By Dennis Dibondo
The Rural and Urban Private Hospitals Association of Kenya (RUPHA) has raised alarm over delays by the Social Health Authority (SHA) to pay for it’s services and the National Health Insurance Fund (NHIF) debt.
The association said the debts will cripple the country’s healthcare system.
RUPHA vice chairman Rev Dr.Joseph Kariuki said the association which represents more than 700 private and faith based sponsored hospitals since SHA’s launch in October 2024, hospitals have submitted claims worth KSh93 billion, yet only 53% (about KSh50 billion) has been reimbursed.
He spoke during a press briefing in Meru on Thursday.
Social Health Authority owes the hospital KSh43 billion while NHIF arrears amount to KSh33 billion.
Kariuki said this has left facilities crippled by debts exceeding KSh76 billion.
Kariuki further accused SHA of failing to meet its own directive requiring reimbursements by the 14th of each month and criticized its public transparency portal as misleading for omitting crucial claim-to-payout ratios.
Kariuki also raised concern over the non-payment of Primary Healthcare (PHC) reimbursements in pilot counties such as Mombasa, Kirinyaga, Embu, and Nandi, arguing that digitization has worsened delays and undermined the government’s promise of free PHC.
In addition, the group decried what it termed as unlawful downgrading and removal of licensed healthcare facilities from the SHA system, citing violations of Gazette Notice No. 269 of 2021 and other legal safeguards.
RUPHA Chairperson Dr. Brian Lishenga called on the government to urgently settle outstanding bills, restore transparency in reimbursements, stop arbitrary downgrades of facilities, and ensure fair treatment of private hospitals that provide nearly half of Kenya’s healthcare services.
“The health sector is on the brink. Many hospitals are now demanding cash only payments, while others risk closure especially in rural counties like Wajir, Mandera, Marsabit, and Samburu, where private facilities are often the only lifeline,” said Dr. Lishenga.
Three days ago Health CS Adan Duale reaffirmed the Ministry’s commitment to tackling structural challenges and called for a collaborative framework.
“I reaffirmed the Ministry’s commitment to tackling structural challenges through legal, institutional and data-driven reforms and called for a Public–Private Collaborative framework involving MoH, SHA, private insurers and IRA,” Duale said.
The health coverage was introduced on October 1, 2024 to replace the National Health Insurance Fund (NHIF).
President William Ruto said NHIF accumulated billions of shillings in debt and had misalignments with the contributions from Kenyans in comparison to the cost of healthcare services.
President Ruto also promised that SHA would rid the healthcare sector of problems associated with NHIF, although recent adaptations of biometrics and bed-sharing fraud by healthcare facilities are proving challenging to ailing Kenyans.
Mt Kenya Times 
John Kariuki