Kenya’s largest public hospitals, including Kenyatta National Hospital (KNH), Kenyatta University Teaching, Referral and Research Hospital (KUTRRH) and Moi Teaching and Referral Hospital (MTRH), are struggling with a mounting pile of uncollected revenues totalling Ksh11.4 billion, exposing growing financial pressure in the country’s health sector.
A new report by the Health Ministry shows that outstanding bills owed by patients, insurance schemes and other third-party payers have surged over the last three financial years, severely constraining the cash flow and operational budgets of the top-tier facilities.
KNH accounts for nearly half the arrears at Ksh5.2 billion, followed by MTRH at Ksh3.4 billion and KUTRRH at Ksh2.8 billion. The bulk of the unpaid funds are linked to long-stay patients unable to clear bills, rejected claims by insurers and delays in reimbursements from the National Health Insurance Fund (NHIF).
Hospital administrators warn that the ballooning receivables threaten the ability of the institutions to buy drugs, pay suppliers and maintain critical medical equipment, warning that service delivery could deteriorate unless the outstanding amounts are recovered.
The Health Ministry has now directed the hospitals to strengthen debt collection, digitise billing systems and fast-track legal agreements with insurance firms to minimise future losses.
Analysts say the Ksh11.4 billion figure highlights a systemic funding challenge facing public referral hospitals that serve high volumes of uninsured and low-income patients.
The hospitals have been forced to write off millions each year as bad debt, even as demand for services grows. The government is under fresh pressure to review NHIF payments, expand coverage and consider additional subsidies to stem cashflow crises.
Hospital CEOs are pushing for stronger legal backing to pursue defaulting debtors and streamline cost-sharing policies.
With patient numbers rising sharply and budgets already stretched, stakeholders now warn that without urgent reforms, Kenya’s flagship public hospitals risk slipping into deeper financial distress that could undermine healthcare delivery.
Written By Ian Maleve
