The Social Health Insurance Act of 2023 introduced the Social Health Authority (https://sha.go.ke). Under the Social Health Authority are three funds: Primary Healthcare Fund, Social Health Insurance Fund (formally the National Health Insurance Fund) and Emergency, Chronic and Critical Illness Fund.
It is an ambitious model extending coverage of basic health services to preventative, promotive, curative, rehabilitative and palliative care. Chronic conditions are included in the package of services.
The process to gain access is registration, including biometrics, to obtain a Social Health Authority number. Minors (under the age of 18 years) will receive a Minor Social Health Authority number. No cards will be issued. There will be a household annual premium to be paid upfront. With membership all services can be accessed.
The new model also incorporates the Linda Mama programme that provided maternity services for women. A a means tested tool will be administered during antenatal clinics for those who are unable to pay for maternity services.
We are interested to hear your experiences and suggestions on this new model.