In a significant move aimed at strengthening Kenya’s healthcare reform agenda, Health Cabinet Secretary Aden Duale has formed a high-level advisory panel to guide the Social Health Authority (SHA) on critical matters relating to benefits and tariffs under the Social Health Insurance Regulations, 2024. The newly constituted Benefits Package and Tariffs Advisory Panel is composed of 11 seasoned professionals and supported by five joint secretaries, reflecting a strong emphasis on expert input in health policy design. The official establishment of the panel was communicated through a gazette notice dated April 23, 2025, where Duale underscored the importance of aligning health coverage benefits with evolving healthcare needs and economic considerations.
Chaired by Prof. Walter G. Jaoko, a respected figure in medical research and academia, the panel is mandated to serve a three-year term, during which it will provide strategic guidance on the formulation, implementation, and periodic review of benefit packages and tariffs. The appointed members represent a diverse blend of expertise from public health, healthcare administration, health economics, and clinical medicine. Among them are Dr. Patrick Amoth, Nehemiah Odera, Margaret Macharia, Dr. Hajara El Busaidy, Robert Rapando, Dr. Gabriel Muswali, Dr. Mary Kigasia Amuyunzu-Nyamongo, Dr. Walter Oyamo Obita, Dr. Valeria Makory, and Stephen Kaboro. Supporting their work, the secretariat will be run by Francis Motiri, Dr. Christine Wambugu, Dr. Tabitha Okech, Dr. Patricia Nyokabi, and Dr. Abdiaziz Abdikadir Ahmed.
The panel’s primary objective is to advise both the Cabinet Secretary for Health and the SHA on structuring benefit packages that are sustainable, equitable, and responsive to the health needs of Kenyans. It will also assess and recommend tariffs that health facilities can charge under the SHA programme, helping standardize pricing across public, private, and faith-based healthcare institutions contracted by the government. This comes at a time when access to healthcare remains a pressing concern for many citizens.
One of the notable expansions under the SHA scheme is the provision for critical care, including ICU and HDU admissions. Households are now eligible for up to 180 days of ICU or HDU coverage annually. However, this coverage is subject to co-payment requirements in cases where healthcare costs exceed the established limits. Additionally, the government has introduced improved benefits for cancer patients, who can now access up to Sh550,000 annually for treatment, a move intended to ease the financial burden associated with chronic illnesses. The funding is sourced from both the Social Health Insurance Fund and the Emergency, Chronic, and Critical Illness Fund.
Reimbursement rates for ICU and HDU services have also seen a substantial increase, with daily charges rising from Sh4,480 to Sh28,000. Duale emphasized that this revision is part of the government’s broader efforts to ensure the viability and accessibility of essential services across the country’s healthcare landscape.
Despite these reforms, the SHA programme has not been without criticism. Since its implementation in October 2024, many Kenyans have voiced concerns about the system’s inefficiencies, unexpected out-of-pocket costs, and limited access to contracted facilities. While the newly introduced benefits mark progress toward Universal Health Coverage, public confidence in the system remains fragile. Effective implementation, transparency, and continued stakeholder engagement will be key to ensuring that the promises made under the SHA reforms translate into real-world improvements in healthcare delivery.
