Free Soul

Trinity Family Medicine CEO, A Man

[Fabian 💎 ✨ @_Fabian_254]

@mrnoven29 last year

[The Kenyan Gyne (#HealthServiceCommission) @simonkigondu]

SHA SHUT DOWN! WHEN HEALTH SYSTEMS FAIL, PATIENTS PAY THE PRICE
On 13th October 2026, the Social Health Authority (SHA) portal was switched off at Kigumo Subcounty Hospital in Murang’a County.
Why?
Because https://t.co/Kj09Wsuur5, the Health Management Information System (HMIS) that Murang'a County Government has used for the past four years, has not yet been integrated with the new SHA system.
The immediate consequence is devastating: patients who have registered with and contributed to SHA are now being required to pay out of pocket to access services at Kigumo Hospital.
How did we get here?

A GOOD IDEA, POORLY EXECUTED
SHA, in its latest effort to integrate hospital information systems with its invoicing and payment platform through the Health Information Exchange (HIE), issued a hard deadline of 1st October 2026 for HMIS providers to complete the integration process.
The intention is good. The timelines are ridiculous!
As of yesterday, approximately 35 systems were reportedly accredited by the Digital Health Agency (DHA) as compliant with the integration requirements.
Any hospital using a system that had not received the necessary accreditation would effectively be locked out of SHA transactions.
And that is precisely what has happened to Kigumo Hospital.

FOUR YEARS OF INVESTMENT AND HARD WORK AT RISK
For the past four years, Murang’a County has invested considerable resources, time and institutional effort in developing and improving AfyaKE.
I have personally witnessed this journey.
The first two years were particularly difficult. We experienced system failures, operational challenges, workflow disruptions and considerable frustration among healthcare workers and patients.
We persevered.
Today, AfyaKE is a relatively reliable and functional HMIS that supports patient registration, clinical documentation, hospital operations and other aspects of service delivery.
It has become part of our institutional infrastructure.
Now, there are reports that Murang’a County, alongside several other counties, may be required to migrate to a different HMIS.
Feedback from some facilities that have used the proposed alternative suggests that the transition may not be smooth.
There will be tears before another system becomes fully functional.
We know this because we have already walked that journey.
Why should counties that have invested years and considerable public resources in developing functional systems be compelled to abandon them when integration with the national HIE is technically possible?

IS THIS DIGITAL TRANSFORMATION OR VENDOR-DRIVEN DISRUPTION?
The objective of integrating clinical information systems with health financing, invoicing and reimbursement platforms is sound.
Indeed, this is the direction modern healthcare systems should take.
However, successful digital transformation requires proper planning, stakeholder engagement, interoperability, realistic timelines and effective change management.
Unfortunately, the health sector has experienced repeated episodes of poorly managed change over the past four years.
The SHA transition is increasingly becoming a case study in how not to manage major health system reforms.
There is also a legitimate concern that the current approach risks becoming vendor-driven rather than patient-centred.
The national digital health architecture should promote interoperability, not unnecessarily force every hospital onto a particular software platform.
If AfyaKE can be integrated into the HIE and meet the required technical, security and data standards, why should Murang’a County be compelled to discard it?

WHAT HAPPENS TO FOUR YEARS OF PATIENT DATA?
There is another serious concern.
Over the past four years, Kigumo Hospital has accumulated substantial electronic patient information through AfyaKE.
This includes clinical records, patient histories, service utilisation data and other information essential for continuity of care.
What happens to this information if the county is forced to migrate to another HMIS?
Who guarantees its integrity, security, accessibility and continuity?
Will historical records remain available to clinicians?
Who bears responsibility if important patient information is lost during migration?
These are not minor technical questions. They are fundamental issues of patient safety, confidentiality, clinical governance and institutional accountability.
The county may also be forced to incur additional expenditure to migrate systems, retrain healthcare workers and reconfigure existing services.
This is public money that could otherwise support medicines, equipment, staffing and direct patient care.

WHEN SYSTEMS FAIL, DOCTORS TAKE THE BLAME
At Kigumo Hospital, we already receive complaints from patients whenever our otherwise functional HMIS experiences downtime.
Patients understandably become frustrated when registration, consultation, laboratory requests, pharmacy services or billing processes are interrupted.
Often, the patient does not understand the technical problem.
The patient simply sees a doctor who is taking too long to attend to them.
The doctor becomes the face of a system failure that he or she did not create.
Now imagine explaining to a patient who has faithfully contributed to SHA that the hospital cannot process their SHA services because the portal has been switched off.
Imagine telling a pregnant mother, an elderly patient or someone living with a chronic illness that they must now pay out of pocket because two government digital systems cannot communicate.
How do we justify that?
The patient has fulfilled their obligation. The hospital is available. The healthcare workers are ready to provide services.
Yet access is interrupted by an administrative and technological decision.
This is not Universal Health Coverage. This is a barrier to healthcare created by the very system that is supposed to facilitate access.

CHANGE MANAGEMENT MUST PUT PATIENTS FIRST
The government, through SHA and DHA, must recognise that digital health transformation is not simply about software procurement, accreditation deadlines and switching systems on or off.
It is about people.
It is about patients who need treatment.
It is about healthcare workers who need functional tools.
It is about county governments that have invested scarce resources in developing their health infrastructure.
And it is about protecting the public investment already made in functional systems.
A more reasonable approach would be to allow existing HMIS platforms that are capable of meeting national standards adequate time and technical support to integrate with the HIE.
During the transition, hospitals should have access to workable interim arrangements that protect patients from interruptions in care and unnecessary out-of-pocket expenditure.
There must also be a clear, secure and independently verifiable plan for preserving and migrating historical patient data wherever migration is genuinely necessary.
THE PATIENT MUST REMAIN AT THE CENTRE
Ultimately, what is the purpose of a health system?
A health system exists to serve patients, not software vendors, administrators or government agencies.
Technology is supposed to make healthcare more accessible, efficient, affordable and safe.
When technology becomes the reason patients cannot access healthcare, something has gone fundamentally wrong.
The events at Kigumo Hospital today should prompt serious reflection by SHA, DHA, the Ministry of Health and county governments.
We support digital integration.
We support accountability in health financing.
We support modern, interoperable health information systems.
But we cannot support a transition that disrupts healthcare delivery, wastes previous public investment and transfers the financial burden of administrative failures to patients.
The coming days will test the wisdom of the approach being imposed on county health systems.
We wish those responsible for implementing these changes well.
But above all, we ask them to remember the patient.
Because when SHA shuts down access, it is not the software that suffers. It is the Kenyan patient.

Dr Simon Mucara Kigondu
Consultant Obstetrician & Gynaecologist
Kigumo Subcounty Hospital
Emeritus President, @KenyaMedics_KMA

#SHA #AfyaKE #DigitalHealth #UniversalHealthCoverage #PatientSafety #MurangaCounty #HealthSystems #KenyaHealthcare See less

[Billy Ojwang @ojwang_bil9070]

Alafu sai wanatwambia ati votes are not online,, maumbwaa nyinyi😅😅

[Boniface @kilundeezy]

We forget too fast aki

[I am Chege @_James041]

MAJAMAA, you are being conned and may it not be said that I had information and kept it for myself.

Ouru Kinyasa, the thug from Ichaweri is not interested in replacing the thug from Sugoi.

His biggest nightmare is being hunted over Eurobond and grabbed parcels of land.

He cannot imagine someone who is not a thug running the country.

Remember that instead of being hunted over Eurobond 1, his fellow thug from Sugoi illegally borrowed another Eurobond 2 to settle Eurobond 1.

' Kumira Kumira' was not just a statement. It was an agreement that involved an oath.

Ouru Kinyasa is interested in controlling Nairobi politics and keeping the Presidency in the leadership of a thug.

Either his puppet in opposition or the one presently in power.

If his puppet wins, he wins. If the present thug wins, he also wins.

And it's we the people of Kenya who loses, because in February 2028, a budget will come and a murderous Finance Bill will come to tax you more to service Ksh 4T illegal debt that is expected to mature before June 2028.

That is why the killer regime has started scripting deflections and scripted arrests to harvest your emotional dopamine and to forget about the MPs who went against the will of people in 2024.

Aden Duale's statement of a President being elected by MPs was not just an utterance.

IEBC chairman's utterances that he will not hold elections in a toxic environment are also not just utterances.

It's part of the game plan. Infiltrate the opposition with their trusted thugs, con Kenyans into electing them as MPs,

Make the country ungovernable during elections, trap the country into a trap that IEBC is unable to conduct Presidential elections then push in between a parliamentary elections system.

Lastly Ouru Kinyasa does not trust your favorite young man because he has not gotten anything to use against him if by any chance he changes his mind and refuses to serve his interests.

He's planning to push the young man into accepting a CS position in the name of " you are still young, you will get another opportunity in future."

Young people, our agenda must not just be about change but REAL CHANGE.

We have an opportunity to completely liberate ourselves from CHATHAM House slave masters.

We must openly push for a working system where we are not overtaxed to service illegal debts.

We MUST not go back to another season of protests over a murderous Finance Bill.

We MUST put our focus on hunting down thugs, repudiating Odious debts, tracing looted funds, nationalizing our minerals and land redistribution.

For us to win this war, the war must be about Kenyans Vs Thugs.

Thugs MUST not be allowed to infiltrate a genuine course.

Kenya needs a renaissance and Kenyans MUST drain the swamp.

#DrainTheSwamp

[Litoro_Ke @CPA_Soft]

@TerryanneChebet You guys are not serious.
Seed capital for NIF should never be borrowed funds. It should be real money with no obligations.
The ONLY way to get Free money is from our mineral resources .
Do away with nonsensical royalties and own them 100%.
Start with magadi and Mrima hiils.

[William Omondi @FreeThinker_88]

I dont know whether its just me, but I have completely ZERO TOLERANCE to Ruto supporters. I stopped arguing with them or responding to them. I just block them. My timeline is now full of Sifuna type of tweets, but when I see Ruto supporters, BLOCK! I just cant stand that murderer

[Sir Meshack Obiero @Dr_Kwach]

@AnuarSaddat We will NEVER FORGET

[Lenny Papito @lenny_papito]

Two iconic photos with one remarkable political lineage. It’s impressive how Sifuna has forged a meteoric political rise under the mentorship of the late RAO and now the watchful eye of Jimmy. His journey, marked by courage, conviction and resilience, is just getting started. 🇰🇪

[Free Soul @princehillmaina]

@gabrieloguda Supporting this govt you have to suspend your brains,do factory reset ,see and blind,hear and deaf,you are a true disciple

[Lenny Papito @lenny_papito]

We would never have seen the condition of the roads in Homabay County. Thank you Linda Mwananchi

[BRAVIN YURI @BravinYuri]

This video is very useful in the History and Political Science class. Hell, even literature. I mean, the rain has literally started beating him.

[Britney @OwanghB]

Huwa nashangaa kama sisi wote watched someone get shot...for just selling masks
We all did
Kenyans forget very fast

[Free Soul @princehillmaina]

@lenny_papito Time to deny Christ...

[Lenny Papito @lenny_papito]

When you are a mole and you’ve to oversell it.

[Anwar Saddat @AnuarSaddat]

Uhuru handed over power peacefully to Ruto. For four years, Ruto has had an opportunity to implement his manifesto and improve the lives of hustlers as he promised.

After four years of monumental failure, wanton theft of public resources, overtaxation of hustlers, and the largest borrowing of any government in our history,

Ruto is now blaming Uhuru Kenyatta for his failures.

We may hold a differing political opinion but 99% of Kenyans agree that Ruto was a mistake that we must never allow to happen if we want Kenya to continue its existence.

[Chris Sambu @the_sambu]

It didn't take long for the cat to get out of the bag haha !

[Njambi @A_Njambi]

GUESS HOW MANY PARENTS WON’T BE ABLE TO CELEBRATE THEIR CHILDREN’S MARRIAGES BECAUSE YOU KILLED THEM IN THE STREETS WHEN THEY WERE FIGHTING FOR A BETTER COUNTRY!!!! YOU’RE TRASH!

[Keith Siau @drkeithsiau]

Blood transfusion compatibility - simplified 🩸

[𝗪𝗲𝗹𝗹𝗻𝗲𝘀𝘀 𝗖𝗵𝗲𝗺𝗶𝘀𝘁 @GodswillChemist]

Simple natural habits can support your body in powerful ways.