Health services in private hospitals around the country under the Rural and Urban Private Hospitals Association of Kenya (RUPHA) risk disruption following an announcement that they will suspend Social Health Authority (SHA) services.
RUPHA chairperson Dr. Brian Lishenga on Thursday, February 20, said that hospitals under the association will suspend SHA services nationwide starting Monday next week, citing continued ignorance to iron out existing challenges.
Dr. Lishenga stated that challenges surrounding the new healthcare system have been ignored, endangering the lives of patients.
The RUPHA chairperson, at the same time, said that the debacle is threatening the survival of health facilities due to inefficiency service provision.
Private Hospitals Announce Suspension of SHA Services
According to him, 54% of hospitals have not received payments from SHA, while 83% of hospitals have reported serious difficulties in verifying patient eligibility due to SHA’s system glitches.
RUPHA further said that 89% of facilities have reported SHA portal failures.
The authority announced that it will no longer provide care under the medical administrator Medical Administrators Kenya Limited (MAKL) which handles medical schemes for Police officers and teachers.
“We have unpaid debt dating back to 2017, hospitals are facing bank defaults, we have stock out of essential medicines and many consultants haven’t been paid for years,” Dr. Lishenga stated.
“Without urgent intervention teachers and police officers will be left without quality healthcare service.”
At the same time, private hospitals demanded the government to settle Ksh30 billion debt in full payment of arrears accrued in the defunct National Health Insurance Fund (NHIF).
Also Read: List of Questions SHA Asks Self-Employed Kenyans to Determine Monthly Contribution
They further urged the government to revise and streamline the SHA outpatient reimbursement model and ensure fair and timely payment under MAKL.
Govt says only 3M out of 19M Kenyans are making SHA contributions
The statement by RUPHA comes after the Ministry of Health appealed to Kenyans to contribute to the Social Health Insurance Fund (SHIF) to ensure uninterrupted medical services.
Health Cabinet Secretary (CS) Deborah Barasa who was flanked by Director General of Health Dr Patrick Amoth at a weekly briefing outside Afya House on Wednesday, February 12 highlighted the financial troubles at SHIF.
The health officials said that the main issue is Kenyans’ contributions to a scheme meant to offer medical services to all, highlighting that only 3.3 million of the 19.4 million Kenyans registered on SHA are contributing to the scheme.
Amoth lamented that the failure of Kenyans to make contributions is causing disruptions in services and urged all Kenyans to share the responsibility.
“Health services are expensive, and we cannot only have those in formal employment bearing the burden of the rest of the Kenyan population. We appeal to all those who have registered to ensure that they go through the means testing process, generate their premiums, and actually commit to paying for that,” Amoth said.
“We appeal to counties to ensure more Kenyans register for SHA, with arid and semi-arid areas leading in low registration.”
Advisory Panel set up
The new healthcare scheme has notably been rocked with endless glitches as Kenyans complain of its inefficiency since its introduction in October 2024.
Following complaints about system glitches and tariffs, the Ministry of Health has established the Benefits Package and Tariffs Advisory Panel in its pursuit of providing more inclusive and responsive healthcare to Kenyans.
The panel will, among other roles, review and recommend benefits packages to ensure comprehensive review.
According to the MoH, 8,813 out of 17,755 health facilities have enrolled with SHA representing 56 percent.
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