The Rural Private Hospitals Association of Kenya (RUPHA) has sounded the alarm over what it terms a deepening financial crisis in the country’s healthcare sector, citing massive unpaid bills and delayed reimbursements by the Social Health Authority (SHA).
Speaking during a press briefing in Meru, RUPHA Vice Chairperson Rev. Dr. Joseph Kariuki revealed that since SHA’s rollout in October 2024, hospitals have submitted claims worth Ksh 93 billion, yet only 53 percent about Ksh 50 billion has been reimbursed. This has left a staggering Ksh 43 billion gap, compounded by Ksh 33 billion in unpaid arrears inherited from the defunct National Health Insurance Fund (NHIF). In total, the sector is grappling with debts exceeding Ksh 76 billion.
According to RUPHA, the situation has crippled hospitals, forcing many to take on unsustainable debts to keep facilities operational. The association, which represents more than 700 private and faith-based hospitals across the country, accused SHA of failing to honor its own directive requiring reimbursements to be made by the 14th of every month.
Concerns were also raised about SHA’s public transparency portal, which RUPHA claims is misleading as it omits critical information such as claim-to-payout ratios. In addition, the association decried non-payment of Primary Healthcare (PHC) reimbursements in pilot counties including Mombasa, Kirinyaga, Embu, and Nandi. They argued that digitization, instead of easing processes, has worsened delays and undermined the government’s pledge of free PHC services.
RUPHA further criticized what it described as the “unlawful downgrading and removal” of licensed healthcare facilities from the SHA system, saying such actions contravene Gazette Notice No. 269 of 2021 and other legal safeguards.
RUPHA Chairperson Dr. Brian Lishenga called on the government to urgently address the crisis by clearing outstanding bills, restoring transparency in reimbursement processes, halting arbitrary downgrades of healthcare facilities, and ensuring fair treatment of private hospitals.
“Private hospitals provide nearly half of Kenya’s healthcare services. Undermining them puts millions of lives at risk,” Dr. Lishenga warned.
The association urged the government to act swiftly, warning that failure to resolve the crisis could destabilize the entire health system and jeopardize access to essential services for millions of Kenyans.
