No Pay, No Service: Faith-Based Hospitals Reject SHA Contracts Over Ksh.21B Debt.

Medical facilities under faith-based organizations and the Rural and Urban Private Hospitals Association of Kenya (RUPHA) have raised concerns over the new Social Health Authority (SHA) contracts, citing a Ksh.21 billion debt owed to them by the defunct National Health Insurance Fund (NHIF).

These facilities have refused to sign the new contracts, arguing that the agreements are structured to exclude them from service delivery and deny Kenyans access to crucial healthcare services.

Their key worry lies in the government’s failure to guarantee payment of the pending NHIF debt under the new SHA system. They fear that records of what is owed might be lost during the transition.

“We’re worried about the transition because we’ve seen claims get lost before when systems change. Right now, Ksh.6 billion in claims are still pending,” said Dr. Samuel Mwenda, Secretary-General of faith-based organizations.

“Government health providers are owed Ksh.30 billion, with Ksh.15 billion owed to RUPHA alone. We needed a reconciliation before NHIF shut down to prevent claims from disappearing,” added Dr. Brian Lishenga, RUPHA’s Secretary-General.

Though the stakeholders participated in the policy-making process, they claim their recommendations were ignored. Dr. Mwenda pointed out that the new referral system deliberately limits their ability to provide outpatient care, forcing them to treat only referrals from smaller facilities.

“Outpatient services are restricted to level 2 and 3 facilities, meaning our hospitals can’t treat patients directly. There’s also no system to verify these referrals,” Mwenda explained.

Dr. Lishenga further highlighted, “Under SHA, it’s illegal for level 5 hospitals to offer direct outpatient care. Kenyans don’t know this, but they will face the consequences.”

For now, these facilities will treat patients on a cash basis, as no contract has been signed. They accuse the government of crafting SHA contracts that reduce benefits for Kenyans, despite higher contributions, forcing people to pay out of pocket.

The hospitals and private facilities are firm—they won’t sign until SHA addresses the problematic clauses. As the standoff continues, healthcare services remain disrupted, raising questions about whether the transition was rushed or if proper planning was done.

Article By Suzy Nyongesa.