The Lower Eastern Times Opening The Third Eye
The government is in the process of establishing a committee to assess the tariffs and benefits under the Social Health Insurance (SHA) Regulations.
The committee will evaluate the current system and propose practical solutions to address both immediate and long-term challenges facing the health insurance scheme.
Harry Kimtai, Principal Secretary for Medical Services, explained that the committee’s role will be to analyze feedback from stakeholders and provide informed recommendations aimed at ensuring the sustainability of SHA and improving its responsiveness to the healthcare needs of Kenyans. The report from the committee will focus on both short-term and long-term interventions.
The committee’s review is part of efforts to enhance the Social Health Authority’s (SHA) sustainability and to ensure equitable access to healthcare services for all Kenyans. Kimtai clarified that SHA’s coverage is based on gazetted tariffs that define the benefits, which are designed to maintain sustainable healthcare coverage. In instances where hospital charges exceed the set limits, beneficiaries may be required to make co-payments.
The implementation of SHA, which began on October 1, 2024, is progressing well. It includes member registration, healthcare provider contracting, and the ongoing digitization of health systems to improve service accessibility. Kimtai highlighted that SHA is actively addressing emerging challenges, including the provision of cancer management, renal care, maternity, and outpatient services, with the goal of removing barriers to care.
Furthermore, Kimtai emphasized the government’s commitment to advancing Universal Health Coverage (UHC) through the Taifa Care program, a key component of the Bottom-Up Economic Transformation Agenda (BETA).
He urged Kenyans to enroll in SHA, with particular emphasis on informal sector workers undergoing means testing and contributing premiums to ensure the continuity of services. Employers were also encouraged to ensure their employees are registered and that monthly premiums are promptly remitted.
In addition, the government is exploring ways to strengthen the healthcare delivery system, including the potential recapitalization of the Kenya Medical Supplies Authority (KEMSA) to enhance the distribution of essential medical supplies to healthcare facilities. This initiative is expected to complement SHA’s efforts to ensure uninterrupted access to vital healthcare services.
