The Social Health Authority (SHA) has announced newly revised healthcare benefit packages aimed at improving access to affordable medical services and strengthening Universal Health Coverage (UHC) in Kenya.
The enhanced packages, funded through the Primary Healthcare Fund and the Emergency, Chronic and Critical Illness Fund, target maternal healthcare, cancer treatment, sickle cell management, and chronic illnesses.
The reforms are expected to significantly reduce out-of-pocket healthcare expenses for millions of Kenyans.
Under the new SHA package, all registered mothers, including teenage mothers, will access free antenatal care (ANC), delivery services, and referrals at Level 2 and Level 3 health facilities.
Previously, mothers were required to have fully paid-up SHA membership contributions before they could access maternity services, a requirement that often limited expectant women’s timely access to healthcare.
Under the revised Social Health Authority (SHA) maternity package, healthcare providers will now be reimbursed Ksh 10,000 for normal deliveries and Ksh 30,000 for Caesarean Section (C-Section) procedures conducted at accredited Level 3 health facilities.
The move is expected to improve access to maternal healthcare and reduce financial barriers for expectant mothers across Kenya.
Cancer Care Coverage increased to Ksh 800,000
As part of the reforms, SHA has increased oncology coverage from Ksh 550,000 to Ksh 800,000, offering major relief to cancer patients and families struggling with treatment costs.
The revised SHA cancer care package also expands access to essential diagnostic and supportive services aimed at improving treatment outcomes and patient care.
New Oncology Benefits Under SHA
The updated package now includes:
- Histopathology testing
- Biomarker testing
- Supportive care for chemotherapy and radiotherapy side effects, such as nausea and related complications
Additional Oncology Allocations
SHA has also introduced additional allocations for key cancer treatment services:
- Consultations – Up to Ksh 2,500 per visit (maximum of four visits)
- Chemotherapy administration – Ksh 5,000 per visit
- Chemo port insertion – Ksh 15,000
- Supportive care – Up to Ksh 10,000
The enhanced oncology package is expected to improve the affordability of cancer treatment, increase access to critical services, and support better health outcomes for patients across Kenya.
Specialised Sickle Cell Anaemia Coverage
For the first time, SHA has introduced specialised standalone support for sickle cell anaemia patients.
The package will cover at least three sessions per policy period for:
- Aphaeretic platelets
- Red cell exchange procedures
The inclusion is expected to improve access to specialised blood-related interventions for affected patients.
Critical Illness Fund Increased to Ksh 400,000
SHA has also increased the Emergency, Chronic and Critical Illness Fund from Ksh 150,000 to Ksh 400,000.
The expanded fund is designed to cushion patients facing severe and life-threatening medical conditions.
Progress Made Under the SHA Taifa Care Model
Healthcare advocacy groups, including the Kenyan Network of Cancer Organisations (KENCO), have welcomed the reforms as a positive step toward accessible healthcare in Kenya.
Achievements So Far
- Millions of Kenyans registered under the SHA
- AI-driven fraud detection systems introduced
- “Afya Yangu” digital portal launched
- Free primary healthcare services available at clinics and dispensaries
Challenges Facing SHA Implementation
Despite the progress, several operational challenges continue to affect the transition from the former NHIF system to the Taifa Care model.
Key Challenges
- Technical glitches and ID mismatches on the SHA platforms
- Delayed payments to healthcare providers
- Inherited NHIF debts
- Concerns from private hospitals over reimbursement delays
Concerns Over SHA Costs and Data Security
Although SHA promises free healthcare services at Level 2 and 3 facilities, many Kenyans continue to experience unexpected out-of-pocket expenses caused by medicine shortages and slow pre-authorisation processes.
Concerns have also been raised regarding the management of SHA’s digital infrastructure after the Auditor General questioned the involvement of private consortia in handling public healthcare data.
What Stakeholders Want the Government to Address
Stakeholders are urging the government to prioritise:
- Faster payments to healthcare providers
- Resolution of legal disputes surrounding SHA deductions and data management
- Enforcement of the 5% administrative expenditure cap
The success of the Taifa Care model will largely depend on how quickly the government resolves these operational and financial challenges while maintaining public trust in the healthcare system.
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