Eric Latiff Reality check on SHA
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We know who bought NMG
upepo
Elder Lister
TO:
H.E. THE PRESIDENT, CABINET SECRETARY FOR HEALTH, COUNCIL OF GOVERNORS, PARLIAMENT, SENATE, KMPDU, SHA, FELLOW KENYANS
FROM: A CONCERNED HEALTHCARE WORKER
SUBJECT: UNDERSTANDING NESP, VENDORS & FEE-FOR-SERVICE: THE WAY FORWARD FOR UHC
Wakenya Wenzangu, Wapendwa Viongozi,
I write this with respect, patriotism, and deep love for our country. The conversation around NESP, Vendors, and SHA has become heated. Let us pause, listen to facts, and build solutions together.
PART 1: WHAT IS NESP 2024/2025? THE OFFICIAL POSITION
Q1: What is NESP?
The National Equipment Service Program (NESP) was launched in FY 2024/2025 after the expiry of the MES program in Dec 2023.
Goal: Ensure continuous access to specialized equipment - ICU, Surgery, Radiology, Dialysis, laboratory equipment, Cath Lab, Radiotherapy, Theatres - in County and Referral hospitals with no upfront cost.
Q2: Why the transition?
To ensure no disruption in services. MES had ended. NESP was to guarantee surgery, ICU, Dialysis, Laboratory and radiology services continue uninterrupted.
Q3-Q4: What is Fee-For-Service (FFS)
Under FFS, 7 vendors were contracted in October 2024 through a transparent tender under PPDA Act 2015 and PPP Act 2021. Counties signed Intergovernmental Participatory Agreements to join.
How it works: Vendor provides, installs, and maintains equipment. SHA pays the vendor and hospital only when a service is done, based on approved tariffs.(IPAs)
The 7 Contracted NESP Vendors:
1. Obaidulla Contracting - UAE-based, multiple specialist services
2. Megascope Healthcare- Ultrasound equipment
3. Sunview Medipro International- CT Scan units
4. Caring International- Referral hospital equipment
5. Angelica Medical Supplies - Dialysis machines
6. Melco Kenya- X-ray and Cardiothoracic units
7. Provered Technologies - X-ray and medical infrastructure
Q5-Q9: Intended Benefits
1. Financial Sustainability - Counties don’t buy 500M machines
2. 95% Equipment Uptime - Vendors must service and maintain
3. Training- Continuous skills upgrade for health workers
4. UHC Support- Specialized care closer to wananchi
5. Revenue Retention- Counties keep part of SHA revenue to reinvest
This policy is good. The intention is noble.
PART 2: THE REALITY ON THE GROUND - WHERE WE ARE BLEEDING
Viongozi, with respect, there is a gap between policy and practice. This is what doctors, nurses, and patients face daily:
1. THE 90/10 PAYMENT SPLIT IS STARVING HOSPITALS
Example: SHA pays KSh 100,000 for a CT Scan
Recipient : Amount - Covers
VENDOR: 90% = KSh 90,000- Machine, service, software
HOSPITAL: 10% = KSh 10,000-Rent, food, linen, medicine, medical supplies, consumables, Nurse, drugs, electricity, cleaning, waste, servecing and maintenance other machines such as oxygen plant , C -ARM
Result: That 10K cannot run a CT room for one day. MRI electricity alone is 200K/month. Service contracts are 4-6M/year.
Outcome: We have the machine + we have the specialist + we have the patient. But no drugs, no catheter, no contrast. Patient is told “buy outside”.
2. SUPPLIERS ARE NOT BEING PAID
Because hospitals only get 10%, they owe pharmaceutical and medical suppliers. Shelves are empty in Level 4, 5, and 6 hospitals.
3. HEALTHCARE WORKER MORALE
Q7 of NESP says we will be trained. True. But it is demoralizing to be trained, have a patient, have a machine, and then watch the patient suffer and watch him or her die because there are no consumables or no laboratory reagents such as hepatitis B or Quality cannot be Granted. This is what Health Professionals are crying about.
4. KNH PRESS STATEMENT 20TH AUG 2026 CONFIRMS THE CRISIS
KNH reported overcrowding due to industrial action in counties. Level 6 hospitals are now carrying the burden of the entire country, with the same 10% funding.
SHA DOES NOT PAY SALARIES. That is County and MOH. We agree, but with 50 percent budget cuts, No revenue anymore, staff go without salaries for months, or no statutory deduction including No insurance cover for the same people giving the services- But they cannot afford, but they contribute 2.75 percent of the gross income to SHA every month.
But SHA is supposed to pay for SERVICE DELIVERY. And 10% cannot deliver service.
No medicines- but registered as SHA member- buy from outside the hospital, some may be fake, leads kindness rejection within a week.
PART 3: LEGAL, ETHICAL & OVERSIGHT QUESTIONS
1. Is NESP legal? Yes. PPPs are provided for in law. Vendors won tenders fairly.
2. Should we cancel vendors? No. They invested billions. If unpaid, they remove machines.
3. Who is liable when a patient dies for lack of drugs? The hospital. Yet it only got 10%.
4. Parliament & Senate are already asking questions on procurement, costs, 90/10 split, and payment delays. This is good oversight.
PART 4: THE SOLUTION - LET US FIX, NOT SCRAP
To H.E. The President, CS Health, CoG, Parliament: We don’t need to cancel NESP. We need to recalibrate it.
5 IMMEDIATE ACTIONS:
1. REVIEW THE FFS SPLIT: 90/10 → 70/30
Give hospitals 70 % minimum. This pays for drugs, power, cleaning, and running the ward. Vendors still get 30 % to cover machine and service. Both survive.
2. RING-FENCE CONSUMABLES
Mandate that part of every SHA payment goes directly to drugs, kits, reagents, and sutures. No machine should work without supplies.
3. TIMELY PAYMENTS - 30 DAY RULE
SHA must pay both hospitals and vendors within 30 days. This will unblock suppliers.
4. TRANSPARENCY PORTAL
Publish monthly: SHA collections, payments to each Vendor, payments to each Hospital. Let Kenyans audit.
5. STRENGTHEN LEVEL 2-4 FIRST
As KMPDU proposed, let SHA also pay for OPD and primary care. This will reduce the burden on Level 6 hospitals.
PART 5: A MESSAGE TO ALL KENYANS
Ndugu zangu,
The Vendor is not the enemy. They are partners who brought machines.
The Doctor is not the enemy. We want to heal.
The Nurse is not the enemy. They are on the frontline.
The 90/10 Formula is the enemy.
NESP had a good heart: No Kenyan should die for lack of equipment.
Let us give it a working body: Equipment + Trained Staff + Drugs + Money.
If we fix 90/10 today, tomorrow:
Vendor will be paid.
Hospital will have drugs.
Doctor will treat.
Patient will go home healed without paying cash.
That is Universal Health Coverage.
FINAL APPEAL TO LEADERSHIP
Your Excellency, CS, Governors, MPs, Senators:
We commend the progress on intern posting, CBA arrears, and PnP conversion. Asante.
Now please hear the cry from the wards:
“Tupewe pesa ya kuendesha hospitali.”
In solidarity,
Let us build a health system that works for the Vendor, the Hospital, the Worker, and the Mwananchi.
Mungu abariki Kenya. Afya ni Haki.