Notably, the Health Committee chair says health is devolved and that majority of patients are served in the lower-cadre hospitals.
County governments have also highlighted the concerns and challenges they face when implementing SHA services.
Lennox Mugawari, the chairperson of the Health Committee in Kwale County cites the sluggish implementation of the Facilities Improvement Financing (FIF) Bill, as a hindrance to the adoption of SHA services.
"We have several counties that are still struggling because we understand that the FIF bill states that there must be a 100 per cent transition. But as far as the way it is delineated, we have some bottlenecks that still exist in the system that need to be addressed for the counties to now fully adopt the FIF.
I may not have the exact number of counties that have managed and those who have not managed, but some of the bottlenecks that we've experienced is that, for example, the FIF bill, requires that in every facility you must have a financing officer who is going to be handling the cash," Mugawari said.
The Bill, now the Facilities Improvement Financing Act, 2023, provides the framework for public health facilities to collect, retain, and manage revenue generated from their services, aiming to improve patient care and facility infrastructure.
It provides for a unified system to guide financial management in public health facilities, improving efficiency and effectiveness, and ultimately quality.
Mugawari, a county lawmaker, says counties have reached their ceiling and therefore, they are not able to employ more people.
"Then the other issue with the FIF bill is that we've seen a situation where there are some of the governors who are not ready to fully adopt it simply because they used to get the money from the health department and realign it to other priorities instead of channeling the same cash back to health so that it can improve the facilities," he stated.
Mugawari made the observations at a panel discussion during the 5th Legislative Summit by the Council of Assemblies Forum where Members of all County Assemblies were in attendance.
Kisumu was the only county that acknowledged they had successfully implemented the FIF Bill and it was functional.
For effective service delivery in the counties, private hospitals have urged the state to upgrade health facilities by modernising records and adoption of modern equipment.
SHA was implemented on October 1, 2024, and has faced a myriad of opposition, scrutiny and backlash from Kenyans who have had challenges accessing the service.