Private hospitals blame flawed SHA model as 40 facilities face suspension
KUPHA described the SHA model as flawed and financially unstable, highlighting a sharp drop in revenue despite increased premiums.
The Rural & Urban Private Hospitals Association (KUPHA) has criticised Health Cabinet Secretary Aden Duale’s decision to suspend more than 40 hospitals from the Social Health Authority (SHA) programme.
In a statement released on August 9, 2025, the association accused the Health CS of unfairly blaming the private health sector and the media for the challenges facing SHA, instead of addressing the fundamental issues within the health insurance system.
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KUPHA described the SHA model as flawed and financially unstable, highlighting a sharp drop in revenue despite increased premiums.
“The CS Health has resorted to attacks on the private health sector and the media as the scapegoats for the flawed SHA model. SHA collected just Sh56 billion in the 9 months to July compared to NHIF’s Sh65 billion for the same period in 2021/22,” the association said.
This shortfall occurred even after SHA introduced higher premiums. KUPHA also pointed out that the proxy means testing, which was supposed to adjust contribution levels based on income, has not worked as expected.
The association further warned that SHA’s financial situation is worsening. During the same period, SHA incurred claims worth Sh89 billion, leading to a deficit of Sh32 billion.
Rather than fixing these structural and operational problems, KUPHA claims the authority has chosen to punish health facilities.
“Despite higher premiums, proxy means testing has failed. In the same period, SHA incurred claims worth Sh89 billion. SHA is in the red to the tune of Sh32 billion,” KUPHA said.
The group added that any facility requesting payment for services is being labelled a fraudster, a cartel member, or accused of benefiting from corruption under the old NHIF system.
KUPHA emphasised that public relations efforts and blaming stakeholders cannot fix the crisis. It called for urgent reforms to save the SHA programme from collapse.
This backlash comes after the official suspension of over 40 hospitals from the SHA programme following investigations by the Directorate of Criminal Investigations (DCI).
On August 8, 2025, CS Duale ordered the publication of the names of the suspended facilities in a Gazette Notice. The Ministry of Health has promised to maintain strong oversight to protect the SHA programme and ensure that public funds reach genuine healthcare providers.
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