The Kenyan government currently owes healthcare providers a staggering Sh10 billion, while parastatals have accumulated Sh25 billion in unpaid debts to the now-defunct National Health Insurance Fund (NHIF). This was revealed by Acting Social Health Authority (SHA) CEO Robert Ingasira, who acknowledged the financial strain on healthcare facilities as discussions to resolve the crisis continue.
The situation has worsened following the suspension of services by the Rural and Private Hospitals Association of Kenya (RUPHA), now in its second day. The decision has disrupted operations in numerous hospitals, further jeopardizing patient care.
Ingasira reassured stakeholders that the government is actively working to clear the outstanding payments. He disclosed that the initial debt stood at Sh19 billion, but Sh9 billion had been settled between October and November. However, healthcare providers are still owed a significant amount, and efforts are being made to reconcile the remaining balances.
“The details of disbursements made from October 1 to date will help us agree on what has been paid and what remains outstanding,” Ingasira explained.
Despite concerns about the transition from NHIF to SHA, Ingasira affirmed that the NHIF system remains operational. Reports suggesting its shutdown were inaccurate, and hospitals continue to use the system for debt reconciliation.
“Let me start by saying that the NHIF system is still operational. It is very much alive. It is the system the facilities are using to reconcile the debt. The supplier contract has not been terminated, as we still require data for final settlements,” he clarified.
Addressing concerns over funding for primary healthcare services, Ingasira revealed that the government has allocated Sh4 billion for the sector in the current financial year. So far, Sh1.3 billion has been disbursed, with another Sh2.4 billion set to be released upon verification of hospital reports.
“Capitation is based on population data, and facilities must submit reports detailing the number of patients treated and services rendered. Once we finalize these reports, we will proceed with the remaining disbursements,” he stated.
The CEO emphasized that SHA operates three distinct funds, each designated for specific purposes, and these funds cannot be reallocated.
“The money under primary healthcare can only be used for primary healthcare. Out of the Sh4 billion allocated, Sh3.7 billion has already been transferred to SHA, with Sh1.3 billion paid out. The remaining Sh2.4 billion will be used to settle pending claims,” he said.
Meanwhile, RUPHA’s service suspension has caused disruptions in healthcare facilities across the country. The association has cited system failures, delayed payments, and weak service provision as key reasons for the action.
According to RUPHA chairperson Brian Lishenga, these ongoing challenges have placed both patients and healthcare facilities at risk.
“The challenges surrounding the new healthcare system have been ignored, endangering the lives of patients,” he stated.
He further revealed that:
Only 54% of hospitals have received payments from SHA.
89% of facilities have experienced failures in the SHA portal.
83% of hospitals have struggled to verify patient eligibility due to system glitches.
Lishenga warned that unless urgent action is taken, the crisis could collapse private healthcare facilities, leaving millions of Kenyans without essential medical services.
The healthcare sector now faces a looming crisis, with the Ombudsman recently giving SHA seven days to settle Sh30 billion in arrears. Healthcare providers and unions have urged the government to expedite payments and address technical failures affecting SHA operations.
As the situation unfolds, patients in rural and private hospitals remain the most vulnerable. With delayed payments and system inefficiencies continuing to plague the sector, urgent government intervention is necessary to prevent a full-scale healthcare shutdown.
