Private Hospitals Suspend SHA Services Over Payment Delays, Digital Failures

Nairobi, Kenya – Kenya’s ambitious universal health coverage programme has suffered a major setback after private hospitals across the country suspended services under the Social Health Authority (SHA), citing months of unpaid claims and persistent failures in the scheme’s digital infrastructure.

In a strongly worded notice issued on Monday, the Rural and Urban Private Hospitals Association of Kenya (RUPHA) said all patients relying on the SHA scheme would now be required to pay cash for treatment. The association explained that the drastic move was necessary to keep hospitals running, safeguard patient care, and prevent shortages of essential drugs and medical supplies.

Hospitals Say Government Has Not Paid for Months

RUPHA officials revealed that the Ministry of Health had delayed payments for services already rendered, leaving hospitals cash-strapped and unable to meet operational costs.

“Our priority is to keep hospitals operational and protect our patients. But the government has left us with no choice. We cannot continue offering services without reimbursement,” the notice stated.

Hospital administrators warned that the non-payment crisis was jeopardising both the financial viability of private health facilities and access to healthcare for thousands of Kenyans, particularly those from low-income backgrounds who rely on the public insurance scheme.

Digital Claims Platform Under Fire

The association also criticised SHA’s digital claims platform, saying it lacks proper fraud-detection capabilities and has failed to guarantee quality assurance in medical services.

Billions of shillings allocated for quality management, hospital accreditation, and fraud prevention remain unimplemented, leaving healthcare providers exposed to administrative chaos and financial risk.

“Digital efficiency was supposed to be the backbone of this new system, yet it has become its weakest link,” said one hospital director in Nairobi, warning that continued system failures could erode confidence in the entire universal health coverage agenda.

Patients Fear Rising Costs and Barriers to Care

The suspension has already sparked concern among patients who worry that paying out-of-pocket will deter many from seeking treatment. Health rights groups argue that the stalemate could reverse gains made in expanding access to affordable healthcare.

“For ordinary Kenyans, this means longer delays, higher costs, and possible neglect of vulnerable patients. Universal health coverage cannot succeed if private hospitals—the backbone of Kenya’s healthcare system—pull out,” said public health expert Dr. Anne Njoroge.

Ministry Promises Action but Offers No Timeline

The Ministry of Health responded by acknowledging the complaints and pledging to engage RUPHA to resolve the crisis. However, officials did not give a clear timeline for settling outstanding bills or upgrading the troubled digital platform.

Health economists warn that unless the government addresses both financial reimbursements and technological inefficiencies, the credibility of the SHA and the wider universal health coverage plan could be undermined ahead of its full rollout in 2026.

What’s Next for SHA and Kenya’s Health Goals

The standoff comes barely a year after SHA replaced the controversial National Health Insurance Fund (NHIF) as part of President William Ruto’s pledge to achieve universal health coverage. The programme was designed to pool resources, prevent catastrophic health costs for families, and ensure equitable access to medical care.

But with private hospitals now suspending participation, experts say the government risks losing critical partners who provide more than 50 percent of healthcare services nationwide.

RUPHA has demanded:

• Immediate payment of outstanding claims

• A fully functional, fraud-proof digital claims system

• Transparent allocation of funds for quality assurance and hospital accreditation

Unless these conditions are met, the association says cash payments will remain in force, leaving millions of Kenyans to shoulder medical costs that the universal health coverage scheme was designed to eliminate.