Understanding the Social Health Authority (SHA) and its Impact on Kenyans
Starting October 1, 2024, the Social Health Authority (SHA) will take over from the National Health Insurance Fund (NHIF), marking a significant shift in Kenya’s healthcare system.
This move is part of Kenya’s broader Universal Health Coverage (UHC) strategy, designed to ensure all citizens access essential healthcare services without suffering financial hardship.
Under the Social Health Insurance Act of 2023, SHA will manage three distinct funds:
- Primary Healthcare Fund (PHF)
- Social Health Insurance Fund (SHIF)
- Emergency, Chronic, and Critical Illness Fund
All Kenyans who register for SHA will automatically be enrolled in these funds, and unlike the NHIF, there will be no need for physical membership cards.
Primary Healthcare Fund (PHF)
The Primary Healthcare Fund focuses on delivering essential health services at local facilities such as dispensaries and health centres.
As the first point of care at Level 2 and 3 facilities, patients will receive treatment free of charge, whether directly or through referrals from community health promoters.
One of the key components of the PHF is that no individual contributions are required for access.
The fund is sustained through government allocations and external grants, making it possible for all Kenyans to benefit from these services without out-of-pocket costs.
Social Health Insurance Fund (SHIF)
The Social Health Insurance Fund (SHIF), which has attracted a lot of attention, is a critical part of the SHA but only one aspect of the broader UHC agenda.
SHIF is designed to cover inpatient services at Level 4, 5, and 6 healthcare facilities or accredited providers, once a patient has been referred.
Kenyans will contribute 2.75% of their monthly or yearly income to SHIF, regardless of whether they are salaried or in the informal sector.
The fund covers comprehensive inpatient services such as pre-admission evaluations, hospital accommodation, meals, nursing care, and general ward bed charges.
It also covers the management of illnesses during admission, with a maximum coverage of 180 days per household.
The Broader UHC Vision
The SHA is a cornerstone of Kenya’s goal to achieve Universal Health Coverage.
By integrating various health funds under one authority, the government aims to streamline healthcare access and make it more equitable for all citizens.
This approach also helps ensure financial sustainability in the long term, reducing the burden on individuals and increasing government responsibility in healthcare financing.
