Doctors during a past nationwide strike. Courtesy/X
By Daisy Okiring
Kenya’s healthcare sector is facing a looming crisis as private and faith-based hospitals threaten to shut down operations over delayed reimbursements from the government.
The Rural and Urban Private Hospitals Association of Kenya (RUPHA), which represents over 700 facilities nationwide, has accused the Social Health Authority (SHA) and the Ministry of Health of failing to honor payments amounting to Ksh76 billion. The association warns that the stalemate risks crippling access to health services for millions of Kenyans.
Hospitals on the brink
RUPHA revealed that since SHA’s establishment in October 2024, hospitals have submitted claims worth Ksh93 billion. Of this, only Ksh50 billion—slightly over half—has been reimbursed, leaving a pending balance of Ksh43 billion.
“Hospitals across Kenya are on the brink. Many have already shifted to cash-only payments, while others are preparing to shut their doors,” said Dr Brian Lishenga, RUPHA Chairman.
Read More: CS Duale suspends 40 hospitals over SHA fraud claims
The association noted that the Ministry of Health had directed reimbursements to be made by the 14th of every month, but the directive has never been honored. Instead, RUPHA argues, hospitals are drowning in debt as the government delays payments.
“The SHA claims to be transparent by publishing facility-level reimbursements online. But without showing how much was claimed versus what was actually paid, this is propaganda, not transparency,” Dr Lishenga added.
Allegations of downgrades and discrimination
Beyond delayed payments, RUPHA accuses SHA of arbitrarily deleting hospital bed capacity and downgrading facilities on its portal despite valid medical licenses. According to the association, over 10,000 inpatient beds and 3,500 maternity beds have been erased from Level 2 and Level 3C facilities.
“These downgrades are unlawful and unconstitutional. There is no due process, no lawful framework, and no appeals mechanism. Private hospitals are being unfairly targeted,” the association said in a statement.
The crisis is further worsened by pending National Hospital Insurance Fund (NHIF) bills, which remain unsettled despite a presidential directive in early 2025. Hospitals were assured that debts below Ksh10 million would be cleared within 90 days, but none have been paid. RUPHA estimates NHIF owes an additional Ksh33 billion, pushing total government debt to private hospitals to Ksh76 billion.
Read More:Gov’t raises red flag on ozempic misuse for weight loss in Kenya
Read More: Tycoons in Sh200bn counties’ medical kit deal unmasked
Strain on universal health coverage
Private hospitals account for nearly half of healthcare services in Kenya, especially in underserved counties. RUPHA now warns that continued neglect undermines the government’s Universal Health Coverage (UHC) agenda.
“How can the government promise Kenyans free primary care when hospitals on the ground are not being paid?” the association posed.
In counties such as Mombasa, Embu, Nandi, and Kirinyaga, which are piloting the government’s Digital Superhighway system, hospitals report that the platform has created fresh bottlenecks rather than streamlining claims. Facilities remain underfunded, staff demoralized, and patients increasingly asked to pay out-of-pocket.
RUPHA has also accused the Ministry of weaponizing fraud investigations to delay legitimate payments for surgeries and inpatient admissions, leaving hospitals in financial distress.
Uncertain future
With a combined debt burden of Ksh76 billion, private hospitals say insolvency is becoming inevitable. They warn that unless immediate payments are made, mass closures will disrupt essential services including maternity, surgery, and emergency care.
“The President spoke. Hospitals are still waiting. Instead of being paid, they are sinking into insolvency,” RUPHA stated.
The association is now calling for urgent government intervention to prevent what it describes as the most serious healthcare funding crisis in Kenya’s history.
About the Author
