17th November 2025
The Kenya Medical Association, together with partners under the CEBA initiative, wishes to draw urgent attention to critical challenges currently undermining health service delivery across the country. These challenges threaten progress towards Universal Health Coverage and place avoidable risks on mothers, newborns, children, and families.
1. Counties Are Central to Health Service Delivery
County governments carry the constitutional mandate for frontline health services. Both public and private facilities jointly contribute to Kenya’s reproductive, maternal, newborn, child, and adolescent health and nutrition (RMNCAH-N) outcomes.
It is therefore essential to recognize that healthcare providers are partners—not adversaries—in the shared mission to save lives and strengthen the health system.
2. Respect for Existing Regulatory Structures
Healthcare facilities already undergo rigorous licensing through the Kenya Medical Practitioners and Dentists Council (KMPDC).
For this reason, Single Business Permit fees are not applicable to health facilities.
We therefore urge county finance departments to verify KMPDC registration before issuing demand notices. Compliance with KMPDC accreditation should be used as a quality assurance measure, not an avenue for unnecessary revenue collection.
3. Maternal and Child Health Indicators Reveal the Truth
Maternal and child health outcomes remain the most sensitive indicators of whether a health system is functioning. A functional system is grounded in the six pillars of health, and failure in any one of them directly translates into preventable deaths.
4. Non-Payment to Health Facilities Has Crippled Service Delivery
When a health facility provides services but is not reimbursed, service delivery slows, staff are laid off, and essential services stall.
The Social Health Authority (SHA) has become a major bottleneck:
• SHA reimbursement is stuck at 30%, far below what is needed to sustain operations.
• Billions of shillings owed to both public and private providers remain unpaid.
• Facilities are shutting down or scaling back services.
• Thousands of health workers have lost jobs.
• Key associations such as RUPHA have already stopped attending to SHA-insured clients.
This makes SHA a direct cause of unemployment, facility collapse, and disruption of essential RMNCAH services.
5. SHA Poses the Biggest Risk to Maternal and Child Health
Access to skilled care during pregnancy, delivery, and the newborn period is significantly compromised when facilities lack drugs, staff, equipment, or operational funds.
Unless SHA urgently reforms its payment systems and clears outstanding arrears, Kenya risks a reversal of hard-won gains in maternal and child survival.
6. CEBA Support and MPDSR Are Successes Worth Building On
We commend the Council of Governors for driving Maternal and Perinatal Death Surveillance and Response (MPDSR), one of the most impactful outcomes supported through CEBA.
MPDSR provides the data needed for evidence-based action.
However, data alone cannot replace common sense—the ongoing collapse of facilities due to non-payment is visible and undeniable.
CALL TO ACTION
We urge the Government of Kenya—particularly the Council of Governors, Ministry of Health, National Treasury, and SHA—to:
1. Clear all pending SHA payments to public and private facilities without delay.
2. Reform SHA reimbursement processes to ensure predictable, timely, and adequate payments.
3. End illegal Single Business Permit charges on health facilities and align county revenue teams with KMPDC standards.
4. Protect and strengthen RMNCAH services, recognizing them as core indicators of system performance.
5. Engage healthcare providers as partners, not adversaries, in building a resilient health system.
A healthy nation requires collaboration, predictable financing, and functional systems. The time to act is now—before more facilities close, more workers lose their livelihoods, and more lives are put at risk.
Dr Simon Kigondu, President Kenya Medical Association speaking at CEBA stakeholders’ Knowledge Summit