Kenya’s Healthcare Emergency: SHA and Private Hospitals at Breaking Point

Kenya’s health system is facing an acute funding and governance crisis after private hospitals formally suspended credit services to the Social Health Authority (SHA). The move follows the expiry of a 14-day notice issued on September 5, 2025, and was announced by Dr. Brian Lishenga, national chairperson of the Rural and Urban Private Hospitals Association of Kenya (RUPHA).

Unraveling the SHA Dispute

RUPHA issued a 14-day notice on September 5, 2025, to SHA, citing five major concerns.
That notice expired and RUPHA has now suspended SHA credit facilities to hospitals.
The suspension stems from repeated and large-scale claim rejections, long-standing unpaid liabilities, and what RUPHA describes as politically driven investigations and procedural irregularities.

The core grievances explained

Mass rejection and sidelining of claims

Hospitals say this mass rejection and the transfer of claims into open-ended medical review have frozen crucial cash flows and prevented predictable, lawful payment for services already delivered.

Large unpaid historical liabilities

These unpaid legacy liabilities, RUPHA says, are not theoretical. They are used to pay salaries, keep lights and equipment running, buy drugs and supplies, and pay essential suppliers.

SHA described as a bad borrower and creditor

RUPHA stresses that hospitals have continued to deliver care on credit for long periods; the failure to return those funds has pushed many facilities to the brink.

Alleged weaponization of fraud investigations and DCI involvement

RUPHA says investigations have bypassed statutory dispute-resolution routes and risk exposing confidential patient records to non-medical actors. The association calls the DCI route unprocedural and legally suspect.

RUPHA’s demands

Dr. Brian Lishenga and RUPHA outlined five urgent actions they want the government to take. They are calling for the immediate settlement of all verified claims below Ksh 10 million, and fast-tracked verification and payment of larger claims within seven days. They also want a review and reversal of mass claim rejections, and activation of an independent Dispute Resolution Tribunal to handle disputes.

Beyond the claims, RUPHA insists that Kenya must urgently reform SHA’s financing model to reduce its over-reliance on a narrow base of salaried workers. Finally, they demand a reversal of arbitrary hospital downgrades and deletions of bed capacities, which they say directly threaten service delivery.

Immediate impact on patients and hospitals

Concrete effects RUPHA identifies include unpaid staff salaries, inability to pay for power and supplies, stockouts of medicines and consumables, and the reduction or suspension of services. The association warns these pressures will translate into longer waiting times, higher out-of-pocket payments, and potential life-threatening gaps in access to routine and emergency care.

Legal and governance concerns

RUPHA repeatedly stresses that the law provides a statutory dispute-resolution pathway for contested claims. The association argues that those internal mechanisms should be fully used before criminal investigations are initiated, and that patient privacy must be protected at all stages.

What RUPHA says this reveals about SHA and the system

In Dr. Lishenga’s assessment, the crisis exposes a system that is underfunded, mismanaged, and subject to politicized decisions that harm patients and providers. He frames the mass rejections and medical review as a short-term political fix that shifts the burden onto hospitals and ultimately onto patients.

Closing call to action

RUPHA is clear: it remains open to partnership, but only if claims are handled lawfully, verified payments are made in a timely manner, dispute-resolution channels are activated, and SHA’s financing and governance are reformed.