The Social Health Authority (SHA) has announced a major expansion of healthcare coverage for cancer treatment and critical care services in Kenya. Starting April 1, 2025, cancer patients will now receive up to KES 550,000 annually, while ICU and HDU patients will get higher reimbursements, rising from KES 4,480 to KES 28,000 per day.
This move is part of the government’s push toward Universal Health Coverage (UHC) under the Bottom-Up Economic Transformation Agenda (BETA). However, despite the big announcement, questions remain about whether SHA can effectively deliver these benefits, given the challenges that have plagued its rollout since October 2024.
What’s Changing? SHA’s New Healthcare Benefits Explained
SHA’s latest adjustments target two key areas in Kenya’s healthcare system:
1. Higher Cancer Treatment Coverage
- Cancer patients will now get up to KES 550,000 per year for treatment costs.
- KES 400,000 will come from the Social Health Insurance Fund (SHIF).
- An additional KES 150,000 will be available under the Emergency, Chronic, and Critical Illness Fund (ECCIF).
- This funding covers chemotherapy, radiotherapy, diagnostics, and follow-ups.
🔹 What It Means for You: More cancer patients can access life-saving treatments without the extreme financial burden that often comes with the disease.
2. ICU and HDU Reimbursement Increased
- The daily reimbursement for Intensive Care Unit (ICU) and High Dependency Unit (HDU) stays has risen from KES 4,480 to KES 28,000.
- This adjustment aims to ease the financial strain on families needing critical care for loved ones.
🔹 What It Means for You: ICU and HDU care will be more accessible, reducing the number of families forced to fundraise or take out loans for medical expenses.
Can SHA Deliver on These Promises? Key Challenges Ahead
While these improvements sound promising, SHA’s track record since its October 2024 launch has been rocky.
1. Out-of-Pocket Costs Remain High
Many Kenyans have reported being forced to pay for services upfront, despite SHA’s promise of cashless access to medical care. Hospitals have been slow to adapt, leading to confusion and additional costs for patients.
2. System Glitches & Delayed Reimbursements
SHA’s digital system has experienced frequent downtime, causing delays in patient registration and claim processing. Medical providers are still waiting for payments, raising concerns about whether SHA has the financial stability to support these new benefits.
3. Public Awareness is Low
Many Kenyans still don’t understand how SHA works, and hospitals haven’t fully adopted it. The government needs to ramp up education efforts to ensure Kenyans actually benefit from the expanded coverage.
How to Access SHA’s New Benefits
If you are a patient seeking cancer treatment or ICU/HDU care, follow these steps to make sure you get the coverage you’re entitled to:
1️⃣ Ensure You Are Registered with SHA
- Visit your nearest Huduma Centre or a participating hospital.
- Confirm your SHA status via the official SHA portal.
2️⃣ Get Treatment from Approved Hospitals
- Only SHA-contracted facilities will honor these new benefits.
- Check SHA’s official list of providers before seeking treatment.
3️⃣ Know Your Rights
- You should NOT be asked to pay out-of-pocket for services covered under SHA.
- If a hospital refuses to honor SHA, report the issue immediately to the SHA hotline.
4️⃣ Stay Updated on SHA Policy Changes
- The government may introduce additional changes—keep checking SHA’s website or social media channels.
The Bigger Picture: What This Means for Kenya’s Healthcare System
These new benefits are part of a larger effort to fix Kenya’s healthcare system. With UHC as a national priority, the government hopes to:
✅ Lower the financial burden on patients
✅ Reduce reliance on fundraisers and loans for medical bills
✅ Improve the quality and accessibility of public healthcare
However, implementation is everything. Without proper enforcement and system upgrades, these benefits may remain just promises on paper.
SHA’s increased funding for cancer treatment and critical care services is a step in the right direction, but serious issues need to be addressed for it to work smoothly.
➡️ Hospitals must be held accountable for accepting SHA patients without demanding extra payments.
➡️ The government must fix system glitches to avoid reimbursement delays.
➡️ Public awareness campaigns are needed so that more Kenyans know how to access SHA benefits.
🔹 Will SHA be able to fix these challenges and deliver on its promises? Let’s wait and see.
