Dilemma of M-Pesa payment as patients suffer, revenue rises

Income at Coast General Hospital increased from Sh17 million to Sh25 million 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 increased.

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 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.

POVERTY

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 are 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.

“I have seen several patients seeking treatment turned back either because they did not have phones, or were not registered for M-Pesa. But they should accept cash from old people who cannot use the service,” Ms Julia Katheu said.

REVENUE

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 four-year-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.

CORRUPTION

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 percent of the revenue. Our revenue has more than tripled since we automated,” the governor added.

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. The county’s chief officer of Health, Ms Khadijah Shikely, recently concurred that the use of M-Pesa at Mombasa hospitals had increased revenue.