The Challenge of Running a Mission Hospital (Part 2)
Last week, we pulled back the curtain on Kenya’s healthcare system—how government hospitals struggle with resources, private hospitals remain extraordinarily expensive, and countless patients are left with nowhere to turn. But in the midst of these challenges, mission hospitals stand as a vital resource.
Still, managing a mission hospital in Kenya presents significant challenges. So this week, we’re diving into a critical question:
Why is it so difficult to run a mission hospital in Kenya?
Patients waiting in Kapsowar Mission Hospital’s outpatient department.
Let’s take a step back and look at how health insurance works in Kenya. For years, the government has offered some form of insurance to its citizens, with the current system being the Social Health Authority (SHA). The good news is that SHA is income-based, making it accessible for the poorest individuals to enroll and receive healthcare coverage.
On paper, it sounds like a great idea. In reality, hospitals face two major challenges in this system:
First, reimbursements don’t fully cover the cost of care. For example, hospitals receive a flat rate of about $30 per day for a patient in the medical ward—regardless of the medications, lab tests, or critical care services required. This often falls short of the actual cost of treatment, leaving hospitals operating at a loss.
Second, even these inadequate reimbursements are rarely paid on time—if at all. Payments from the government are frequently delayed for months, and some never arrive. As of this month, our hospital is owed more than eight months of back payments, totaling $750,000 in outstanding claims. It is very possible these claims will never be paid by the government. And even if these claims were paid, they would only cover about 75% of the total costs.
Because of these financial strains, private hospitals charge exorbitant fees to compensate for losses, while government hospitals struggle to provide even basic care. Just last year, all government doctors in Kenya went on strike for two months—one of the key reasons being unpaid wages.
One of our general surgeons, Dr. Celeste, rounding on a patient in our surgical ward.
Can you sense the challenge we face? This broken system leaves mission hospitals like ours shouldering the responsibility of caring for the sick with limited resources—stretching every supply, every salary, and every service just to keep going. Without reliable funding, providing this level of care feels like an uphill battle. There have been moments this year when our hospital’s bank account held just $400.
Yet, there is hope. While we may not have the financial backing of the government or the steady income of private hospitals, we have something even more powerful—you.
Stay tuned—our next post is the final part of this series, where I’ll share how individuals like you have made, and continue to make, an incredible difference in the lives of our patients.
Read Part 1: Healthcare in Kenya