The Rural and Urban Private Hospitals Association of Kenya (RUPHA) has sounded the alarm over massive payment delays by the Social Health Authority (SHA) and the National Health Insurance Fund (NHIF), warning that the country’s healthcare system is at risk of collapse.

Speaking during a press briefing in Meru Rev Dr. Joseph Kariuki Vice chair, RUPHA, association  which represents more than 700 private and faith based sponsored hospitals, revealed that since SHA’s launch in October 2024, hospitals have submitted claims worth Ksh 93 billion, yet only 53pc (about Ksh 50 billion) has been reimbursed.

The Ksh 43 billion shortfall, coupled with Ksh 33 billion in unpaid NHIF arrears, has left facilities crippled by debts exceeding Ksh 76 billion.

The association 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. RUPHA 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.