Your Read is on the Way
Every Story Matters
Every Story Matters
The Hydropower Boom in Africa: A Green Energy Revolution Africa is tapping into its immense hydropower potential, ushering in an era of renewable energy. With monumental projects like Ethiopia’s Grand Ethiopian Renaissance Dam (GERD) and the Inga Dams in the Democratic Republic of Congo, the continent is gearing up to address its energy demands sustainably while driving economic growth.
Northern Kenya is a region rich in resources, cultural diversity, and strategic trade potential, yet it remains underutilized in the national development agenda.
Can AI Help cure HIV AIDS in 2025
Why Ruiru is Almost Dominating Thika in 2025
Mathare Exposed! Discover Mathare-Nairobi through an immersive ground and aerial Tour- HD
Bullet Bras Evolution || Where did Bullet Bras go to?
Kenya’s healthcare system has undergone a seismic shift with the introduction of the Social Health Authority (SHA), a newly established body charged with administering a universal, social-based health insurance model. Designed to phase out the now-defunct NHIF (National Health Insurance Fund), SHA is meant to provide equitable access to healthcare — but what does that really mean in practice?
As the central body coordinating enrollment, funding, and service delivery, SHA isn’t just an insurance administrator; it’s the engine of Kenya’s universal health coverage ambitions.
Under the SHA’s three-tier structure — Primary Care, Emergency and Chronic Care, and Specialized Care — every Kenyan is theoretically guaranteed a comprehensive package of health services:
This covers routine outpatient visits, maternal and child health services, immunizations, screening for common diseases, family planning, and basic diagnostics. These are offered through registered facilities under the Primary Healthcare Fund.
All life-threatening emergencies — including trauma, accidents, stroke, heart attack, or childbirth complications — are to be covered immediately without preauthorization. Long-term conditions such as diabetes, hypertension, cancer, and HIV/AIDS fall under this category too, ensuring patients can access continuous medication and re view.
When a patient needs advanced interventions like surgery, cancer treatment, mental health therapy, or intensive care, this is catered to through a separate fund managed by SHA. Access may require a referral from lower-tier facilities, but the intent is to eliminate catastrophic healthcare spending.
SHA operates under the principle of mandatory participation. All Kenyan citizens — whether employed formally, self-employed, or unemployed — are expected to enroll and contribute based on their income. For the informal sector, SHA will use household income estimates to assign a tiered premium.
But it doesn’t stop there. Vulnerable populations — including persons with disabilities, orphans, the elderly, and indigent families — will be fully subsidized by the national government through public funds.
Employers, too, will have a legal duty to remit premiums on behalf of their workers. This means more robust integration of health contributions into payroll systems — and tighter compliance monitoring by the SHA.
Unlike the NHIF, which had erratic contracts and delays in payments, the SHA framework aims for a centralized service delivery model. Health facilities — public or private — must be accredited by SHA to offer insured services. SHA will reimburse them from designated funds, with strict adherence to service quality and transparency.
This means a patient can, in theory, access a private hospital for covered services, provided that hospital is in the SHA network. The goal is not just access, but timely, dignified care.
To facilitate seamless access, SHA is rolling out a digital health identity system. Every enrolled member will have a unique identifier linked to their biometrics and mobile number. Healthcare providers will verify coverage using an electronic claims system, minimizing paperwork and fraud.
This integration is meant to make healthcare data portable and transparent — so that a patient can be treated in Eldoret today and in Garissa tomorrow, with the same continuity of service.
Despite its expansive mandate, SHA will not cover every health need. Elective cosmetic procedures, luxury hospital amenities, and unproven therapies remain excluded. Some services — such as expensive elective surgeries — may require co-payments or prior authorization, especially in private hospitals.
Additionally, members who default on contributions may face restricted access until their premiums are settled, although emergency care will still be provided.
SHA’s success hinges on enrollment rates, revenue collection, facility readiness, and fraud control. There are already concerns about whether the informal sector can keep up with regular contributions.
Questions also linger about whether public hospitals, still plagued with understaffing and drug shortages, are prepared for an influx of patients expecting full coverage.
The transition from NHIF has not been seamless — but SHA insists it is building a new foundation, not patching up the old one.
The SHA is more than a funding mechanism. It is Kenya’s attempt at a social contract in health — one that binds citizens, government, and providers in shared responsibility. If it succeeds, Kenyans won’t have to sell land or beg online to pay for treatment. They’ll walk into hospitals and walk out treated — with dignity.
But if mismanaged, SHA could go the way of its predecessor: bloated, inefficient, and distrusted. The coming months will determine whether this system can live up to its promises.
0 comments