Thousands of patients across five counties are stranded, unable to access essential healthcare services such as dialysis and maternity care, after 1,029 facilities were abruptly locked out of the national Social Health Authority (SHA) system without prior notice.
The digital suspension, affecting facilities in Nyamira, Kisii, Mandera, Wajir, and Nairobi counties, means patients arriving at physically open clinics and hospitals are finding their SHA claims cannot be processed.
Directors of affected facilities, such as Giftland Medical Centre in Nyamira, report encountering queues of confused patients. “My facility was inspected by KMPDC two weeks ago… Three days later, the SHA portal was suspended,” the director stated, citing being told the reason was late licence renewal, despite a successful inspection.
Investigations reveal that this is the result of an unprecedented administrative action. The Ministry of Health directed the Kenya Medical Practitioners and Dentists Council (KMPDC), the Digital Health Agency (DHA), and the SHA to lock out facilities — predominantly Level 3 hospitals — bypassing the legally required due process for downgrading or closure, even after collecting registration fees.
The impact is severe. Level 3 facilities, a critical middle tier in Kenya’s healthcare system typically run by doctors, offer specialised services such as dental care, X-rays, comprehensive maternity care (antenatal and postnatal), dialysis, and cancer treatment. Downgrading them to Level 2 immediately cuts off their ability to provide these crucial services through SHA.
The SHA’s financial structure intensifies the crisis. Access to the Social Health Insurance Fund (SHIF) requires Level 3 status. Downgraded facilities find previously approved services instantly rejected by the portal — saving SHA millions in claim processing, but devastating both the facilities and the patients who rely on them.
Health Cabinet Secretary Aden Duale presented inspection statistics supporting the action, framing it as a quality control effort targeting non-compliance:
- Mandera: 269 inspected, 58 closed, 60 downgraded
- Nairobi: 1,017 inspected, 394 closed, 23 downgraded
- Wajir: 239 inspected, 77 closed, 11 downgraded
- Kisii: 291 inspected, 120 closed, 63 downgraded
- Nyamira: 167 inspected, 79 closed, 41 downgraded
He stated that KMPDC, DHA, and SHA had identified 728 non-compliant facilities that were closed, and 301 facilities downgraded via digital systems.
However, the medical community disputes this narrative. The Rural & Urban Private Hospitals Association of Kenya (Rupha) reports widespread confusion and frustration. Dr Brian Lishenga, Rupha Chairperson, highlighted procedural flaws: “Closing down a health facility has to be by official notice… What they have done is lock people out of the SHA portal… Revocation of a licence is a legal process.” He estimates that “almost all Level 2 and Level 3” facilities in Nyamira and Kisii are affected, warning that this signals a national expansion.
Rupha further alleges that inspections lacked due process: facilities were not allowed self-assessments, received no prior notice, were given no feedback on deficiencies, and crucially, had no chance for corrective action before the digital lockout.
Despite the controversy, CS Duale cited SHA progress: 9,365 facilities contracted nationwide (5,219 public, 3,650 private, and 496 faith-based), enabling access for 5.7 million Kenyans.
SHA has processed Sh5.4 billion in Primary Healthcare (PHC) claims — with 53% to public, 38% to private, and 9% to faith-based facilities. He also announced partnerships with major private hospitals for specialised care at SHA rates.
— By Nusurah Nuhu
