Delayed SHA reimbursements leave 96% of Kenyan health facilities in financial crisis, with private hospitals hardest hit.
Kenya’s Social Health Authority Faces Financial Turmoil Amid Reimbursement Delays
NAIROBI, Kenya – Kenya’s Social Health Authority (SHA) is facing a major financial credibility test as a new survey reveals 96% of contracted health facilities are in financial distress, citing delays in reimbursement of claims under the new social health insurance model.
A recent report by the Rural & Urban Private Hospitals Association of Kenya (RUPHA) paints a grim picture: many facilities have resorted to bank loans and deferred staff salaries to stay operational.
Survey Uncovers Widespread Distress
Conducted between October and December 2024, the RUPHA survey highlights that:
- 98% of private hospitals report financial strain.
- 90% of faith-based facilities are also struggling.
- Top challenges include operational costs (89%), payroll expenses (87%), and supplier debts (81%).
“Specific measures to ensure financial sustainability for primary care services are urgently needed.”
— Dr. Brian Lishenga, Chairperson, RUPHA
Claims Payment Lags Behind
The same survey reveals only 42% of facilities received any reimbursement during the quarter. Among these:
- 52% were paid less than 20% of their total claims.
- Most received only one payment between October and December.
These delays have sparked concern that the sustainability of Kenya’s Universal Health Coverage (UHC) is at risk, especially for smaller private and rural providers who depend heavily on consistent funding. Some local health facilities, however, have cut for themselves a niche and are not affected by the crises.
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SHA Responds to Criticism
In response, Robert Ingasira, Acting CEO of SHA, disputed the findings, saying that Sh7.3 billion has already been disbursed to over 5,000 health facilities.
“For SHA, October and November, more than 90% of the facilities received more than 90% of their money.”
— Robert Ingasira, Acting CEO, SHA
According to SHA, these payments covered a mix of public, private, and faith-based facilities under the Social Health Insurance Fund (SHIF) and Emergency, Chronic, and Critical Illness Fund (ECCIF).
Call for Urgent Reforms
The growing tension between healthcare providers and SHA highlights a pressing need to streamline reimbursement systems, improve transparency, and restore trust within Kenya’s ambitious healthcare reform agenda.
📊 Key Figures at a Glance
- 🏥 96% of facilities report financial distress
- 🏥 98% of private hospitals affected
- 💸 42% received any SHA payments (Oct–Dec 2024)
- 📉 52% of paid claims were under 20% of submissions
- 💰 Sh7.3 billion disbursed, according to SHA
🔗 Related Content
Why Primary Healthcare Needs Better Funding
How Kenya’s UHC Plan Works Under SHA
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