The government has reiterated its commitment to delivering Universal Health Coverage (UHC) under the Taifa Care program, a pivotal element of the Bottom-Up Economic Transformation Agenda (BETA).
Ministry of Health has outlined key updates regarding the Social Health Authority (SHA) and its newly established benefits and tariffs.
The SHA, which replaced the National Hospital Insurance Fund (NHIF) under the Social Health Insurance (SHI) Act, operates through three strategic funds: the Social Health Insurance Fund (SHIF), the Primary Healthcare Fund (PHCF), and the Emergency, Chronic, and Critical Illness Fund (ECCIF).
“The SHA rollout began on October 1, 2024, and implementation is ongoing through the registration of members, contracting of healthcare service providers, and digitization of health systems to facilitate access to healthcare services,” the Ministry stated in a press release dated December 15, 2024.
Tariffs
In response to public concerns about the scope of SHA’s coverage, the Ministry confirmed that the program operates based on gazetted tariffs published in November 2024.
These tariffs are accessible on the SHA’s official website.
“These tariffs ensure sustainable healthcare coverage and equitable access while maintaining a shared responsibility model,” the statement noted.
Key details include: ICU and HDU Services: SHA covers admissions in critical and high-dependency care units based on a per diem rate that varies by facility level – level 4: Ksh, 3,360 per day, level 5: Ksh3,920 per day and level 6: Ksh4,480 per day.
A household is limited to 180 days of access per year, with co-payments required for charges exceeding the coverage limit. This framework applies uniformly across public, faith-based, and private healthcare facilities.
Addressing challenges
SHA has pledged to tackle barriers to healthcare access, particularly for services like cancer treatment, renal care, maternity, and outpatient care.
To that end, the Ministry announced the formation of a committee under Regulation 41 of the Social Health Insurance Regulations.
“The committee will review tariffs and benefits based on stakeholder feedback and provide practical solutions,” the Ministry revealed.
The findings will guide both immediate and long-term interventions to enhance the SHA’s sustainability and responsiveness.
Kenyans are urged to enrol in SHA to secure healthcare access. The Ministry emphasized that informal sector members should undergo means testing and remit premiums promptly, while employers should onboard all employees and ensure timely premium payments.
Additionally, the government is exploring measures to strengthen the healthcare system, including recapitalizing the Kenya Medical Supplies Authority (KEMSA) to improve the availability of essential commodities in health facilities.
“This measure will complement SHA’s efforts to ensure uninterrupted access to critical healthcare services,” the statement said.
To prevent misinformation, the Ministry advised beneficiaries and stakeholders to rely on official SHA channels for details about benefits, tariffs, and access rules.
Queries can be directed to the SHA helpline at 147 or via email at [email protected].
