Ministry of Health has revealed the steps it is taking to address the concerns raised by Rural Private Hospitals Association (RUPHA).

The government says it recognises RUPHA as a key stakeholder in the healthcare sector and that its is keen in fostering a collaborative approach with private healthcare providers to enhance service delivery under SHA.

“The Ministry has met and engaged with RUPHA, amongst other stakeholders, to address the concerns raised. One of the key concerns raised by RUPHA relates to delays in claims processing and reimbursement for services rendered under SHIF and the PHC Fund.

“The Ministry has introduced clear guidelines for facility accreditation, standardized claims submission processes, and an enhanced digital system for real-time claim tracking. These measures are designed to eliminate past inefficiencies and ensure that all service providers receive their payments on time,” the Ministry of Health said in a statement released on Wednesday, February 26, 2025.

The government said that SHA represents a significant shift from the previous NHIF structure, which struggled with inequitable contributions, inefficiencies in reimbursements, and financial instability.

“By adopting a structured and transparent payment system, SHIF enhances efficiency in fund management, guarantees timely payments to healthcare providers, and safeguards the availability and quality of healthcare services. This transformation addresses past challenges and ensures that healthcare financing is sustainable, inclusive, and aligned with UHC goals,” the statement said in defence of SHA over NHIF.

Debts

RUPHA had also raised the issue of debts saying the government owes their facilities over Ksh30 billion. While acknowledging the existence of debts, the ministry said they have taken steps to address the matter too.

“SHA inherited a substantial debt from the defunct NHIF, posing a significant financial challenge to the healthcare system. The Ministry of Health has made considerable progress in addressing these outstanding obligations, having already paid Ksh8.6 billion towards settling NHIF debts between September and December. This demonstrates the government’s commitment to ensuring financial stability in the health sector and sustaining service delivery.

“To ensure transparency and accuracy, SHA has been meticulously verifying NHIF claims and conducting reconciliations with each affected healthcare facility. This process involves rigorous validation to confirm legitimate claims before finalizing payments. Once verification is complete and agreements are signed with the respective facilities, a structured settlement plan will be developed in consultation with contracted providers to clear the outstanding NHIF debt,” the statement added.

The government added that as it moves forward with SHA implementation, it encourages private sector partners to embrace the changes and actively participate in policy discussions.