The Rural & Urban Private Hospitals Association of Kenya (RUPHA) has suspended the provision of healthcare services on credit to the Social Health Authority (SHA), citing unresolved concerns over unpaid claims, arbitrary downgrades, and unsustainable debt. The decision, announced on Monday, follows the expiry of a two-week notice issued on 5th September.
RUPHA, which represents more than 700 private and faith-based healthcare facilities across the country, said the move was a “painful but necessary” step to protect hospitals and patients from the fallout of SHA’s financial mismanagement.
Among the key grievances is the Health Cabinet Secretary Aden Duale’s directive on 27th August to reject claims worth Kshs 10.6 billion. RUPHA argues this contravened Clause 8.2.2 of the SHA Provider Contract, which requires timely written communication on rejections, denying hospitals an opportunity to respond.
The association also decried selective claims settlement, failure to pay historical debts dating back to 2017, and the lack of a functional Dispute Resolution Tribunal under the Social Health Insurance (SHI) Act.
As of August 2025, SHA reportedly owes hospitals Kshs 43 billion, with a further Kshs 24 billion under review. With claims worth Kshs 8.8 billion against monthly revenue of just Kshs 6 billion, RUPHA said hospitals have been forced to underwrite a collapsing system, now carrying liabilities of up to Kshs 76 billion.
Service delivery has also been undermined by what RUPHA termed “unprocedural downgrades and bed erasures.” The association estimates that 3,478 maternity beds, 1,080 delivery beds, and 10,000 inpatient beds have been arbitrarily removed from records, cutting access in rural counties such as Mandera, Turkana, and Garissa, as well as in urban informal settlements.
RUPHA’s demands include immediate settlement of verified claims below Kshs 10 million, reversal of mass rejections, establishment of a tribunal, and a review of SHA’s financing model.
The association also opposed the planned migration of teachers’ and police medical schemes in December until outstanding arrears are cleared.“The private and faith-based sector provides nearly half of Kenya’s healthcare. If it collapses, Universal Health Coverage will collapse with it,” warned RUPHA Chairman Dr. Brian Lishenga.
