The Social Health Authority’s (SHA) benefits have been a point of contention recently, with Kenyans raising concerns about the extent of coverage under the system. Addressing these concerns, Medical Services Principal Secretary Harry Kimtai clarified that SHA coverage is firmly based on gazetted tariffs, which were published in November 2024.
In a public statement, Kimtai emphasized that these tariffs, available on the SHA’s official website, aim to promote sustainable healthcare coverage, equitable access, and a shared responsibility model. He assured Kenyans that the system is designed to balance affordability with sustainability, while also ensuring that no one is left behind in accessing essential health services.
Sustainable Healthcare through Transparent Tariffs
Kimtai highlighted that the use of gazetted tariffs ensures transparency and uniformity in healthcare service provision. This approach seeks to eliminate disparities in healthcare access by clearly defining what SHA covers and to what extent. The SHA’s tariff structure has been designed to promote inclusivity while ensuring the long-term viability of the healthcare system.
“Gazetted tariffs provide a framework for equitable healthcare access and sustainable service delivery. The shared responsibility model allows for accountability among stakeholders, including beneficiaries, healthcare providers, and the government,” Kimtai said.
Co-Payments for Costs Beyond Limits
While the gazetted tariffs aim to provide comprehensive coverage, Kimtai acknowledged that there may be instances where hospital charges exceed the specified limits. In such cases, beneficiaries may be required to make co-payments to bridge the gap.
This announcement has sparked mixed reactions among Kenyans, with some expressing concerns over affordability, especially for low-income households. However, Kimtai reassured the public that the Ministry of Health is actively working to address these issues through a participatory approach.
Plans to Review Tariffs and Benefits
Recognizing the evolving needs of the healthcare sector and the feedback received from stakeholders, Kimtai revealed that the Ministry is in the process of forming a committee to review the current tariffs and benefits. The committee will be tasked with assessing the existing framework and recommending practical solutions to address emerging challenges.
“This committee will review feedback gathered over time and ensure that the SHA benefits align with the healthcare needs of all Kenyans. Our aim is to make the system more responsive and inclusive,” Kimtai stated.
This move is expected to provide a platform for stakeholders, including patients, healthcare providers, and policymakers, to contribute to shaping a more effective healthcare system.
Accessing Accurate Information
Kimtai urged all beneficiaries and stakeholders to rely on official SHA channels for accurate information regarding tariffs, benefits, and rules. He cautioned against misinformation, which he said could lead to unnecessary confusion and anxiety among the public.
To address information gaps, the SHA has enhanced its communication channels, including updates on its website and social media platforms. Beneficiaries are encouraged to regularly check these platforms for the latest updates and guidelines.
A Step Towards Universal Healthcare
The SHA’s reliance on gazetted tariffs represents a critical step in Kenya’s journey toward achieving universal healthcare coverage. By anchoring benefits on a transparent and sustainable model, the government aims to provide all Kenyans with access to quality healthcare services without financial hardship.
However, the success of this initiative will depend on continued collaboration among stakeholders and timely interventions to address challenges such as co-payment burdens and evolving healthcare demands. The Ministry’s commitment to review and refine the system is a promising sign that the government is responsive to the needs of its citizens.
As SHA coverage continues to evolve, Kenyans will be watching closely to see whether the planned adjustments and committee deliberations result in tangible improvements to the healthcare system. For now, the assurance of transparency and inclusivity remains a cornerstone of the SHA framework.
