Dilemma of M-pesa payment as patients suffer, revenue rises
Income at Coast General Hospital increased from Sh17m to Sh25m since last year when a cashless payment system was adopted, but poor patients without mobile phones are disadvantaged
When Mombasa Governor Hassan Joho's administration adopted M-pesa as a mode of payment for health services at public hospitals, revenue collection doubled.
In September last year, officials of Coast General Provincial Hospital (CPGH), the largest referral facility in the region, directed that all transactions be conducted electronically, instead of cash, to end corruption.
To access health services at CPGH, unless in emergency cases, one was required to buy a patient booklet at Sh100, besides making other payments via M-pesa.
The revamped facility is relied on by many patients, including those from neighbouring counties such as Kwale, Tana River, Lamu and Taita Taveta, as well as North Eastern counties like Garissa and Mandera.
But payment via M-pesa has greatly inconvenienced many patients.
Coast General Hospital also handles major medical specialities, including open heart surgery, oncology, endoscopy and laparoscopy.
Other health facilities in the county that have adopted the electronic payment method include Mvita Health Centre and Kaderbhouy.
But families from poor households, who lack mobile phones, are crying foul over the new mode of payment, which Mr Joho insists helps promote transparency and accountability, hence reducing corruption.
“I have seen several patients seeking treatment turned back either because they did not have phones, or were not registered with M-pesa. But they should accept cash from old people who cannot use the service,” Ms Julia A downside to the cashless mode is service interruption, for instance in July when Safaricom network was disrupted following multiple fibre link cuts, affecting millions of subscribers.
In June, Coast General Hospital boss denied reports that two patients had died while queuing to make payments after Safaricom suffered network outage.
Coast General Hospital, with a 700-bed-capacit, serves about 1.3m people. It faces many challenges — including shortage of staff and long lists of referrals. Similar complaints have been received from other parts of Kenya which have adopted cashless systems of payment. Katheu said.
Patients from rural areas say adoption of the cashless system is unfair to them.
“I am sorry but to access treatment at CPGH, you must pay via M-pesa. This is after the county government fully automated its payment system,” a health worker at the facility told a Nation reporter who sought treatment.
A year after adoption of the new system, the county's health department has registered increased revenue, even as many poor residents lament the technology shift.
On November 19, Ms Mariam, a Mombasa resident, narrated to the governor how she had suffered due to the change in the payment mode. She was seeking treatment at CPGH.
“I was at the hospital, seven months pregnant and with a fouryear-old child with a fractured leg. I left the emergency section to pay via M-pesa. But I didn't have cash in my mobile phone, so I had to go out and put cash in my M-pesa account then return to the hospital to pay,” she said.
“After paying, I had to wait for an M-pesa confirmation message, then carry my child to see the doctor. The doctor told me to go for an X-ray. This meant I had to go to pay via M-pesa once again. The queue is long; I am in turmoil. I don't know how you will address this issue,” she told the governor.
Ms Mariam, who identified herself only by one name, challenged Mr Joho during a live broadcast on a local TV station to address the issue, saying people from rural areas seeking health services at the facility were suffering.
But Governor Joho insisted that patients must pay through M-pesa, which he said had improved efficiency at the facility.
“We also wanted to minimise human interaction, especially on issues concerning money, so as to end corruption. Before we introduced M-pesa payments, we used to lose 60 per cent of the revenue. Our revenue has more than tripled since we automated,” added the governor.
He assured residents that the county would consider people who had not adopted M-pesa services.
He told the hospital's administrator, Dr Iqbal Khandwala, to engage Safaricom to place more M-pesa points at the facility.
He said the county is moving away from cash transactions. “We want to ensure that public cash is not lost; it is my responsibility to do this,” he added.
The county's chief officer of Health, Ms Khadijah Shikelly, recently said use of M-pesa at Mombasa hospitals had increased revenue collection. “Coast General Hospital is now fully automated, with the collection rising from Sh17 million to Sh25 million," she said in an article on the county's website.
Mombasa Governor Hassan Joho during the opening of a high dependence unit (HDU) at Coast General Provincial Hospital, equipped by Safaricom Foundation, on July 23, 2018. Patients from rural areas say adoption of an M-pesaonly payment system at the health facility is unfair to them, especially the elderly.