Kenyan Hospitals Drowning in Debt as SHA Drags on Payments

From Kiambu to Kisumu, hundreds of clinics and hospitals have found themselves hanging by a thread—trapped in a web of unpaid reimbursements under Kenya’s Social Health Authority (SHA). For months, the national health insurance system has failed to keep up with mounting claims from over 9,000 contracted healthcare facilities.

Now, SHA Chief Executive Mercy Mwangangi says the logjam is finally beginning to clear. On July 22, she announced that full payments will be made within three weeks, and that the authority has already settled some critical claims. But for many in the health sector, the damage may already be done.

The Pile-Up of Promises

According to Mwangangi, SHA has already concluded its review of claims related to primary healthcare and maternity services. Those payments were set to hit facility accounts the same day as her statement.

Additional claims—covering inpatient care, surgical procedures, and specialty treatments—are still under review. These will reportedly be settled by mid-August. So far, KSh 3 billion has been paid to eligible hospitals, covering areas like accident and emergency services, cancer and blood care, and renal treatment.

Mwangangi stressed that only claims compliant with Regulations 59 and 61 under the Social Health Insurance Act would be honored. The Authority is manually combing through submissions to avoid misallocation or fraud. Yet the scrutiny comes at a cost: delay.

Behind the Numbers: Hospitals on the Brink

debt 2.jpg — **Health Cabinet Secretary Aden Duale, in the same breath, touted the achievements of SHA. Source: theweeklyvisionews.net**

Data from the Rural and Urban Private Hospitals Association of Kenya (RUPHA) paints a disturbing picture. Only one in five hospitals has received their full monthly payment under SHA’s primary care model. The result? A healthcare system inching toward collapse.

-36% of facilities have been forced into debt

-30% face potential default on loans

-13% risk being auctioned

-9% are battling court cases from suppliers

-1% have already shut down completely

These are not statistics from a collapsing war zone—they are from Kenyan towns and counties today. In Kiambu alone, several clinics have scaled back services or sent patients away due to lack of medicine, supplies, and staff wages.

Government Claims and Ground Realities

Health Cabinet Secretary Aden Duale, in the same breath, touted the achievements of SHA. As of July 22, over 24 million Kenyans are enrolled in the national health scheme. Of these, 4.5 million have received treatment for routine ailments and maternal care, while another 2.2 million accessed specialized services.

But for hospitals expected to deliver these outcomes, those numbers don’t add up. They’re struggling to treat a growing population with shrinking resources, and the wait for reimbursement is squeezing them out of survival.

Faith-based institutions and private facilities—who make up nearly half of the SHA-contracted base—are particularly exposed. Unlike public hospitals, they lack state buffers and must rely on timely payments to maintain services.

What Comes Next?

The SHA has three weeks to make good on its word. But if its internal processes remain slow and bureaucratic, it risks pushing more hospitals over the edge—especially in rural areas where government infrastructure is thin and private players fill critical gaps.

For now, Kiambu, Nairobi, Nakuru, and other major counties are holding their breath. They’ve heard promises before. This time, health workers, suppliers, and patients want action—before the next hospital closes its doors for good.