The Ministry of Health has responded to a report aired by NTV concerning cancer care coverage under the Social Health Authority (SHA), clarifying the current benefit structure and refuting claims of neglect.
Speaking on Thursday, July 24, SHA Chief Executive Officer Dr. Mercy Mwangangi clarified that the SHA currently provides a cancer care package worth KSh 550,000 for all Kenyan patients, covering all types of cancer.
“But I will explain to you the current benefit package that we have for cancer care,” Dr. Mwangangi stated. “So under cancer care, Kenyans are eligible to 550,000 Kenya shillings. That's a little bit over half a million Kenya shillings.”
According to her, the first step in a cancer patient’s treatment involves diagnosis, which SHA covers by reimbursing necessary tests and biopsies to determine both the type and stage of cancer, and then a treatment plan is formulated.
“If it is a surgical plan, then surgery is actually catered for on SHA rates that are available in the tariff, depending on what part of the body would be excised, where the tumor would be taken out,” she said. “If this patient is determined to require both medical and surgical care, surgical care will be covered by SHA. Medical care will now involve chemotherapy cycles at that cap limit of 550K.”
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Dr. Mwangangi further stated that patients who exhaust this initial benefit are eligible for an additional KSh 150,000 under the Enhanced Comprehensive Cancer Intervention (ECCI) fund.
Mwangangi also addressed the specific case raised in the NTV report, stating that the patient had not exhausted his SHA benefits.
“Erroneously so, the patient who came to your offices still has a balance in his cover, and he has not exhausted his cover, and we're willing to help him. He just needs to dial *147#, and we'll attend to his case and educate him on the cover and the availability of his cover,” she affirmed.
The response comes after NTV aired an interview with Gatamu Waigwa, a 70-year-old man diagnosed with stage 3 prostate cancer. In the report, which aired on Tuesday, July 22, Waigwa alleged that SHA had declined to cover the cost of his treatment and that he had been told coverage would only resume in the new financial year.
He further claimed that SHA’s cancer package was inferior to the one previously offered under NHIF, forcing patients like him to pay out of pocket.
However, Health Cabinet Secretary Aden Duale dismissed the claims as misleading.
“Even that elderly man you saw yesterday on NTV, we reviewed the records this morning and found that he still has an active premium,” Duale said. “If he has any issues, he shouldn’t go to Nation Media. Nation is not a hospital. He should go to the SHA office and seek help from a Community Health Promoter.”
