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

Daily Nation (Kenya) - - SUNDAY REVIEW - BY WIN­NIE ATIENO

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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.

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