Aga Khan Hospital warns of service strain over Sh1.5bn NHIF debt

KENYA – The Aga Khan University Hospital is raising concerns over Sh1.5 billion (US$ 11.6 million) in unpaid claims from the now-defunct National Health Insurance Fund (NHIF), warning that the mounting debt is straining its operations and threatening essential services. ​

According to CEO Rashid Khalani, the unpaid bills—accumulated since 2018 across its Nairobi, Mombasa, and Kisumu branches, are disrupting financial planning, delaying infrastructure upgrades, and hampering investments in medical training and research. ​

“These delays are affecting our financial planning, slowing expansion, and jeopardising our investments in technology, research, and medical training,” Mr Khalani said. ​

While the hospital has maintained its clinical standards through robust internal quality controls, he warned that the current situation is not sustainable. ​

“Everything has a cost—staff, equipment, drugs and laboratory work. If these costs are not paid, quality will eventually suffer. At the moment we are still absorbing the shocks, but this is not sustainable in the long term,” he added. ​

The financial strain comes amid Kenya’s transition from NHIF to the Social Health Insurance Fund (SHIF), which aims to broaden access to private healthcare.

However, Khalani noted that the shift has increased pressure on providers like Aga Khan, especially as more patients enroll but payments lag. ​

“Even before SHIF, about 20 to 25 percent of our patients paid cash. The perception that Aga Khan only serves insured patients is wrong,” said Mr Khalani.

“SHIF has opened more doors for Kenyans to access private healthcare. However, as more SHIF patients come and payments are not made on time, it creates a strain and reduces capacity.” ​

In response, the government has formed a 19-member committee to audit NHIF’s pending medical claims.

Health Cabinet Secretary Aden Duale stated that claims under Sh10 million (US$ 77,071) will be settled immediately, while larger ones will undergo a 90-day verification process.

“After verification, a payment plan will be agreed upon for all genuine claims,” he said. The initiative aims to restore confidence in the health financing system and align resources with the government’s Universal Health Coverage (UHC) targets.