Palliative Care providers say SHA gaps leaving patients in agony

The Kenya Hospices and Palliative Care Association (KEHPCA) has raised the alarm over glaring gaps in the new Social Health Authority (SHA) scheme, warning that thousands of patients battling life-threatening illnesses are being left without essential care and pain relief.

Speaking during the World Hospice and Palliative Care Day commemorations in Embu County on Wednesday, KEHPCA officials criticized the SHA for focusing solely on inpatient services while excluding home-based and outpatient care — the core of palliative services.

KEHPCA Executive Director David Musyoki said the exclusion undermines the very purpose of universal health coverage, leaving many patients to suffer.

“Health insurance funded by monthly contributions should guarantee full coverage for critical patients without delay. Health matters cannot wait for gradual implementation,” Musyoki stated.

The situation is further worsened by frequent shortages of vital painkillers, including morphine, in public hospitals.

KEHPCA attributed the shortages to bureaucratic delays in procurement processes at the Kenya Medical Supplies Authority (KEMSA), which often result in prolonged suffering for patients — especially those with advanced cancers and other terminal illnesses.

In addition, KEHPCA highlighted the shortage of trained healthcare workers capable of handling palliative care needs.

Many nurses and clinical officers lack the necessary training to prescribe or manage strong pain medications, compounding the agony of patients who depend on consistent medical attention.

“Financial barriers, lack of essential drugs, and untrained staff collectively add to the suffering of patients who already face immense emotional and physical pain,” said one KEHPCA official.

At the event, Rosie Wafula, Head of the Division for Health Aging and Palliative Care at the Ministry of Health, acknowledged the challenges and stigma that patients with chronic or terminal illnesses continue to face.

She reiterated the government’s commitment under the National Palliative Care Policy 2021–2030 to decentralize care and make it accessible at the community level.

“Families must be at the forefront of providing emotional and physical support, as the ministry works to strengthen the policy framework and integrate palliative care in all county health systems,” Dr. Wafula stated.

Despite the challenges, Embu County was cited as a success story in expanding access to palliative care. Over the past decade, the number of patients receiving such services has grown from just two to 40 daily, reflecting increased awareness and local investment in the program.

However, patients themselves painted a grim picture of the daily struggles they endure. Nelson Nyaga, a prostate cancer patient, described palliative care as “a lifeline,” but lamented the high cost of treatment and the persistent lack of essential drugs in public facilities.

“We appeal to the government to step in and ensure we can access the medicines and care we need to live with dignity,” Nyaga said.

KEHPCA has urged the Ministry of Health to review the SHA framework urgently and include comprehensive palliative care coverage, saying that without such reforms, the promise of universal health coverage will remain out of reach for Kenya’s most vulnerable patients.