KMA raises concern over SHA payment delays
The Kenya Medical Association (KMA) has raised concerns over delays in payments to healthcare facilities by the Social Health Authority (SHA), a situation that is affecting the welfare of doctors and the delivery of healthcare services across the country.
In a statement released on Tuesday, September 16, 2025, KMA emphasised its commitment to supporting the government’s efforts to achieve Universal Health Coverage (UHC) through a well-funded and efficient SHA.
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“A robust, well-funded SHA is indispensable for building a resilient, equitable, and sustainable health system for Kenya,” the association said.
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KMA urged the government to ensure sustained and adequate funding for SHA, saying this is crucial for the success of UHC.
“We commend the government’s efforts and urgently call upon the legislature and the National Treasury to prioritise and allocate increased resources to the health sector, ensuring the long-term financial sustainability of this vital initiative,” the statement read.
The association acknowledged that SHA is a young institution and that some implementation challenges were expected. However, it warned that delays in remitting payments to healthcare facilities and issues with the Practice 360 platform have directly impacted healthcare providers.
“These challenges have directly impacted healthcare providers’ welfare and disrupted service delivery,” KMA said, adding that it has already engaged SHA leadership to ensure resolutions are pursued.
To help address these challenges, KMA encouraged doctors to actively engage with the claims system, submit accurate and complete claims to reduce rejection rates, and take part in capacity-building initiatives.
“KMA, in collaboration with SHA, commits to providing regular opportunities for training on the claims process,” the statement noted.
The association also offered its expertise to support claims adjudication and peer review processes, as well as providing feedback to improve the Practice 360 platform.
KMA further highlighted the threat of fraud, which it said could undermine the sustainability of the insurance fund.
“Fraud poses an existential threat to the sustainability of any insurance fund. KMA condemns all fraudulent practices and urges all members to uphold the highest levels of professional integrity and report any suspicious activities through the appropriate channels,” the statement said.
Adding;
“We bring to the table our collective expertise, a commitment to constructive dialogue, and a shared vision for a health system that works for every Kenyan. By working together to address these initial challenges, we can build a transparent, accountable, and effective Social Health Insurance framework that truly delivers on the promise of Universal Health Coverage.”
