About 82 percent of private health facilities have scaled down operations in the past year due to financial pressures, staff shortages, and rising regulatory costs, a new survey has found, resulting in fewer treatment options for patients, longer waiting times, and reduced access to specialised care.
The survey, conducted by the Rural and Urban Private Hospitals Association of Kenya (Rupha) between March 2 and 3, 2025, included responses from 157 private and faith-based health facilities in 30 counties, covering Kenya Essential Package for Health levels two to five.
The report shows that service cuts are widespread—66 percent of facilities have reduced clinical services, including outpatient, inpatient, dialysis, and nutritional care.
More than 60 percent have reduced administrative functions, affecting hospital management, claims processing, and financial oversight.
Nearly 40 percent have reduced diagnostic services, reducing access to essential tests, while 30 percent have cut surgical and theatre services, leading to delays in critical procedures.
Brian Lishenga, chairman of Rupha, said the crisis was primarily driven by delayed reimbursements, increased operating costs, and shrinking hospital revenues, forcing many facilities to cut back on essential services.
“Private and faith-based health providers are facing a silent crisis. Without urgent reforms to funding, regulation, and staff protection, we risk losing vital frontline facilities,” said Dr Lishenga.
More worryingly, one in four private healthcare providers (around 25 percent) is considering selling their facilities or going out of business altogether, with level two and three hospitals—the backbone of primary and outpatient care—most at risk.
"The closure of these facilities would leave millions of patients without access to critical medical services, further overwhelming public hospitals that are already struggling with capacity issues," said Dr Lishenga.
In a further finding, the Rupha survey highlights severe staff instability, with 85 percent of private health facilities reducing staff in the past year and 71 percent reporting an increase in voluntary resignations, particularly among nurses and clinical officers.
Nurses have been particularly affected, with 64 percent of hospitals reducing nursing staff and 44 percent experiencing resignations.
Other key roles such as clinical officers, laboratory staff, pharmacy staff, and doctors have also been significantly affected.
Most facilities expect further staff reductions (61 percent) and additional service cuts (56 percent) in the coming year.
"The main drivers of this exodus are financial insecurity, burnout, and job instability. Delayed reimbursements from the Social Health Authority (SHA) and insurance providers have left many hospitals struggling to pay salaries on time, leading to frustration and high turnover among healthcare workers. Increased workloads resulting from staff cuts have also contributed to burnout, making retention even more challenging," said Dr Lishenga.
In addition to staff shortages, the report reveals that the financial sustainability of private hospitals is under serious threat. More than half of the facilities surveyed have reduced staff costs, but 41 percent have seen their costs rise due to inflation and the high cost of temporary staff.
Another 88 percent of level 4 hospitals cited government deductions and licensing fees as a major financial burden.
"Delayed reimbursements from the SHA continue to cause severe cash flow problems, preventing hospitals from maintaining operations. Statutory deductions, including housing fund contributions, training levies, and other compliance costs, have further eroded hospital revenues," the report said.
