The Rural and Urban Private Hospitals Association of Kenya (RUPHA) has announced that, effective immediately, all healthcare services for Social Health Authority (SHA) beneficiaries will be provided on a cash basis. The association cited unpaid claims from the SHA as a major factor threatening the survival of private hospitals.
“Please be advised that, effective today, all healthcare services (unless otherwise stated) at this facility for SHA beneficiaries will be provided on a cash basis,” RUPHA stated.
The association linked the crisis to outstanding bills from the defunct NHIF and the new SHA, which it says have left the sector financially strained. Earlier this month, RUPHA gave the Ministry of Health 14 days to settle part of the debts, warning of a “go-slow” if payments were not made.
“RUPHA hereby issues a 14-day go-slow notice effective today for the SHA to address the following: immediate settlement of NHIF liabilities in line with the Presidential Directive of 5th March 2025 and payment of at least 50% of the Ksh43 billion outstanding SHA liabilities within 14 days,” the statement read.
RUPHA Chairperson Brian Lishenga said private hospitals are at risk of collapse if the government does not act promptly. “We are Sh76 billion in debt as a sector—Ksh33 billion NHIF debt, and Ksh43 billion SHA liability. The health sector cannot continue bearing this burden. If the NHIF debt is not paid immediately, it is very likely that by December, either you will not have private hospitals or the entire system will revert to 100% cash payments,” Lishenga warned.
He also cautioned that continued delays could force hospitals to permanently switch to cash payments, affecting thousands of Kenyans who rely on SHA for affordable healthcare.
While RUPHA acknowledged the difficulty of the decision, it insisted that the move is necessary to prevent a total collapse of private healthcare services and to ensure hospitals can continue operating effectively.
