Private hospitals in Kenya are facing mounting pressure from the Social Health Authority (SHA) to resume full medical services, despite a lingering Sh30 billion debt inherited from the defunct National Health Insurance Fund (NHIF).
Healthcare facilities, which had limited their services to emergency care and elective surgeries, claim they are being threatened with contract termination if they do not comply with SHA directives.
SHA Warns Against Contract Breaches
In a memo dated February 25, SHA’s Nyeri branch accused hospitals of violating contract agreements by suspending certain services.
“All contracted healthcare providers must fully comply with the contract’s implementation. Any deviation constitutes a breach, warranting prompt action as per the contract terms,” the memo stated.
Medical Services Principal Secretary Harry Kimtai is scheduled to convene a meeting on Thursday to address the impasse.
Private Hospitals Push Back
Dr. Brian Lishenga, Chairperson of the Rural and Urban Private Hospitals Association of Kenya (RUPHA), dismissed SHA’s threats, arguing that healthcare providers cannot be coerced into offering services under unfavorable conditions.
“Hospitals have the right to withdraw services in the event of a contract breach. Our members should ignore these directives—we cannot be forced to operate without guaranteed payments,” said Lishenga.
According to him, SHA contracts merely outline the scope of covered services and the claims submission process, rather than mandating full-service provision.
Growing Discontent in the Health Sector
SHA has so far contracted 3,993 hospitals, including 2,244 private, 352 faith-based, and 1,366 county-run facilities. However, private hospitals have been disproportionately affected by delayed reimbursements, leaving patients to bear out-of-pocket costs despite government promises of affordable healthcare.
Dr. Erick Musau, Chairperson of the Kenya Association of Private Hospitals, confirmed that many Nairobi-based facilities are only accepting SHA for critical services such as dialysis, oncology, and emergency care.
SHA CEO Robert Ingasira acknowledged the backlog, stating that the authority currently owes hospitals Sh10 billion in unsettled claims.
As negotiations continue, the standoff threatens to disrupt healthcare access, raising concerns about the future of Kenya’s universal health coverage ambitions.