Health CS Deborah Barasa has insisted that the Social Health Authority (SHA) scheme is functioning effectively, despite the ongoing healthcare crisis that has seen private hospitals suspend SHA-related services.
Speaking during her inaugural question time appearance before the Senate plenary on Wednesday, February 26, 2025, Barasa maintained that positive developments were emerging from the SHA scheme. She assured Kenyans that the initiative was designed to prevent citizens from selling their properties to afford medical care and hinted at upcoming documentation to demonstrate the impact of SHA.
“I believe SHA is going to be a game changer where we will have Kenyans not selling their properties to access medical services. There are very good stories out there I can attest to that, and maybe next time we can have documentation to show that more than half a million people can access these services. SHA is working,” Barasa stated.
Deborah Barasa: I believe SHA is going to be a game changer. There are very good stories out there. More than half a million people are able to access these services. SHA is working.#K24Siasa pic.twitter.com/FysAXuBj39
— K24 TV (@K24Tv) February 26, 2025
Her remarks come amid a deepening crisis in Kenya’s healthcare sector following the decision by private hospitals to halt SHA-related services. The Rural & Urban Private Hospitals Association of Kenya (RUPHA) announced an indefinite suspension of SHA insurance scheme services on February 20, 2025, with the directive effect on February 24, 2025. This decision has affected over 600 private and faith-based hospitals across the country.
Unpaid claims
RUPHA cited financial constraints as the primary reason for the suspension, revealing that private hospitals are struggling due to unpaid claims amounting to KSh30 billion. The association also pointed to an unsustainable reimbursement model that has made it difficult for hospitals to sustain their operations.
As a result of the financial strain, many healthcare facilities have been forced to lay off staff, delay salary payments, experience shortages in medical supplies, and default on loans. The association stated that the government’s failure to honour its financial obligations had pushed hospitals to a breaking point, leaving them with no option but to suspend services under SHA.
“The continued failure to resolve critical challenges in the SHA transition is directly endangering patient care and hospital sustainability. Hospitals have lost staff, defaulted on loans, and faced medicine shortages due to delayed payments,” RUPHA Chairman Brian Lishenga said.
To mitigate the impact of the suspension, RUPHA issued operational guidelines aimed at ensuring patients are not abandoned while also safeguarding healthcare providers from financial collapse. According to these guidelines, patients who were admitted before February 24, 2025, will continue receiving treatment without any disruptions. Additionally, private hospitals will maintain emergency services. However, new admissions under the SHA scheme remain suspended until the financial dispute is resolved.
In response, the government denied that it owed private hospitals the said Ksh30 billion and encouraged patients to seek medical care at public hospitals, where services remain free. However, this directive has intensified tensions between the government and private healthcare providers, as private institutions struggle to stay afloat while public hospitals brace for an influx of patients.
The crisis has been exacerbated by longstanding financial challenges inherited from the now-defunct National Health Insurance Fund (NHIF). Despite the government’s promises to settle outstanding debts, many private hospitals report that they have yet to receive payments, worsening their financial struggles.
Technical failures within the SHA system have also contributed to the problem. Hospitals have faced difficulties in processing claims due to a non-functional claims portal and challenges in verifying patient eligibility, leading to delayed reimbursements and inefficiencies in service delivery.
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