Kenyan Patients at Risk as Private Hospitals Cut Ties with Social Health Authority

By Liz Anyango

Kenya’s dream of universal health coverage is facing a serious challenge. The Rural and Urban Private Hospitals Association of Kenya (RUPHA) has announced that over 700 private and mission hospitals will stop offering services on credit to the Social Health Authority (SHA).
The dispute is mainly about money and broken contracts. But the people who will suffer most are patients who depend on these hospitals for treatment.

RUPHA says SHA is in a financial crisis. Hospitals are owed Kshs 43 billion, with another Kshs 24 billion in pending claims. Without payment, many hospitals say they cannot continue to operate. Patients will now be asked to pay cash upfront—or risk missing out on care.

The association also pointed out a weakness in the financing model. Almost all contributions, 96%, come from salaried workers. The informal sector contributes only 4%. This imbalance has left SHA struggling to meet its obligations.

RUPHA also accused SHA and the Kenya Medical Practitioners and Dentists Council (KMPDC) of unfairly reducing hospital capacity. According to them, the country has already lost 3,478 maternity beds, 1,080 delivery beds, and 10,000 inpatient beds. For many Kenyans, this means longer waits, longer travel, and higher risks—especially for expectant mothers.

Another big issue is the rejection of claims worth Kshs 10.6 billion. RUPHA says this was done outside contract terms and without giving hospitals a chance to defend themselves. They argue that SHA has used fraud checks as an excuse to delay or deny payments, but without fair systems for resolving disputes. The legally required tribunal is also missing.

For ordinary families, this standoff is worrying. Many people who depend on private and faith-based hospitals will now be forced to pay before treatment. For those who cannot afford it, healthcare may simply become out of reach.

To resume services, RUPHA has given six conditions. These include: paying all claims under Kshs 10 million immediately, starting verification of larger claims within a week, cancelling unfair claim rejections, setting up the independent tribunal, fixing the financing model, and restoring hospital beds that were downgraded.

The situation raises bigger questions. Is this only a case of poor financial management, or does it point to deeper problems in Kenya’s universal health coverage plan? Unless quick action is taken, the promise of affordable healthcare for all Kenyans may remain just that a promise

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