Kenyan citizens relying on the Social Health Authority (SHA) to access care in private hospitals woke up to bad news after the Rural & Urban Private Hospitals Association of Kenya (RUPHA) suspended all services for SHA patients.

The announcement means that more than 700 private health facilities represented by RUPHA will no longer accept SHA coverage, forcing patients to pay out of pocket. For many families, the decision results in unexpected financial strain, especially those who had relied on private facilities for faster, more reliable services.

In its circular, RUPHA explained that the drastic decision was not taken lightly. “The decision has been taken due to delayed and unsettled payments by SHA, which has made it unsustainable for hospitals to continue offering services on credit,” the association stated.

For months, hospitals have been treating patients without seeing a single coin in return, leaving them with ballooning debts and tough choices between serving patients and keeping their doors open.

Behind the numbers lies a picture of collapse waiting to happen. As of August 2025, SHA owed hospitals Sh43 billion, with another Sh24 billion still under review. Every month, claims worth Sh8.8 billion are submitted, yet reimbursements trickle in at only Sh5.4 to Sh6 billion.

The deficit has left hospitals quietly subsidising the system. “We can no longer afford to carry the weight of a failing system at the expense of patient care,” one hospital administrator said, echoing the frustrations of many facilities, particularly in rural counties.

The burden is already impacting patients. Outside a private clinic in Nakuru, a young mother who had brought her child for treatment expressed shock at the sudden change.

“I only had my SHA card with me. Now they are asking me to pay cash. I don’t know how I will manage,” she said, clutching her toddler. For patients like her, the suspension is not just about policy disputes; it is about whether they can afford lifesaving care.

Doctors, too, are caught in the crossfire. A senior physician in Kisii described how the delays in payments had stretched resources to breaking point.

“We want to treat everyone who comes through the door, but when suppliers are not paid and staff salaries are delayed, something has to give. It is painful that patients are the ones who suffer,” he explained.

RUPHA’s suspension follows the expiry of a two-week notice issued on September 5, warning that services would be withdrawn if the claims were not settled. The association insists its demands are reasonable, pointing to a presidential directive that NHIF arrears below Sh10 million be cleared immediately, a step they say has yet to be honoured.

Beyond that, they want verification and payment processes for larger claims expedited, unfair rejections overturned, and an independent tribunal set up to settle disputes.

The association has also called for reforms to SHA’s financing model, which it believes is the root cause of the crisis. Without such changes, it warns, hospitals risk closure, and patients will continue to bear the cost of a broken system.