In a bid to advance Universal Health Coverage (UHC) under the Taifa Care program, the Kenyan government has clarified its Social Health Authority (SHA) tariffs, addressing emerging concerns regarding healthcare affordability and access. The initiative is part of the Bottom-Up Economic Transformation Agenda (BETA), designed to deliver equitable healthcare to all Kenyans.
The Social Health Authority (SHA), established after repealing the NHIF Act of 1998, manages three key funds: The Social Health Insurance Fund (SHIF), the Primary Healthcare Fund (PHCF), and the Emergency, Chronic, and Critical Illness Fund (ECCIF). According to the Ministry of Health, the SHA rollout began on October 1, 2024, marking a critical transition in healthcare management and strategic resource pooling.
“SHA’s coverage is based on gazetted Tariffs to the Benefits published in November 2024,” confirmed the Ministry. The framework addresses hospital costs, particularly for critical care units like Intensive Care Units (ICU) and High Dependency Units (HDU). Rates have been standardized: KES 3,360 per day for Level 4 facilities, KES 3,920 for Level 5, and KES 4,480 for Level 6.
Beneficiaries will be capped at 180 days annually for access, ensuring sustainable resource management. However, members are required to co-pay any costs exceeding the specified limits.
The Ministry also emphasized addressing challenges such as access to cancer care, renal treatment, and maternity services. “We are committed to removing any barriers that may hinder access, ensuring beneficiaries face no hurdles,” the statement noted.
Additionally, the government is evaluating ways to recapitalize the Kenya Medical Supplies Authority (KEMSA) to enhance healthcare delivery. A review committee will also assess long-term tariff sustainability.
Employers are encouraged to onboard employees onto SHA and ensure prompt premium payments to sustain the system. The government reiterated, “SHA’s efforts aim to guarantee uninterrupted access to critical healthcare for all Kenyans.”
