SHA hasn't paid healthcare centres Sh5.5b since February, say workers

The Social Health Authority (SHA) has not remitted claims to level two and three health facilities across the country since February, with outstanding payments now amounting to Sh5.5 billion, operators has claimed.

The delay in remitting claims, they say, is disrupting service delivery in public, private and faith-based health facilities, including dispensaries, health centres and hospitals.

Healthcare workers say some of the facilities they ran are struggling with acute shortages of drugs, medical supplies and staff. Key laboratory tests have also been suspended due to a lack of reagents.

“We are not receiving any money, yet so many patients require care. At times we review them, and send them to buy drugs in private pharmacies,” said a public hospital health worker in Vihiga County, who sought anonymity. “SHA has not paid us since February this year.”

The level two and three facilities are served by Primary Healthcare Fund (PHF) whose allocation is done from the exchequer.

Another level three hospital worker in Kabarnet, Baringo county, said they are struggling to provide healthcare, after failing to get claims. He said the hospital pharmacy is empty, laboratory lacks reagents, while a section of healthcare providers have not been paid for three months.

“Most patients here require care for common ailments like malaria and deliveries. We however, can’t serve them effectively because of the financial strain,” said the healthcare service provider.

SHA management, he said, is shrouded in mysteries and suspects payments depend on services provided, and number of patients served. “I can’t tell how much I am owed by SHA, for PHF. It is SHA that develops the payment formula.”

Failure to allocate the money according to experts and stakeholders derail promotive and preventive objective of the government’s universal health cover agenda under SHA.

Rural and Urban Private Hospitals Association of Kenya (RUPHA) pleaded with the government to pay the hospitals. 

In a statement, the association said the facilities have continued attending patients, treating common illnesses, managing chronic diseases, supporting mothers and children, running basic diagnostics, dispensing medicines and keeping frontline services open, without payment.

“This is unacceptable. Primary healthcare is not an abstract government programme. It is where Kenyans first seek care. It is where hypertension is picked before stroke, diabetes is managed before kidney failure, and a sick child is treated before admission,” said RUPHA chair Brian Lishenga.

He said when PHC facilities are not facilitated, patients suffer more.

“Medicines have run out. Laboratories have slowed down. Health workers are going unpaid. Facilities have accumulated huge debt. Patients will eventually be asked to pay out of pocke,” added Lishenga.

The official maintained that failure to pay the facilities, affects patients in need of healthcare.

RUPHA maintained that the government cannot promise Kenyans primary healthcare while failing to pay the facilities delivering that care.

“Nurses cannot be paid with promises. Laboratories cannot run on press statements. Where facilities have provided services under contract, SHA must honour its obligations,” said the official.

Delayed disbursement of PHC payment is not a minor administrative inconvenience, according to the association, but failure of accountability and breach of contract by SHA.

RUPHA is, therefore, calling on the Ministry of Health, the SHA Board and SHA management to immediately pay all outstanding PHC disbursements, publish a clear payment calendar for all pending PHC months, provide facility-level reconciliation statements showing what has been paid, what is pending, and why and commit to predictable future PHC payments so that this does not happen again, he said.

Additionally, the association demanded an engagement of providers before the situation becomes a crisis. “A Ministry of Health that does not pay for primary healthcare for five months is effectively on strike against its own patients.”

The accusation arise even after National Treasury Cabinet Secretary John Mbadi said the government was committed in strengthening primary healthcare. In his budget statement, Mbadi said health sector received a substantial boost of Sh133 billion to strengthen primary healthcare and medical services.

PHC fund, received the biggest share of Sh18 billion, a sharp increase from Sh3.8 billion under 2025/26 financial year.

Additionally, to stabilize the transition to SHA, the Treasury allocated Sh4 billion to settle pending bills owed under the defunct NHIF.