The Social Health Authority (SHA) has dismissed claims that some Kenyan patients receive preferential treatment when accessing health services, insisting that differences in approval levels stem from varying clinical needs rather than influence or connections.
The authority issued the clarification following a Daily Nation report published on Tuesday, which suggested that patients without access to influential figures often receive lower healthcare package approvals compared to those linked to powerful individuals.
In a swift response, SHA said approvals may differ even when patients share a similar diagnosis and seek treatment at the same hospital. According to the authority, such variations arise because patients present different clinical profiles, diagnostic requirements, and treatment pathways.
SHA explained that its pre-authorisation system, including applications for cancer treatment, operates through an automated digital platform designed to eliminate human interference.
“Individual staff members don’t have the ability to arbitrarily adjust approvals,” the authority said.
SHA outlined several factors that influence approval decisions, including the stage of care, the remaining balance within a patient’s annual oncology package, the complexity of the medical case, and the completeness and structure of the request submitted by the healthcare provider. The choice of medical facility also plays a role.
“As a result, differences in approvals don’t imply preferential treatment, but reflect the application of uniform benefit rules to differing clinical circumstances,” SHA stated.
The authority strongly condemned any form of preferential access to healthcare packages and warned that it would investigate any attempts to manipulate the system.
At the same time, SHA disclosed ongoing efforts to improve access to cancer care across the country by integrating the National Cancer Control Programme (NCCP) into its systems.
“This will support more standardised diagnostic panels, clearer provider submissions and improved patient experience,” the authority said.
