Low claiming rate across all facilities in the subcounty
  • Riakithiga dispensary leads in claiming rate within the subcounty
  • One facility(Gaciongo) did not claim within the quarter, but now claiming

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Level 2 and Level 3 Health Facilities Performance�Kirinyaga West Subcounty

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Findings

  • Improved performance in all facilities within the subcounty
  • Gathambi health centre leading in claiming rate in the month of December
  • Good claiming rate for deliveries conducted in the subcounty

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Recommendations

  • Ammend county legistlation to enable level 2 and 3 health facilities charge for services offered at this level of care. This can be a catalyst for improved SHA registration
  • Continous sensitization of members of public to burst myths/ misinformation around SHA
  • Establishment of a SHA registration desk in every health Facility
  • Dedicate SHA claiming officers in Level 2 and 3 Health facilities to enable claiming of all patients seeking services in health facilities
  • Continous support supervision on SHA registration/Claiming

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Pending NHIF/LINDA MAMA Claims

COUNTY CLAIMS

Payment as at 31st OCT

Payment as at 27th November

Total Amount Paid as at November

NHIF Outstanding Debt

TOTAL

18,890,655.00

8,177,300.00

27,067,955.00

120,337,224.00

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KIRINYAGA CENTRAL

Payment as at 31st OCT

Payment as at 27th November

Total Amount Paid as at November

NHIF Outstanding Debt

1

Kerugoya County Referral Hospital

9,297,300.00

2,337,900.00

11,635,200.00

47,762,610.00

2

Kangaita h/c

337,500.00

0.00

337,500.00

2,136,050.00

3

Ucheru community h/c

109,150.00

45,600.00

154,750.00

1,473,900.00

4

Gatwe h/c

92,900.00

32,300.00

125,200.00

1,423,350.00

5

Kagumo h/c

309,850.00

79,950.00

389,800.00

2,939,023.00

6

gatuto disp

255,950.00

30,400.00

286,350.00

1,814,500.00

7

kariko disp

35,100.00

15,900.00

51,000.00

827,450.00

8

mutitu community disp

40,800.00

14,800.00

55,600.00

577,700.00

9

Kiaga disp

70,000.00

11,000.00

81,000.00

337,800.00

10

Gathuthuma Disp

27,500.00

0.00

27,500.00

199,300.00

11

Kiamuthambi Disp

87,600.00

0.00

87,600.00

256,250.00

12

Kamuiru Disp

69,500.00

0.00

69,500.00

221,250.00

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KIRINYAGA WEST

Payment as at 31st OCT

Payment as at 27th November

Total Amount Paid as at November

NHIF Outstanding Debt

13

Sagana Subcounty Hospital

102,000.00

1,019,050.00

1,121,050.00

1,502,770.00

14

Baricho h/c

234,600.00

0.00

234,600.00

3,010,900.00

15

Gathambi h/c

198,950.00

15,300.00

214,250.00

3,479,087.00

16

Kibirigwi h/c

455,000.00

0.00

455,000.00

1,725,050.00

17

Mukangu h/c

127,300.00

10,000.00

137,300.00

1,258,150.00

18

Kiangai h/c

163,250.00

50,050.00

213,300.00

1,315,550.00

19

Gatithi Disp

99,400.00

41,600.00

141,000.00

1,225,950.00

20

Kairini Disp

36,000.00

4,550.00

40,550.00

424,950.00

21

Kangaru Disp

251,350.00

125,350.00

376,700.00

1,834,200.00

22

Kianjege Disp

40,500.00

11,150.00

51,650.00

646,400.00

23

Kiaragana Disp

51,850.00

5,950.00

57,800.00

835,750.00

24

Kiburu Disp

61,750.00

20,500.00

82,250.00

638,400.00

25

Thigirichi Mukui Disp

23,750.00

30,850.00

54,600.00

527,650.00

26

Karimaini Disp

78,850.00

6,200.00

85,050.00

431,900.00

27

Nguguini Disp

10,700.00

4,500.00

15,200.00

392,650.00

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KIRINYAGA SOUTH

Payment as at 31st OCT

Payment as at 27th November

Total Amount Paid as at November

NHIF Outstanding Debt

28

Kimbimbi Subcounty Hospital

442,000.00

1,337,650.00

1,779,650.00

580,590.00

29

Difathas h/c

340,650.00

91,800.00

432,450.00

2,193,300.00

30

Kiumbu h/c

27,000.00

131,500.00

158,500.00

1,904,200.00

31

Murinduko h/c

301,150.00

0.00

301,150.00

2,790,200.00

32

Gathigiriri H/C

69,900.00

62,950.00

132,850.00

588,859.00

33

Kanjinji Disp

40,000.00

14,300.00

54,300.00

431,000.00

34

Kiamanyeki Disp

35,500.00

31,450.00

66,950.00

496,300.00

35

Kirogo Disp

89,350.00

76,100.00

165,450.00

1,215,500.00

36

Kutus Disp

314,600.00

139,250.00

453,850.00

4,527,450.00

37

Mumbuini Disp

351,650.00

46,150.00

397,800.00

584,150.00

38

Kangu Disp

480,700.00

-

480,700.00

2,255,300.00

39

Kiarukungu Dsip

164,550.00

0.00

164,550.00

827,600.00

40

South Ngariama

0.00

0.00

0.00

225,000.00

41

Togonye Disp

7,950.00

28,450.00

36,400.00

418,350.00

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KIRINYAGA EAST CLAIMS

Payment as at 31st OCT

Payment as at 27th November

Total Amount Paid as at November

NHIF Outstanding Debt

42

Kianyaga Subcounty Hospital

244,000.00

1,215,900.00

1,459,900.00

1,706,380.00

43

Gaciongo Dispensary

48,800.00

28,650.00

77,450.00

429,550.00

44

Gatugura Dispensary

68,100.00

28,850.00

96,950.00

662,850.00

45

Joshua Mbai Memorial Dispensary

647,400.00

-

647,400.00

679,050.00

46

Kabare Health Centre

114,450.00

143,150.00

257,600.00

2,570,600.00

47

Kamweti Dispensary

28,100.00

11,300.00

39,400.00

284,900.00

48

Karumandi Health Centre

434,750.00

-

434,750.00

2,448,350.00

49

Kiamutugu Health Centre

463,800.00

27,200.00

491,000.00

185,000.00

50

Kiang’ombe Dispensary

26,700.00

24,400.00

51,100.00

437,050.00

51

Riakithiga Dispensary

21,400.00

21,350.00

42,750.00

212,500.00

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KIRINYAGA NORTH CLAIMS

Payment as at 31st OCT

Payment as at 27th November

Total Amount Paid as at November

NHIF Outstanding Debt

52

Ciagini Health Centre

65,055.00

61,100.00

126,155.00

621,055.00

53

Kandongu Dispensary

26,950.00

51,600.00

78,550.00

1,531,000.00

54

Mutithi Health Centre

467,650.00

163,650.00

631,300.00

3,413,300.00

55

Nguka Health Centre

81,500.00

65,250.00

146,750.00

671,200.00

56

Njegas Health Centre

513,900.00

-

513,900.00

1,734,400.00

57

Rukanga Health Centre

185,600.00

-

185,600.00

459,600.00

58

Rurii Kiandegwa Dispensary

16,850.00

19,250.00

36,100.00

139,200.00

59

Thiba Health Centre

78,200.00

426,500.00

504,700.00

3,566,250.00

60

Wamumu Dispensary

24,050.00

16,650.00

40,700.00

328,650.00

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END!

THANK YOU.