• By Raymond Momanyi

Kenya's Healthcare Revolution: Understanding the Social Health Authority (SHA)

Kenya is on the cusp of a healthcare revolution, and at its heart lies the Social Health Authority (SHA). Launched under the Social Health Insurance Act of 2023, the SHA is not just a new government body; it's a transformative step towards achieving Universal Health Coverage (UHC) for every Kenyan citizen and legal resident. If you've been wondering what the SHA is, how it works, and what it means for you and your family, read on!

From NHIF to SHA: A New Dawn for Healthcare

For decades, the National Health Insurance Fund (NHIF) served as Kenya's primary health insurer. However, the government recognized the need for a more comprehensive, equitable, and sustainable system to truly deliver UHC. This vision gave birth to the SHA, an entity designed to streamline healthcare financing and ensure that no Kenyan is left behind due due to financial constraints.

The Three Pillars of the SHA: How Your Healthcare is Funded

The SHA operates through a sophisticated structure of three distinct funds, each playing a crucial role in managing and disbursing resources for different levels of healthcare:

1. The Social Health Insurance Fund (SHIF): This is the flagship fund, built from the mandatory contributions of all Kenyans. Its primary role is to cover a broad spectrum of medical services, from routine doctor visits (outpatient) to hospital stays and complex procedures (inpatient) for registered members and their dependents. Think of it as the main engine driving your comprehensive health coverage.
2. The Primary Healthcare Fund (PHF): Prevention is better than cure, and the PHF embodies this principle. It's specifically designed to finance essential services at the grassroots level – think local dispensaries, health centers (Level 1-3 facilities). This fund focuses on preventive care, health promotion, and basic curative services, ensuring that common ailments are addressed early before they escalate.
3. The Emergency, Chronic, and Critical Illness Fund (ECCIF): This fund is a game-changer for high-cost, life-threatening conditions. It steps in to cover specialized services such as advanced cancer treatments (oncology), dialysis for kidney failure, intricate diagnostic imaging like CT scans and MRIs, and crucial emergency ambulance and evacuation services. This ensures that devastating illnesses don't lead to financial ruin for families.

Your Role: Mandatory Membership and Fair Contributions

One of the cornerstones of the SHA is mandatory membership. All Kenyan citizens and legal residents living in Kenya for over 12 months are required to register. This inclusive approach ensures a larger risk pool, making the system more sustainable and effective for everyone.

How to register? It's becoming increasingly accessible: via a simple USSD code (*147#), the official online portal, SHA branch offices, or Huduma Centres across the country. Once registered, your entire household – yourself, your spouse, and dependent children – is covered.

What about contributions? The SHA employs an equitable contribution model:

• For the Employed: A fair 2.75% of your gross salary will be deducted by your employer monthly, with a minimum contribution of Ksh 300.
• For the Self-Employed/Informal Sector: You will also contribute 2.75% of your household income. This is determined through a "means testing instrument" that considers various socio-economic factors to ensure fairness. The minimum contribution here is also Ksh 300 per month.
• For the Vulnerable: Critically, the government will step in to contribute for households identified as indigent or vulnerable, ensuring that poverty is not a barrier to accessing healthcare.

What Does This Mean for You?

The Social Health Authority marks a significant shift. It promises a future where access to quality healthcare is a right, not a privilege. By pooling resources and focusing on comprehensive coverage, the SHA aims to protect Kenyans from catastrophic health expenditures and foster a healthier nation.

While the SHA provides a robust social safety net, many Kenyans may still seek enhanced coverage, broader hospital networks, or additional benefits. This is where private health insurance plays a complementary role.

This blog post is for informational purposes. For personalized advice on medical and general insurance, remember that Imana Insurance Agency is always ready to assist you in finding the most competitive and suitable insurance protection. Whether it's for your car, home, or additional medical needs, they can help! Reach out to them via Call/WhatsApp at +254796209402 or +254745218460.