A storm is gathering in Kenya’s healthcare system as private hospitals warn of major disruptions following the government’s plan to move teachers, police officers, and other public servants from private insurance providers to the new Social Health Authority (SHA). The transition, set to take effect before the end of the year, has triggered widespread uncertainty among healthcare providers, unions, and beneficiaries alike.
Hospitals Threaten to Cut Credit Lines
The Kenya Association of Private Hospitals (KAPH) has expressed serious concerns over the SHA’s operational readiness and financial capacity. Many facilities have threatened to suspend credit arrangements with the government once the new system comes into force, fearing delayed reimbursements and bureaucratic inefficiencies.
“We are not against the idea of a unified health scheme, but our biggest concern is sustainability,” said Dr. Joyce Mutua, a Nairobi-based hospital administrator. “If payments are delayed, we won’t be able to provide continuous services. We saw what happened with NHIF — it nearly crippled private healthcare.”
This warning comes as the Teachers Service Commission (TSC) and the National Police Service prepare to exit their private insurance contracts, including the Minet and Madison covers that have served their members for years.
SHA’s Promise of Universal Access
The Social Health Authority (SHA) was established to administer Kenya’s new Social Health Insurance Fund (SHIF), which aims to provide universal medical coverage for all citizens. The government argues that consolidating multiple schemes into a single framework will enhance transparency, reduce administrative costs, and eliminate duplication.
Health Cabinet Secretary Susan Nakhumicha has defended the transition, saying it will ensure equity and accountability. “Every Kenyan, regardless of social status, deserves quality healthcare. The SHA will guarantee that no one is left behind,” she said during a recent press briefing.
However, stakeholders say the policy is being implemented hastily without resolving fundamental operational challenges.
Delayed Payments and Bureaucracy: The Core Fear
Private hospitals are particularly worried about the SHA’s ability to pay claims on time. Under the NHIF system, some facilities reported waiting months — even years — before receiving payment. This, they say, forced some clinics to shut down or refuse NHIF patients altogether.
With teachers and police officers soon joining the SHA program, hospital owners fear a repeat of the same problem, but on an even larger scale.
“SHA could be overwhelmed by the sudden influx of millions of new members,” warned Dr. Samuel Kariuki of the Kenya Healthcare Federation. “Unless the payment systems are digitized, streamlined, and funded adequately, we risk a massive service breakdown.”
Impact on Teachers and Police
For teachers and police officers, the shift to SHA could mean significant changes in how they access healthcare. Currently, most enjoy cashless treatment at private hospitals through established insurers like Minet, which maintains a strong relationship with hospitals and guarantees timely payments.
Once SHA takes over, members may be required to undergo verification or authorization processes that could delay access to treatment — especially in emergencies.
Teachers’ unions, including KNUT and KUPPET, have already raised alarm over the matter. “The government should not gamble with the lives of its workers,” said KUPPET’s Akello Misori. “If private hospitals cut off services, teachers will have nowhere to go.”
Public Hospitals Overstretched
The risk is further compounded by Kenya’s overstretched public health system. If private facilities withdraw, millions of civil servants could be forced to rely solely on public hospitals, many of which are struggling with staff shortages, equipment breakdowns, and frequent medicine stock-outs.
Health economists warn that the transition could overwhelm the system and reduce the quality of care. “We could see longer queues, slower treatment, and a rise in out-of-pocket spending — the very issues the SHA is supposed to fix,” said health policy analyst Dr. Jane Njoroge.
Call for Dialogue and Gradual Implementation
Healthcare stakeholders are calling on the government to delay the transition and hold consultations with unions, insurers, and medical associations. They propose a phased rollout of SHA that allows both the public and private sectors to adapt gradually.
“SHA can succeed if it builds trust first,” said Dr. Mutua. “That means ensuring prompt payments, setting clear service guidelines, and involving hospitals and unions in decision-making.”
As the countdown to the transition continues, uncertainty looms large. Teachers and police officers — two of Kenya’s largest public service groups — remain anxious about what awaits them under the new scheme. For now, all eyes are on the government to see whether it can balance reform ambitions with service stability.
