Health care without barriers: Kenya’s push for universal access through SHA reform

In a bold move to expand health care access across Kenya, the Ministry of Health has ordered all hospitals to eliminate upfront payments for services under the Social Health Authority (SHA). 

This reform allows registered Kenyans to receive medical care in public, private, and faith-based facilities by paying monthly premiums rather than facing immediate financial burdens. 

Medical Services Principal Secretary (PS) Harry Kimtai highlighted the Ministry’s commitment to breaking down barriers to health care access.

"If they have been contracted to provide services under SHA, they must fulfil their obligations without demanding upfront payments from patients,” PS Kimtai stated.

This decision follows increasing concerns from the public about being denied treatment despite having up-to-date SHA payments.

Addressing these issues during a meeting with county commissioners and health CECs from Nairobi, Central, and North Eastern regions, Kimtai emphasised that the new policy is part of a broader drive to ensure healthcare accessibility. 

“No registered SHA patient should be denied treatment,” he stressed, underscoring that the SHA was designed to provide comprehensive, affordable healthcare to all Kenyans.

To sustain the SHA model, the Ministry has also launched an insurance premium financing scheme for those who may prefer making upfront payments.

“We’re developing a financing model that will provide options for Kenyans who want to manage their contributions differently,” said PS Kimtai.

This flexibility is particularly aimed at supporting low-income households who may struggle with regular monthly premiums.

In addition to removing upfront payments, the Ministry has released Ksh 9 billion to clear National Health Insurance Fund (NHIF) debts owed to health facilities across the country. 

“The clearance of NHIF debts will ease tensions and foster cooperation between the government and health facilities, enabling seamless service delivery,” the official said, noting that the funds would be disbursed by the end of the week.

This move is expected to bolster confidence in the SHA programme and encourage more facilities to collaborate with the government.

SHA registrations have already seen a spike, with 91,000 new registrants joining the 13 million already in the system on Tuesday alone.

PS Kimtai attributed this surge to the recent policy changes and highlighted the Ministry’s goal of registering all Kenyans by December 2024. 

“We’re making SHA as accessible as possible, ensuring that no Kenyan has to worry about the cost of basic healthcare,” he said.

To achieve this ambitious target, the Ministry has formed multi-sectoral committees across all counties, chaired by County Executive Committees (CECs) and comprising representatives from National Government Administrative Officers (NGAOs), faith-based organisations, and the Kenya Health Federation. 

“These committees will ensure that SHA reaches every household, including those who may struggle to register independently,” PS Kimtai explained. 

He emphasized that the SHA’s benefits would extend to both primary and referral healthcare levels, ensuring standardised treatment across the board.

The Ministry has also deployed technical teams to various counties to address challenges in the SHA registration process. 

“We want to make it as easy as possible for Kenyans to register and begin accessing health care,” PS Kimtai added. 

He assured that all necessary steps are being taken to streamline registration, particularly in areas where residents face difficulties with technology and internet access.

The Ministry’s directive marks a significant step toward fulfilling Kenya’s goal of universal healthcare, with SHA as its cornerstone. 
For now, as the reforms continue to unfold, the government’s message to health providers and the public alike is clear.

“Kenyans can trust that SHA registration guarantees access to quality healthcare without financial strain,” the PS said.