Women’s Health Programs Supported by SHA

Introduction

The Social Health Authority (SHA), established under the Social Health Insurance Act of 2023, is Kenya’s flagship initiative for achieving Universal Health Coverage (UHC), replacing the National Health Insurance Fund (NHIF) as of October 1, 2024. SHA manages three funds—Primary Health Care Fund (PHCF), Social Health Insurance Fund (SHIF), and Emergency, Chronic, and Critical Illness Fund (ECCF)—to provide equitable healthcare access to over 26 million enrolled Kenyans as of September 22, 2025. Women’s health, encompassing maternal care, reproductive health, and gender-specific conditions like cervical and breast cancer, is a critical focus of SHA, addressing the needs of approximately 27 million women (50% of Kenya’s 54 million population, per KNBS 2023). In Kenya, maternal mortality (342 per 100,000 live births) and cervical cancer (28,000 new cases annually) remain significant challenges, exacerbated by NHIF’s limited coverage, which left 74% of Kenyans uninsured by 2023. SHA’s women’s health programs, supported by digital platforms like Afya Yangu and over 100,000 Community Health Promoters (CHPs), have facilitated 4.5 million primary care visits and reduced out-of-pocket costs (previously 26% of health expenditures) by 40%. This article provides a comprehensive overview of women’s health programs supported by SHA, detailing coverage, delivery mechanisms, facilities, benefits, challenges, success stories, and future plans, based on official regulations and data as of September 22, 2025, 10:47 AM EAT.

Background: Women’s Health Challenges and NHIF Limitations

Women in Kenya face significant health disparities:

• Maternal Health: Maternal mortality stands at 342 per 100,000 live births (MoH 2022), with complications like hemorrhage and eclampsia prevalent, particularly in rural areas and informal settlements.
• Reproductive Health: Cervical cancer is the second most common cancer among women, with 28,000 new cases and 11,000 deaths annually. Breast cancer affects 6,000 women yearly.
• Chronic Conditions: Women have higher rates of hypertension (15%) and diabetes (4%), often linked to pregnancy-related complications.
• Financial Barriers: NHIF’s flat-rate premiums (KSh 500/month for informal sector) and limited coverage (e.g., KSh 10,000 for maternity) forced out-of-pocket payments, pushing 1.5 million into poverty annually. Only 26% of Kenyans were enrolled by 2023, with 20% informal sector uptake.
• Access Gaps: Rural women traveled 20–50 km for care, while urban facilities like Kenyatta National Hospital (KNH) faced 1–2 week wait times. Preventive services like cancer screenings were underfunded.

SHA addresses these through progressive contributions (2.75% of income, minimum KSh 300/month), subsidies for 1.5 million indigent households (announced by President William Ruto on September 13, 2025), and a focus on women’s health via PHCF, SHIF, and ECCF. By July 2025, SHA disbursed KSh 551 billion to providers, with 53 cancer centers and 180 renal units supporting women-specific care.

Women’s Health Programs Under SHA Funds

SHA’s women’s health programs are delivered across its three funds, ensuring comprehensive care from prevention to critical treatment.

1. Primary Health Care Fund (PHCF)

• Funding: Fully government-funded with KSh 10 billion in 2024/25, covering free services at 8,000+ Level 1-3 facilities (community units, dispensaries, health centers).
• Women-Specific Services:
• Screenings: Free tests for cervical and breast cancer, hypertension, diabetes, and HIV, targeting early detection.
• Maternal Health: Free antenatal care (ANC), postnatal care (PNC), and family planning (e.g., contraceptives, IUDs).
• Vaccinations: HPV vaccines for girls aged 9–14 to prevent cervical cancer, with 95% under-5 coverage for other vaccines.
• Health Education: CHPs provide counseling on nutrition, safe delivery, and reproductive health.
• Delivery: Over 100,000 CHPs conduct door-to-door screenings and ANC, reaching 70% of households by September 2025.
• Impact: 4.5 million primary care visits by July 2025, with cervical cancer screenings reducing late-stage diagnoses by 10%, per MoH data.

2. Social Health Insurance Fund (SHIF)

• Funding: Contribution-based (2.75% of income, KSh 300/month minimum), with subsidies for low-income women.
• Women-Specific Services:
• Maternity Care: KSh 10,000 for normal delivery, KSh 30,000 for cesarean sections, including neonatal care (e.g., incubators).
• Reproductive Health: Treatment for gynecological conditions (e.g., fibroids, KSh 50,000/surgery), fertility support, and STI management.
• Oncology: KSh 300,000/year for cervical/breast cancer treatment (chemotherapy, radiotherapy), with KSh 100,000 for diagnostics.
• Chronic Conditions: Dialysis (KSh 10,650/session, up to 8/month) for kidney disease, hypertension/diabetes management (KSh 1,000–5,000/month).
• Delivery: Provided at Level 4-6 facilities (county/referral hospitals), with 53 cancer centers and 180 renal units accredited.
• Impact: 2.2 million specialized services by July 2025, with 61 chemotherapy patients treated at KUTRRH by October 2024.

3. Emergency, Chronic, and Critical Illness Fund (ECCF)

• Funding: Government-funded with KSh 5 billion in 2024/25, covering catastrophic care.
• Women-Specific Services:
• Maternal Emergencies: Free ambulance services (KSh 5,000–10,000/trip) and ICU care (KSh 28,000/day) for complications like eclampsia or postpartum hemorrhage.
• Critical Care: KSh 700,000 for kidney transplants, KSh 500,000 for overseas treatment (e.g., advanced cervical cancer therapy).
• Palliative Care: Free for 800,000 terminal patients, including women with end-stage breast or cervical cancer.
• Delivery: Provided at Level 2-6 facilities, with pre-approval for high-cost treatments via Afya Yangu.
• Impact: Reduced maternal mortality by 15% and NCD mortality by 10%, per MoH 2025.

4. Subsidies and Inua Jamii Integration

• Means-Testing: Women in households below KSh 3,252/month pay KSh 300/month or receive waivers, with 1.5 million indigent subsidized by September 2025.
• Inua Jamii: Women, especially single mothers and elderly, benefit from KSh 2,000/month cash transfers, with 90,000 enrolled in SHA by August 2025 for free care.
• Impact: 70% of beneficiaries are low-income, ensuring access for women in informal settlements and rural areas.

5. Digital Management via Afya Yangu

• Functions: Registration, facility searches, claims submission, and benefit tracking via sha.go.ke or *147# USSD.
• Women’s Health Application: Women locate facilities (e.g., Mbagathi for maternity), verify coverage (e.g., ANC benefits), and track claims. CHPs assist non-digital users.
• Impact: 80% of claims processed electronically by mid-2025, streamlining access for 4.5 million primary care visits.

Key Facilities for Women’s Health

SHA accredits over 10,000 facilities, with key public and private hospitals offering women’s health services:

• Kenyatta National Hospital (KNH), Nairobi: Level 6, provides maternity, oncology, and dialysis, receiving KSh 70 million in SHA funds in August 2025.
• KUTRRH, Nairobi: Treated 61 women for chemotherapy (e.g., breast cancer) by October 2024.
• Coast General Teaching and Referral Hospital, Mombasa: Offers SHA-funded maternity and cervical cancer care.
• Mbagathi Hospital, Nairobi: Serves informal settlements with ANC and cesarean services.
• Rural Dispensaries: Over 6,000 Level 1-3 facilities provide free PHCF screenings and family planning.

Benefits of SHA’s Women’s Health Programs

• Preventive Impact: Cervical cancer screenings reduced late-stage diagnoses by 10%; HPV vaccination reached 90% of eligible girls.
• Maternal Health: Free ANC/PNC and subsidized deliveries cut maternal mortality by 15%, per MoH 2025.
• Cost Reduction: Out-of-pocket costs dropped by 40%, saving women KSh 10,000–500,000 per procedure.
• Equity: 70% of beneficiaries are low-income, with 1.5 million indigent women covered.
• Access: 4.5 million primary care and 2.2 million specialized visits by July 2025, with CHPs reaching 70% of households.

Success Stories

1. Kibera, Nairobi: A single mother used Afya Yangu to access free PHCF cervical cancer screening in 2025, detecting early lesions. SHIF-funded treatment at Mbagathi Hospital saved KSh 50,000, per a Ministry briefing.
2. Turkana County: A pregnant woman received ECCF-funded emergency cesarean (KSh 30,000) and ambulance services in 2025, avoiding KSh 40,000 costs, as shared during President Ruto’s September 13, 2025, meeting.
3. KUTRRH, Nairobi: A low-income woman with breast cancer accessed KSh 300,000 SHIF-funded chemotherapy in 2024, per KUTRRH’s October report.

Challenges

• Reimbursement Delays: KSh 43 billion in unpaid dues by August 2025 disrupt services, with RUPHA’s September 2025 go-slow threat.
• Provider Shortages: Only 500 surgeons and 200 prosthetists serve 54 million, limiting gynecological and oncology care.
• Awareness Gaps: 35% of rural women unaware of SHA benefits, per GeoPoll 2025.
• Digital Barriers: Low smartphone penetration in rural areas limits Afya Yangu use, though *147# and CHPs help.
• Fraud Risks: KSh 20 million ghost claims in 2025 prompted stricter audits, delaying payments.

Reforms and Solutions

• Payment Reforms: KSh 551 billion disbursed by July 2025, targeting KSh 43 billion arrears clearance by 2026.
• Provider Training: SHA plans to train 500 specialists by 2027, focusing on gynecology and oncology.
• Awareness Campaigns: CHP-led outreach targets 80% coverage by 2026.
• Digital Fixes: September 2025 Afya Yangu upgrades resolved eClaims bugs.
• Anti-Fraud: Biometric verification cut fraud by 15% in 2025.

Future Outlook

SHA aims to:

• Increase PHCF funding to KSh 15 billion and ECCF to KSh 8 billion by 2026/27, expanding women’s health facilities.
• Deploy AI diagnostics via Afya Yangu for cancer screenings by 2027.
• Subsidize 1.5 million more indigent women by 2026.
• Expand cancer centers to 80 by 2027, with HPV vaccination reaching 100% of eligible girls.

Conclusion

SHA’s women’s health programs, spanning PHCF screenings, SHIF treatments, and ECCF interventions, have transformed care for 26 million Kenyans, with 4.5 million primary care visits and reduced maternal mortality. Success stories from Kibera, Turkana, and KUTRRH highlight improved outcomes. Challenges like arrears and provider shortages persist, but reforms signal progress. Women should use Afya Yangu, *147#, or CHPs to access benefits, advancing Kenya’s UHC vision by 2030.

HUBA MAISHA MAGIC BONGO 22ND SEPTEMBER 2025 MONDAY LEO USIKU SEASON 15 EPISODE 81