An eight-week-old baby, who had been admitted to hospital and was denied access to the Social Health Authority (SHA) overseas treatment benefits, has passed away.
The family confirmed the news of his death on Tuesday, January 21, 2025.
Callum, who had been admitted to Mater Hospital, was scheduled for corrective heart surgery in India.
However, according to his parents, he was unable to access the overseas treatment package provided under the Universal Health Coverage (UHC) because his parents were not public servants.
A baby dies in Hospital over SHA confusion
The baby’s parents were hoping to receive the Ksh 500,000 overseas treatment benefit to alleviate the burden of the treatment costs, which stood at Ksh 1.8 million.
“We’ve gone to SHA’s headquarters twice, and they told us that the cover only supports public servants for overseas treatment,” said Kelly Kamau, Callum’s father.
According to the family, baby Callum had spent just one week at home after his birth before heart complications led to his admission to the ICU wing at Mater Hospital.
Esther Nyamwero, Callum’s mother, elaborated on the medical condition that affected her baby.
“They said the baby was born with a condition where the main artery supplying blood is narrow and constricted, preventing blood from flowing properly.
As a result, the blood returns to the heart and lungs, which causes pulmonary pneumonia,” she explained.
SHA Acting CEO, Robert Ingasira, stated that the process of empaneling foreign healthcare providers is ongoing but assured registered members that the overseas treatment benefit remains at Ksh 500,000.
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He added that this amount is subject to review soon.
“Very soon, we will be guided on the areas of review. It has been fast-tracked. We are assessing our progress to determine where we may have allocated too little and where enhancement is needed.
I see us revisiting this before the end of the financial year,” said Ingasira.
The Acting CEO also acknowledged challenges within SHA’s systems, which have caused delays in payment, leaving some patients stranded in medical facilities.
“We have increased the number of technical staff at our high-traffic facilities. If you go to Kenyatta Hospital, you will find them there,” he said.
A family in Baringo unable to get heart surgery for their child under SHA
Callum’s case comes shortly after the story of a family in Baringo was highlighted in the media. One of their twins suffers from a heart condition requiring surgery in India.
The Baringo family hopes to fund their daughter’s Ksh 2 million surgery through the government’s Universal Health Coverage under the Social Health Authority, but lack of support has forced them to sell their assets, including land.
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Despite these efforts, they have still not raised enough money for the treatment.
Amid public outcry over SHA’s functionality, Health Cabinet Secretary Deborah Baraza maintains that SHA is working and ensures patients do not need to spend large sums on treatment.
Her sentiments were echoed by President William Ruto, who stated that with SHA, patients no longer need to organize fundraisers for their medical expenses.
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