Dr. Dickens Lubanga, a pediatrician at Bungoma children’s clinic, has reported a significant drop in patient numbers due to high medical costs, noting that previously they would receive around 80 to 60 children in their clinic daily, but now patients avoid seeking medical care due to expenses associated with blood tests and medication.
He expounded that Bungoma County Referral Hospital was once known for providing the best pediatric services.
However, challenges emerged after the establishment of the Social Health Authority (SHA). He explained that after undergoing means testing, patients are required to pay a certain amount but when they visit the hospital they don’t receive the expected services and have to pay for the medication.
Lubanga notes that the sickle cell clinic has been hit the hardest because patients who come to the clinic require regular hemogram tests and kidney and liver checkups, which cost approximately Ksh 4,000.
“If you ask a patient to pay Ksh 4,000, pay for the consultation fee and medication costing around Ksh 2,000, you can see this is a patient who’ll come out of the hospital with a bill of around Ksh 8,000. Most of them ask what the function of that SHA card is if they are still paying,” he said.
Consequently, the patients who were previously on regular follow-ups are becoming weaker, they visit the hospital when their condition has deteriorated to the point of admission, and most of them don’t survive. Others who are unable to afford treatment, turn to traditional medicine and self-medication, purchasing drugs from pharmacies without proper diagnosis.
“Sometimes we are forced to admit a patient who is not supposed to be admitted because they can’t afford to pay for the hospital bill,” he noted.
He recalled that previously, treatment for children under the age of five was free, both for inpatient and outpatient services.
Additionally, back then the county referral hospital had established clinics that were vibrant, attracting patients from places like Bumula, Webuye, Tongaren among others to get treatment. The National Health Insurance Fund (NHIF)could cover the cost of prescribed medication for the outpatient making health care more accessible.
“We thought this system was going to lessen the burden for the patients and pay for their bills, “said the pediatrician.
The pediatrician pointed out that under SHA, patients need referrals to access higher-level care. So far, only inpatient referrals have been made, but SHA has not funded outpatient services, especially in level 4, 5, and 6 hospitals where NHIF previously covered the treatment cost.
“If I open the system for level four or five of SHA, you can’t see anyone in the outpatient, it’s not the hospital’s fault but the system of SHA,” said Lubanga.
He urged the government to address the many challenges in outpatient care and allow patients to seek treatment at any facility to ensure lower-level health centers are adequately resourced. He noted that in Bungoma most dispensaries are far from the county referral hospital
“Most of these dispensaries are not operational at night you only find one or two nurses and don’t have enough medicines, “he said.
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