In a significant development for Kenya’s healthcare sector, the Ministry of Health has unveiled new tariffs under the Social Health Insurance Act (SHIA), with a focus on enhancing healthcare access and quality across the nation. Health Cabinet Secretary Dr. Deborah Barasa confirmed that the Linda Mama program for expectant mothers will be integrated and bolstered to support efforts in reducing maternal mortality rates.
Speaking at the National Validation Forum for the new tariffs, Dr. Barasa highlighted several key changes aimed at improving healthcare services. Cancer patients will now benefit from a cover of up to Ksh. 400,000 for oncological services, which includes treatments such as chemotherapy, PET scans, and radiotherapy. The new tariffs also provide comprehensive support for maternal health, with normal delivery costs increased to Ksh. 10,000 and C-sections to Ksh. 30,000.
For chronic conditions, the new scheme offers up to Ksh. 4,300 for diabetes management in Level 4 to 6 facilities, Ksh. 2,850 for hypertension, and Ksh. 6,800 annually for sickle cell anemia. Inpatient services at Level 4 to 6 hospitals will charge tariffs of Ksh. 3,360, Ksh. 3,920, and Ksh. 4,480 respectively, with a maximum of 180 days per household. Kidney failure treatment will have tariffs ranging from Ksh. 10,650 per session for hemodialysis to Ksh. 85,200 per month for peritoneal dialysis. Additionally, there will be a Ksh. 3,000 cover for embalming and Ksh. 500 per day for body storage for up to five days for families in the event of a death.
Dr. Barasa emphasized that the comprehensive benefit package was crafted with extensive public input and consultations with various stakeholders, including the public, healthcare providers, and government entities. This approach aims to ensure the system’s transparency, accountability, and sustainability.
The SHIA, along with the Primary Health Care Act and Digital Health Act, faced legal challenges earlier this year, with the High Court declaring them unconstitutional due to inadequate public participation. However, Dr. Barasa expressed confidence that the issues would be resolved and the rollout would proceed as planned on October 1st.
The new framework represents Kenya’s first effort to publish specific tariffs for healthcare benefits, fostering greater transparency and helping manage costs effectively. Dr. Barasa urged all Kenyans to register with the Social Health Authority to access these benefits, stressing that registration is crucial for the initiative’s success.
The transition from the National Health Insurance Fund (NHIF) to the Social Health Authority (SHA) marks a major shift in Kenya’s healthcare financing. This transition aims to expand coverage, particularly for vulnerable populations, and improve the quality of health services while ensuring financial protection against medical costs.
Dr. Barasa concluded by acknowledging the collaborative efforts of all involved in shaping the new tariffs and benefit package, reinforcing the commitment to a more equitable and effective healthcare system in Kenya.