Private hospitals warn of collapse over unpaid SHA debts

Social Health Authority (SHA) building located at Upper Hill in Nairobi. [Edward Kiplimo, Standard]

Kenya’s private health providers have sounded an alarm over what they term unprecedented financial distress linked to unpaid claims by the Social Health Authority (SHA), warning that the situation could cripple access to healthcare across the country.

In an internal memo to its members, the Kenya Healthcare Federation (KHF) stated that its network, which accounts for approximately 60 percent of medical care in Kenya, is on the brink of collapse due to ballooning debts inherited from the defunct National Health Insurance Fund (NHIF).

The federation, which comprises private/faith-based hospitals, accused the government of failing to honor President William Ruto’s March 5 directive that all NHIF debts below Sh10 million be settled. 

“This debt has reached an unsustainable level, and further accumulation will lead to lack of access and/or serious deterioration of quality,” the memo seen by The Standard read in part.

KHF warned that providers have been forced into closures, staff layoffs, and auctions, while others are struggling to meet contractual obligations. 

It noted that hostility in the sector, rejection of claims without clear explanation, and blanket accusations of fraud have further eroded investor confidence.

The federation proposed a raft of measures, including issuing default notices to patients covered by non-performing SHA-managed funds, requiring patients to sign liability undertakings, and engaging lawmakers to push for accountability.

KHF further demanded transparency from SHA on claim payments, collections, and performance of its administered schemes, as well as the establishment of a clear appeals process for rejected claims.

“If SHA or any other payer does not pay, client engagement should revert to cash basis,” the federation cautioned, warning that without urgent intervention, Kenyans may face catastrophic out-of-pocket expenses.

Despite the crisis, KHF maintained it remains committed to ensuring access to care, describing its members as “irreplaceable and indispensable” in the health system.

Their statement comes a day after Health Cabinet Secretary Aden Duale dismissed calls for his resignation over alleged fraud at SHA, accusing some lawmakers of blackmail and conflict of interest.

Speaking after a group of MPs under the Kenya Moja coalition demanded he step down within 48 hours, Duale claimed that some legislators' own health facilities flagged in the controversial SHA payment claims saga.