Public-Private Partnerships Enhancing SHA

Introduction

Public-private partnerships (PPPs) in healthcare represent a collaborative model where government entities leverage private sector expertise, capital, and innovation to deliver public services more efficiently and equitably. In Kenya, where a population of 53 million grapples with non-communicable diseases (NCDs) like diabetes (9% prevalence) and hypertension (24%), infectious outbreaks such as cholera (2,000 cases in 2025), and stark regional disparities—with only 40% health facility coverage in rural Arid and Semi-Arid Lands (ASALs) like Turkana compared to 70% in urban Nairobi—PPPs are essential for advancing Universal Health Coverage (UHC) (KDHS 2022, MoH 2025). The Social Health Authority (SHA), launched on October 1, 2024, under the Social Health Insurance Act of 2023, replaced the National Health Insurance Fund (NHIF) to drive UHC by 2030. By September 2025, SHA has registered 26.7 million Kenyans (50% of the population), disbursed KSh 8 billion to frontline services, and covered 4.5 million treatments without out-of-pocket costs. SHA’s three-fund structure—Primary Health Care Fund (PHCF), Social Health Insurance Fund (SHIF), and Emergency, Chronic, and Critical Illness Fund (ECCIF)—relies heavily on PPPs to address NHIF’s legacy of KSh 30.9 billion in debts and fraud (KSh 41 million in ghost claims). Recent collaborations, such as the September 2025 partnership with the Kenya Healthcare Federation (KHF) and Kenya Association of Private Hospitals (KAPH), underscore PPPs’ role in tackling financing gaps and ensuring uninterrupted services. This article provides a comprehensive, factual guide to how PPPs enhance SHA, detailing mechanisms, key partnerships, impacts, challenges, and future prospects, grounded in Kenya’s medical situation, government reports, and public discourse.

The Need for PPPs in Kenya’s Healthcare System

Kenya’s healthcare system is characterized by chronic underfunding, infrastructure deficits, and inequities that PPPs are uniquely positioned to address:

• Financing Challenges: Pre-SHA, NHIF’s 17% coverage left 83% of informal workers (16.7 million) reliant on 40% out-of-pocket spending, pushing 1 million into poverty annually (World Bank 2022). SHA’s KSh 6.1 billion allocation covers only 4% of the KSh 168 billion needed yearly, creating a KSh 4 billion monthly deficit (MoH 2025).
• Infrastructure Gaps: Only 56% of 17,755 facilities are e-contracted with SHA, with rural ASALs lagging at 40% coverage, delaying NCD treatment (39% of deaths) and maternal care (530 per 100,000 live births) (UNICEF 2025).
• Private Sector Role: Private providers deliver 40% of healthcare, including 70% of specialized services like oncology (42,000 cases annually), but NHIF’s inefficiencies led to KSh 76 billion in unpaid claims, threatening viability (RUPHA September 2025).
• Policy Foundation: The Public-Private Partnerships Act (2021) and SHIA (2023) enable PPPs for UHC, with the Benefits Package and Tariffs Advisory Panel (BPTAP) reviewing alignments. A 2018 study in Health Policy and Planning highlighted PPPs’ success in integrating private providers into NHIs in Kenya and Ghana through shared goals and communication (PMC 2018).

PPPs in SHA focus on tariff alignment, data sharing, and fraud elimination, as emphasized in August 2025 MoH-insurer meetings (Nairobi Wire August 2025).

Key Public-Private Partnerships Enhancing SHA

SHA’s PPPs leverage private sector strengths in financing, technology, and service delivery, with recent agreements addressing systemic issues:

1. SHA-KHF-KAPH Partnership (September 2025)

• Overview: In a September 23, 2025, meeting chaired by SHA Chairperson Abdi Mohamed, SHA partnered with KHF and KAPH to strengthen UHC, tackle fraud, and ensure uninterrupted services (Eastleigh Voice September 2025). This addresses KSh 76 billion in unpaid claims threatening private hospitals.
• Key Elements: Joint audits, shared databases for fraud detection, and harmonized accreditation criteria. Private providers commit to SHA e-contracting, with SHA guaranteeing bi-weekly payments (KSh 8 billion disbursed by September 2025).
• Impact: The partnership aims to cover 2.2 million vulnerable Kenyans, with quick wins like invoice discounting via KCB to ease cash flow (KHF June 2025).

2. SHA-Ministry of Health-Private Insurers Framework (August 2025)

• Overview: CS Aden Duale’s August 18, 2025, meeting with private insurers established a PPP for tariff alignment, data sharing, and fraud elimination (Nairobi Wire August 2025). Insurers link to SHA’s centralized claims platform for real-time verification.
• Key Elements: Biometric integration to prevent double-billing, joint training for 5,000 providers, and a shared fraud database. This builds on SHIA’s PPP provisions, ensuring private schemes complement SHA without duplication.
• Impact: Expected to boost insurance penetration (currently low at 3%) and reduce fraud by 15%, supporting 26.7 million SHA registrants (MoH August 2025).

3. SHA-KCB Financing Partnership (June 2025)

• Overview: A June 11, 2025, meeting between SHA, KHF, and KCB explored invoice discounting and e-commerce for diaspora contributions (KHF June 2025). KCB’s Doctors CVP extends credit solutions to SHA facilities.
• Key Elements: SHA provides claims data for KCB assessments, enabling hospitals to access funds against unpaid invoices. Diaspora remittances via integrated platforms aim to raise KSh 10 billion annually.
• Impact: Addresses delayed reimbursements, with pilots in 29 facilities showing 20% cash flow improvement (KHF June 2025).

4. SHA-NES Project and OEM Partnerships (August 2025)

• Overview: The National Medical Equipment Service Project (NESP), launched August 8, 2025, by President Ruto, partners with Original Equipment Manufacturers (OEMs) for fee-for-service equipment (Standard Media September 2025).
• Key Elements: SHA pays per use (e.g., KSh 4,500 per X-ray), equipping 29 facilities in 18 counties without upfront costs.
• Impact: Delivered 60,000 services by September 2025, enhancing diagnostics in under-served areas.

5. SHA-TSC Migration (September 2025)

• Overview: SHA partners with the Teachers Service Commission (TSC) to migrate 460,000 teachers to the Public Health Medical Schemes Fund by December 1, 2025, from private insurers like Minet (Standard Media September 2025).
• Key Elements: Seamless transition with tariff harmonization, ensuring no service disruptions.
• Impact: Covers 2.2 million vulnerable Kenyans, with Minet as administrator under PPP terms.

Partnership	Date	Key Focus	Estimated Impact
SHA-KHF-KAPH	Sep 2025	Fraud elimination, accreditation	2.2M vulnerable covered
SHA-MoH-Insurers	Aug 2025	Tariff alignment, data sharing	15% fraud reduction
SHA-KCB	Jun 2025	Invoice discounting	20% cash flow improvement
SHA-NESP	Aug 2025	Equipment leasing	60,000 services delivered
SHA-TSC	Sep 2025	Teacher migration	460,000 enrolled

Data from MoH, KHF, and media reports (2025).

Impacts of PPPs on SHA

PPPs have accelerated SHA’s rollout and addressed systemic bottlenecks:

• Financing Efficiency: KCB’s discounting resolved KSh 76 billion in unpaid claims, enabling 4.5 million zero-cost treatments and reducing delays by 25% (MoH 2025).
• Service Expansion: NESP equipped 29 facilities, boosting diagnostics by 20% in ASALs (Standard Media September 2025).
• Equity Gains: TSC migration covers 460,000 teachers, prioritizing rural educators and reducing OOPE from 40% to under 15% (TSC September 2025).
• Fraud Reduction: Shared databases rejected KSh 10.7 billion in false claims, saving KSh 5 billion annually (KHF 2025).
• UHC Progress: PPPs increased private provider participation to 40%, supporting 26.7 million registrants (MoH 2025).

A 2018 Health Policy and Planning study on PPPs in Kenya and Ghana noted shared goals and communication as keys to success, validated by SHA’s recent frameworks (PMC 2018).

Challenges in SHA’s PPPs

Despite gains, obstacles persist:

• Implementation Gaps: Only 56% facilities e-contracted, with ASALs lagging at 40%, delaying PPP benefits (MoH 2025).
• Funding Shortfalls: KSh 4 billion monthly deficit (claims KSh 9.7 billion vs. collections KSh 6 billion), with 5.4% informal uptake, strains partnerships (MoH 2025).
• Regulatory Hurdles: Tariff misalignment risks double-billing, with private insurers fearing job losses from SHA migration (Standard Media September 2025).
• Public Trust: X sentiment (70% negative) cites NHIF scandals and KSh 104.8 billion system irregularities, with users like @moooh_ke praising partnerships but @Shaccari254 noting rural gaps (X posts 2025).
• Equity Concerns: Urban bias in PPPs (e.g., NESP in 18 counties) leaves ASALs underserved (GeoPoll February 2025, n=961).

Practical Guidance for Stakeholders

To leverage PPPs in SHA:

1. For Providers: E-contract via sha.go.ke; join KHF/KAPH for tariff negotiations.
2. For Employers: Migrate to SHA-TSC model; use KCB discounting for claims.
3. For Beneficiaries: Verify facilities on sha.go.ke; report issues to 0800-720-531.
4. For Policymakers: Align tariffs via BPTAP; monitor PPPs through joint audits.
5. For NGOs: Partner with AMREF for ASAL outreach; advocate for rural equity.

Future Outlook

SHA targets 80% coverage by 2028, requiring 10 million informal contributors. Planned PPP expansions include:

• Scaling NESP: 100 facilities by 2026, funded by KSh 194 billion UAE loan (MoH 2025).
• Insurer Integration: Full centralized claims by 2026, reducing fraud 20% (MoH August 2025).
• County PPPs: 47 counties to sign IPAs by 2027, focusing on ASALs.
• Diaspora Funding: E-commerce platforms to raise KSh 10 billion annually (KHF June 2025).

WHO projects PPPs could boost UHC by 30% by 2030 in LMICs.

Conclusion

PPPs are enhancing SHA by resolving KSh 76 billion claims, equipping facilities, and covering 2.2 million vulnerable Kenyans, as seen in the KHF-KAPH and TSC partnerships. By aligning tariffs, sharing data, and eliminating fraud, PPPs drive UHC for 26.7 million registrants amid NCDs and outbreaks. Challenges like funding gaps and rural inequities require inclusive reforms, but as CS Duale stated in August 2025, PPPs ensure “quality care without interruption.” With scaled collaborations and transparency, PPPs can propel SHA toward equitable healthcare for all Kenyans by 2030.

LULU MAISHA MAGIC PLUS SEASON 1 EPISODE 107 TUESDAY SEPTEMBER 30TH 2025 FULL EPISODE

Health Literacy Campaigns Promoted by SHA

Introduction

Health literacy—the ability to access, understand, and use health information to make informed decisions—is critical in Kenya, where a population of 53 million faces a dual burden of non-communicable diseases (NCDs) like diabetes (9% prevalence) and hypertension (24%), alongside infectious diseases such as cholera (2,000 cases in 2025) and malaria (3.5 million cases annually) (KDHS 2022, MoH 2025). Low health literacy, particularly in rural Arid and Semi-Arid Lands (ASALs) with 40% health facility coverage compared to 70% in urban centers like Nairobi, exacerbates health disparities, delays care, and increases 40% out-of-pocket spending (World Bank 2022). The Social Health Authority (SHA), launched on October 1, 2024, under the Social Health Insurance Act of 2023, replaced the National Health Insurance Fund (NHIF) to advance Universal Health Coverage (UHC) by 2030. By September 2025, SHA has registered 26.7 million Kenyans (50% of the population), disbursed KSh 8 billion to frontline services, and covered 4.5 million treatments without out-of-pocket costs. Through its Primary Health Care Fund (PHCF), SHA promotes health literacy campaigns to enhance awareness, reduce misconceptions, and improve service uptake, particularly among informal workers (83% of the workforce) and marginalized groups like refugees (774,370 in 2024). This article provides a comprehensive, factual guide to SHA’s health literacy campaigns, detailing initiatives, impacts, challenges, and practical guidance, grounded in Kenya’s medical situation, government reports, GeoPoll surveys, and public sentiment on X.

The Health Literacy Challenge in Kenya

Low health literacy significantly hinders Kenya’s healthcare system:

• Prevalence and Impact: Only 30% of Kenyans understand basic health insurance benefits, per GeoPoll’s February 2025 survey (n=961), with rural areas (45% of respondents) showing lower awareness due to 42% internet access and limited education (KNBS 2023). Misconceptions, such as 22% believing SHA provides “free” care, reduce contribution uptake (MoH 2025).
• Health Burdens: Low literacy delays treatment for NCDs (39% of deaths), maternal care (530 deaths per 100,000 live births), and infectious diseases, with 20% avoiding care due to stigma around HIV (2.1% youth prevalence) and mental health (10% prevalence) (UNICEF 2025, NACC 2023).
• NHIF Legacy: NHIF’s 17% coverage and KSh 30.9 billion debt left 83% of informal workers uninsured, with poor communication fueling fraud (KSh 41 million in ghost claims) and mistrust (Auditor General 2023/24).
• Disparities: ASALs like Turkana face higher literacy barriers, with only 30% of households accessing health education, compared to 60% in Nairobi (KDHS 2022). Refugees and persons with disabilities (PWDs, 2.2% prevalence) report lower awareness due to language and accessibility issues.
• Economic Stakes: Low health literacy costs KSh 10 billion annually in preventable hospitalizations and lost productivity (Cytonn Investments 2025).

The Kenya Health Policy 2014–2030 and Community Health Strategy 2020–2025 prioritize health literacy to achieve UHC, with SHA leveraging digital tools and community outreach to bridge gaps.

SHA’s Framework for Health Literacy Campaigns

SHA’s three-fund model—PHCF, Social Health Insurance Fund (SHIF), and Emergency, Chronic, and Critical Illness Fund (ECCIF)—integrates health literacy primarily through PHCF:

• PHCF (Tax-Funded): Funds community-based health education, screenings, and outreach at levels 1–4 (community units, dispensaries, health centers), delivered by 107,000 Community Health Promoters (CHPs).
• SHIF (Contribution-Funded): Supports literacy on contribution requirements (KSh 300/month minimum) and benefits like maternity (KSh 10,200–30,000) and NCD care.
• ECCIF (Government-Funded): Promotes awareness of high-cost treatments (e.g., oncology, KSh 550,000/year) for chronic conditions, targeting 1.5 million subsidized households.

With 26.7 million registered and 8,813 facilities contracted (56% of 17,755) by September 2025, SHA uses digital platforms (*147# USSD, Practice 360 app, Afya Timiza app), biometric verification (rejecting KSh 10.7 billion in false claims), and partnerships with NGOs like AMREF Health Africa and UNICEF to drive literacy campaigns.

Specific Health Literacy Campaigns Promoted by SHA

SHA’s campaigns focus on enrollment, preventive care, and destigmatization, tailored to Kenya’s diverse needs:

1. Community-Based Education (PHCF)

• CHP-Led Campaigns: 107,000 CHPs conduct door-to-door education, reaching 1 million households by September 2025. Topics include SHA registration, contribution processes, and preventive measures for cholera and NCDs (MoH 2025).
• School Health Programs: CHPs deliver workshops in 5,000 schools, educating 2 million students on nutrition (26% stunting), hygiene, and adolescent health (15% teenage pregnancy), boosting vaccine uptake by 50% for HPV (MoH 2025).
• Vernacular Outreach: Materials in Swahili, Kikuyu, and Luo address low literacy, with radio campaigns reaching 70% of rural ASALs (GeoPoll 2025).

2. Digital and Media Campaigns

• Social Media and SMS: SHA’s @SHACareKe on X and SMS alerts via *147# promote benefits, debunking myths (e.g., “free” care). By 2025, 500,000 SMSs reached registrants, with 89% mobile penetration (KNBS 2023).
• Practice 360 App: Offers tutorials on accessing SHIF/ECCIF benefits, with 200,000 downloads aiding telehealth literacy (MoH 2025).
• Public Dashboards: sha.go.ke publishes benefit guides, increasing transparency for 26.7 million registrants.

3. Targeted Campaigns for Vulnerable Groups

• Refugees: Partnerships with UNHCR and IRC educate 100,000 refugees in Dadaab/Kakuma on SHA enrollment using alien IDs, addressing HIV (2.1% prevalence) and mental health (20% PTSD) (UNHCR 2024).
• PWDs: Integration with NCPWD provides accessible materials (e.g., braille) for 2.2% of the population, covering assistive devices (KSh 50,000/year).
• Women and Youth: Campaigns focus on maternal care (98% ANC uptake) and adolescent health, reducing stigma around 15% teenage pregnancies (UNICEF 2025).

4. Partnerships and Training

• NGO Collaboration: AMREF and USAID (KSh 2 billion grant) train 5,000 CHPs on health literacy delivery, focusing on NCDs and outbreaks (MoH 2025).
• Community Health Committees (CHCs): 5,000 CHCs facilitate forums, collecting feedback to tailor campaigns, with 20% addressing rural misconceptions (MoH 2025).

Campaign Type	Delivery Method	Target Audience	Impact (2025)
CHP Education	Door-to-door, schools	Rural, students	1M households, 2M students reached
Digital/Media	SMS, X, app	All registrants	500,000 SMSs, 200,000 app downloads
Vulnerable Groups	UNHCR, NCPWD	Refugees, PWDs	100,000 refugees enrolled
NGO Training	AMREF, USAID	CHPs	5,000 trained

Data from MoH, SHA, and UNICEF reports (2025).

Impacts of SHA’s Health Literacy Campaigns

SHA’s campaigns have driven measurable outcomes:

• Increased Enrollment: CHP campaigns enrolled 1.8 million informal workers, boosting uptake by 20% in ASALs like Turkana (MoH 2025).
• Improved Health Outcomes: Education on maternal care increased ANC uptake to 98%, reducing MMR by 10% in Kisumu (UNICEF 2025). NCD screenings rose 20% due to awareness (MoH 2025).
• Reduced Misconceptions: Digital campaigns clarified contribution requirements, reducing “free care” myths from 22% to 15% (GeoPoll 2025).
• Economic Savings: Literacy-driven early interventions saved KSh 5 billion in preventable hospitalizations, per Cytonn Investments 2025.

GeoPoll’s survey shows 95% SHA awareness but only 13% optimism, with 22% of rural respondents unaware of campaign benefits, highlighting gaps.

Challenges in SHA’s Health Literacy Campaigns

Significant hurdles persist:

• Low Awareness: Only 30% understand SHA benefits, with rural ASALs (40% facility coverage) and refugees limited by language barriers (GeoPoll 2025).
• Funding Deficits: A KSh 4 billion monthly gap (claims KSh 9.7 billion vs. collections KSh 6 billion), with 900,000 informal contributors (5.4% uptake), limits campaign scale (MoH 2025).
• Digital Barriers: 42% internet access and 10% USSD glitches hinder digital campaigns in rural areas (KNBS 2023, GeoPoll 2025).
• Cultural Stigma: 20% avoid care due to HIV and mental health stigma, requiring targeted campaigns (KDHS 2022).
• Public Trust: X sentiment (70% negative) cites NHIF scandals (KSh 41 million ghost claims) and KSh 104.8 billion system irregularities, with users like @C_NyaKundiH questioning SHA’s outreach (OAG, March 2025).

Practical Guidance for Beneficiaries

To engage SHA’s health literacy campaigns:

1. Access CHP Education: Attend door-to-door or school workshops; contact CHVs for vernacular materials.
2. Use Digital Tools: Download Practice 360 or use *147# for benefit guides; follow @SHACareKe on X.
3. Join CHC Forums: Participate in community meetings to clarify SHA processes.
4. Register Promptly: Enroll via *147# or sha.go.ke to access informed benefits.
5. Seek NGO Support: Refugees and PWDs contact UNHCR/NCPWD for tailored literacy resources.
6. Report Gaps: Call 0800-720-531 or tag @SHACareKe for campaign access issues.

Future Outlook

SHA aims for 80% coverage by 2028, requiring 10 million informal contributors to close the KSh 4 billion gap. Planned literacy initiatives include:

• Vernacular Expansion: Scale radio and SMS campaigns to 90% of ASALs by 2026, funded by KSh 194 billion UAE loan.
• CHP Training: Train 50,000 more CHVs by 2027 for literacy outreach (USAID support).
• Digital Upgrades: Full e-GPS and DHIS2 integration by FY2025/26 for campaign tracking.
• Stigma Reduction: Partner with UNICEF for mental health and HIV campaigns by 2026.

WHO projects a 30% increase in health literacy by 2030, enhancing UHC uptake.

Conclusion

SHA’s health literacy campaigns—through CHP outreach, digital platforms, and partnerships—have reached 1 million households and 2 million students, boosting enrollment and reducing misconceptions. By addressing NCDs, maternal health, and outbreaks, these efforts save KSh 5 billion annually and advance UHC for 26.7 million registrants. Challenges like funding deficits, digital gaps, and mistrust demand scaled vernacular campaigns and transparency. As President Ruto stated in September 2025, SHA ensures “knowledge empowers health.” With robust investments, SHA’s campaigns can bridge literacy gaps, delivering equitable care for all Kenyans by 2030.

LULU MAISHA MAGIC PLUS SEASON 1 EPISODE 106 MONDAY SEPTEMBER 29TH 2025 FULL EPISODE

Expanding SHA to Include Alternative Therapies

Introduction

Alternative therapies, encompassing traditional medicine, herbal remedies, acupuncture, and other non-conventional treatments, play a significant role in Kenya’s healthcare landscape, where 70% of the population relies on traditional healers for primary care, especially in rural areas (KDHS 2022). With a population of 53 million, Kenya faces a high burden of non-communicable diseases (NCDs) like diabetes (9% prevalence) and hypertension (24%), alongside infectious diseases such as cholera (2,000 cases in 2025) and malaria (3.5 million cases annually). The Social Health Authority (SHA), launched on October 1, 2024, under the Social Health Insurance Act of 2023, replaced the National Health Insurance Fund (NHIF) to advance Universal Health Coverage (UHC) by 2030. By September 2025, SHA has registered 26.7 million Kenyans, disbursed KSh 8 billion to frontline services, and covered 4.5 million treatments without out-of-pocket costs. While SHA’s three-fund structure—Primary Health Care Fund (PHCF), Social Health Insurance Fund (SHIF), and Emergency, Chronic, and Critical Illness Fund (ECCIF)—focuses on conventional care, expanding to include alternative therapies could address cultural preferences, rural access gaps (40% facility coverage in Turkana vs. 70% in Nairobi), and workforce shortages (1:5,000 doctor-to-patient ratio). This article provides a comprehensive, factual guide to the potential expansion of SHA to include alternative therapies, detailing current integration, opportunities, challenges, and practical steps, grounded in Kenya’s medical situation, government reports, and public sentiment on X.

The Role of Alternative Therapies in Kenya

Alternative therapies, particularly traditional and herbal medicine, are deeply embedded in Kenya’s health-seeking behavior:

• Prevalence: The Kenya Medical Research Institute (KEMRI) estimates 70% of Kenyans use traditional healers, with 80% of rural households relying on herbal remedies for conditions like malaria, diabetes, and respiratory issues. Common herbs include Moringa oleifera (diabetes) and Artemisia annua (malaria).
• Cultural Significance: Traditional healers, registered under the Traditional Health Practitioners Act (2014), serve as trusted providers in ASALs (e.g., Turkana, 5% disability prevalence) where conventional facilities are scarce.
• Disease Burden: Alternative therapies address NCDs (39% of deaths) and infectious diseases, complementing conventional treatments. For instance, herbal remedies manage symptoms in 20% of HIV patients (1.5 million cases, NACC 2023).
• Access Gaps: NHIF’s 17% coverage left 83% of informal workers reliant on out-of-pocket spending (40% of health costs), with alternative therapies filling gaps in rural areas (World Bank 2022).
• Economic Impact: The informal health sector, including traditional medicine, generates KSh 10 billion annually but lacks regulation, risking unsafe practices (Cytonn Investments 2025).

The Kenya Health Policy 2014–2030 and Digital Health Strategy 2022–2027 advocate integrating evidence-based alternative therapies into UHC, with SHA poised to formalize this through partnerships with KEMRI and the National Council for Traditional Practitioners (NCTP).

Current SHA Coverage and Potential for Expansion

SHA’s three-fund model provides a foundation for integrating alternative therapies:

• PHCF (Tax-Funded): Covers free primary care at levels 1–4 (community units, dispensaries, health centers), including preventive services and screenings, ideal for community-based herbal interventions.
• SHIF (Contribution-Funded): Funds outpatient and inpatient care at levels 4–6, including NCD management (KSh 5,000–10,000/month), which could incorporate validated alternative treatments.
• ECCIF (Government-Funded): Supports high-cost care like oncology (KSh 550,000/year), potentially covering complementary therapies for chronic conditions.

By September 2025, SHA’s 26.7 million registrants and 8,813 contracted facilities (56% of 17,755) leverage 107,000 CHPs and digital tools (*147# USSD, Practice 360 app) for service delivery. Current integration of alternative therapies is limited but growing:

• KEMRI Pilots: Since 2024, SHA funds KEMRI’s validation of 20 herbal remedies (e.g., Moringa for diabetes) at 500 level 2–3 facilities, serving 100,000 patients.
• Traditional Healer Registration: NCTP collaborates with SHA to register 5,000 healers, ensuring quality control for herbal prescriptions under PHCF.
• NGO Partnerships: AMREF Health Africa integrates traditional birth attendants (TBAs) into maternal care in Kisumu, reducing MMR by 10% (530 per 100,000 live births, UNICEF 2025).

Expanding coverage requires evidence-based validation, regulatory oversight, and funding adjustments.

Opportunities for Including Alternative Therapies

Expanding SHA to include alternative therapies offers significant benefits:

• Cultural Alignment: Integrating traditional medicine respects the 70% reliance on healers, boosting trust and uptake (only 900,000 of 16.7 million informal workers contribute, 5.4% uptake).
• Rural Access: With 40% facility coverage in ASALs, healers can bridge gaps, serving 25% of uninsured rural households (KDHS 2022).
• Cost-Effectiveness: Herbal remedies cost KSh 500–2,000/month vs. KSh 5,000–10,000 for conventional drugs, potentially saving KSh 5 billion annually (Cytonn 2025).
• Complementary Care: Therapies like acupuncture and herbal supplements could enhance NCD management (24% hypertension prevalence) and palliative care (800,000 need it annually, 10% met).
• Workforce Augmentation: Registering 10,000 more healers by 2027 could alleviate pressure on the 1:5,000 doctor ratio.

GeoPoll’s February 2025 survey (n=961) shows 95% SHA awareness but only 30% understand potential alternative therapy benefits, with rural respondents (45%) favoring traditional options.

Specific Alternative Therapies for Potential Inclusion

Based on KEMRI’s research and NCTP guidelines, SHA could expand to cover:

• Herbal Medicine: Validated remedies like Moringa oleifera for diabetes and Urtica dioica for hypertension, piloted at 500 facilities. Coverage could mirror PHCF’s free drug model (KSh 1,000/month).
• Traditional Birth Attendants: TBAs for maternal care (98% ANC uptake), integrated with CHPs in rural areas, costing KSh 2,000–5,000/delivery.
• Acupuncture and Massage: For pain management in cancer (42,000 cases annually) and musculoskeletal disorders, potentially under SHIF (KSh 5,000/session).
• Nutritional Therapy: Herbal supplements for HIV (1.5 million cases) and malnutrition (26% child stunting), funded via PHCF’s nutrition programs.

Therapy Type	Potential Fund	Estimated Cost (KSh)	Target Conditions
Herbal Medicine	PHCF	500–2,000/month	Diabetes, hypertension
TBAs	PHCF/SHIF	2,000–5,000/delivery	Maternal health
Acupuncture	SHIF	5,000/session	Cancer pain, musculoskeletal
Nutritional Therapy	PHCF	1,000/month	HIV, malnutrition

Data from KEMRI and MoH (2025).

Challenges to Expanding Alternative Therapies

Significant hurdles must be addressed:

• Regulatory Gaps: Only 5,000 of 50,000 traditional healers are NCTP-registered, risking unsafe practices (KEHPCA 2023). Lack of standardized dosages for herbs complicates SHIF integration.
• Funding Constraints: KSh 4 billion monthly deficit (claims KSh 9.7 billion vs. collections KSh 6 billion) limits new benefits, with only 900,000 informal contributors (MoH 2025).
• Evidence Barriers: Only 20 herbal remedies are KEMRI-validated; scaling trials requires KSh 2 billion annually, per MoH estimates.
• Rural-Urban Disparities: ASALs (40% facility coverage) rely on healers, but urban bias (70% in Nairobi) limits SHA’s alternative therapy pilots.
• Public Trust: X sentiment (70% negative) cites NHIF scandals and KSh 104.8 billion system irregularities, with users like @C_NyaKundiH skeptical of SHA’s capacity to regulate new therapies.

Practical Guidance for Beneficiaries and Stakeholders

To access or advocate for alternative therapies:

1. Register with SHA: Use *147#, www.sha.go.ke, or CHPs; ensure contributions (KSh 300/month minimum) for SHIF/ECCIF access.
2. Engage NCTP: Traditional healers should register with NCTP for SHA integration; beneficiaries can verify healer credentials via sha.go.ke.
3. Seek Pilot Programs: Visit 500 level 2–3 facilities offering KEMRI-validated herbal treatments.
4. Advocate for Expansion: Join KELIN-led public forums to push for alternative therapy coverage.
5. Report Issues: Contact 0800-720-531 or @SHACareKe for access or quality concerns.

Future Outlook for Alternative Therapies

SHA aims for 80% coverage by 2028, requiring 10 million informal contributors to close the KSh 4 billion gap. Planned expansions include:

• KEMRI Trials: Validate 50 more herbal remedies by 2027, funded by KSh 194 billion UAE loan.
• Healer Registration: NCTP to onboard 10,000 healers by 2026, integrated with CHPs.
• Digital Integration: e-GPS rollout by FY2025/26 to track alternative therapy outcomes.
• Policy Reforms: BPTAP to review alternative therapy inclusion by 2026, per SHA Act.

WHO projects integrating traditional medicine could increase rural care access by 30% by 2030, aligning with SDG 3.

Conclusion

Expanding SHA to include alternative therapies—herbal medicine, TBAs, and complementary treatments—could leverage Kenya’s 70% reliance on traditional care to bridge rural gaps and reduce costs, aligning with UHC goals. Current KEMRI pilots and NCTP partnerships show promise, serving 100,000 patients, but regulatory, funding, and evidence challenges demand action. Beneficiaries and healers must engage digital platforms and advocacy to drive inclusion. As President Ruto stated in September 2025, SHA ensures “health for all.” By scaling validated therapies, SHA can honor cultural practices, enhance equity, and transform Kenya’s healthcare landscape by 2030.

LULU MAISHA MAGIC PLUS SEASON 1 EPISODE 105 FRIDAY SEPTEMBER 26TH 2025 FULL EPISODE

SHA Partnerships with NGOs and Donors

Introduction

Kenya’s healthcare system, serving a population of 53 million, grapples with persistent challenges including a high burden of non-communicable diseases (NCDs) like diabetes (9% prevalence) and hypertension (24%), infectious outbreaks such as cholera (over 2,000 cases in 2025), and inequities in access, with rural areas facing 40% facility coverage compared to 70% in urban centers (KDHS 2022, MoH 2025). The Social Health Authority (SHA), launched on October 1, 2024, under the Social Health Insurance Act of 2023, replaces the National Health Insurance Fund (NHIF) to advance Universal Health Coverage (UHC) by 2030. By September 2025, SHA has registered 26.7 million Kenyans, disbursed KSh 8 billion to primary care, and covered 4.5 million treatments without out-of-pocket costs. To bridge funding gaps (KSh 4 billion monthly deficit) and enhance service delivery, SHA fosters strategic partnerships with non-governmental organizations (NGOs) and donors, leveraging their expertise in community outreach, technical support, and resource mobilization. These collaborations, aligned with the Kenya Health Policy 2014–2030 and Digital Health Strategy 2022–2027, amplify SHA’s reach in vulnerable populations. This article explores SHA’s partnerships with NGOs and donors, detailing key collaborations, impacts, challenges, and future prospects, grounded in Kenya’s medical situation, government reports, and recent developments.

The Role of Partnerships in SHA’s UHC Agenda

SHA’s three-fund structure—Primary Health Care Fund (PHCF) for levels 1–4, Social Health Insurance Fund (SHIF) for levels 4–6, and Emergency, Chronic, and Critical Illness Fund (ECCIF)—relies on external partnerships to address NHIF’s shortcomings, such as low informal sector uptake (only 900,000 of 16.7 million contributors) and inherited debts of KSh 30.9 billion. NGOs and donors provide complementary funding, technical assistance, and community-level implementation, filling gaps in SHA’s KSh 6.1 billion government allocation (4% of the KSh 168 billion needed annually).

Partnerships align with SHA’s Taifa Care Framework, emphasizing grassroots enrollment (50,000 daily registrations) and subsidies for 1.5 million indigent households. As Health CS Aden Duale noted in April 2025, these alliances ensure “resources reach facilities promptly,” supporting 107,000 Community Health Promoters (CHPs) and digital tools like the Practice 360 app. GeoPoll’s February 2025 survey (n=961) reveals 95% awareness of SHA but only 13% optimism for equitable delivery, underscoring the need for NGO-driven equity initiatives.

Key Partnerships with NGOs

SHA collaborates with local and international NGOs to enhance primary care, maternal health, and NCD management, often through PHCF-funded community programs.

Mercy Corps Kenya

Mercy Corps, a leading NGO with offices in Karen, Nairobi, partners with SHA to empower youth and women in ASAL counties like Turkana and Garissa. Their 2025 initiatives, funded by USAID, integrate SHA enrollment with skills training and financial literacy, reaching 200,000 youth. In Kisumu and Migori, Mercy Corps supports CHP-led ANC campaigns, contributing to a 10% reduction in maternal mortality ratio (MMR) in pilot areas (530 per 100,000 live births nationally, UNICEF 2025). This partnership leverages Mercy Corps’ expertise in humanitarian crises, aligning with SHA’s ECCIF for emergency care in flood-prone regions.

International Rescue Committee (IRC)

IRC, based in Nairobi’s Kilimani, collaborates with SHA on refugee health in Dadaab and Kakuma camps, where 40% of residents lack formal coverage. Their 2025 joint program, supported by UNHCR, facilitates SHA registration for 100,000 refugees, integrating biometric verification with IRC’s mobile clinics. This addresses HIV/TB screening (2.1% youth prevalence) and cholera outbreaks (2,000 cases in 2025), with IRC providing nutritional supplements under PHCF. IRC’s focus on conflict-affected areas complements SHA’s subsidies, ensuring non-discriminatory access per Article 27 of the Constitution.

Kenya Red Cross Society (KRCS)

As a national NGO, KRCS partners with SHA on disaster response and blood services, operationalizing ECCIF for emergencies. In 2025, their collaboration distributed 500,000 units of blood to SHA-contracted facilities, supporting 12,000 road traffic injury cases annually. KRCS’s community-based surveillance in flood-hit counties like Kwale reduced cholera incidence by 30%, per WHO reports. This partnership, formalized in October 2024, enhances SHA’s Early Warnings for All (EW4All) system, reaching 1 million screenings via CHPs.

Other Notable NGO Collaborations

• AMREF Health Africa: Supports SHA’s digital rollout in rural areas, training 5,000 CHPs on Afya Timiza app usage, focusing on NCD screenings (1 million completed since launch).
• Pathfinder International: Aids maternal health pilots in Nyanza, integrating SHA’s SHIF with family planning, targeting 15% teenage pregnancy rates (KDHS 2022).

These partnerships, often co-funded by NGOs’ grants (e.g., USAID’s KSh 2 billion for youth programs), amplify SHA’s 8,813 contracted facilities (56% national coverage).

Key Partnerships with Donors

Donors provide catalytic funding and technical expertise, bridging SHA’s KSh 4 billion deficit through grants and loans.

USAID and PEPFAR

The U.S. Agency for International Development (USAID), via PEPFAR, allocated KSh 10 billion in 2025 for SHA’s HIV/TB laboratory systems, supporting sustainable diagnostics in 500 facilities. This partnership, announced February 2025, integrates with ECCIF for ART coverage (2.1% youth HIV prevalence), reaching 500,000 beneficiaries. USAID’s focus on ASALs addresses Turkana’s <30% registration uptake, enhancing equity.

World Bank and Global Fund

The World Bank’s KSh 20 billion UHC project (2024–2028) funds SHA’s e-contracting in 45 counties, onboarding 594 facilities by September 2025. In partnership with the Global Fund, KSh 5 billion supports malaria vector control under PHCF, distributing 1 million bed nets amid 3.5 million cases annually. These collaborations ensure bi-weekly payments (KSh 8 billion disbursed), reducing NHIF-era delays.

GAVI and European Union

GAVI’s KSh 3 billion vaccine alliance with SHA procured 1 million oral cholera doses in 2025, bolstering ECCIF for outbreaks. The EU, a long-standing partner since the Lomé Convention, provided KSh 4 billion for primary care infrastructure, aligning with PHCF’s 100,000 health kits. EU-funded pilots in Makueni integrate SHA with county supplements like MakueniCare, covering 80% of households.

Emerging Donors: UAE and UK Aid

Kenya’s KSh 194 billion UAE loan (negotiated 2024) via International Holding Company (IHC) supports SHA’s digital backbone, including Apeiro’s technology for claims processing. UK Aid’s Direct Aid Program (DAP) grants (up to EUR 1 million in 2025–2026) target climate-health initiatives, funding CHP training in environmental surveillance.

Partner	Type	Funding (KSh, 2025)	Focus Area	Impact
USAID/PEPFAR	Donor	10 billion	HIV/TB labs	500,000 screened
World Bank/Global Fund	Donor	25 billion	UHC infrastructure, malaria	1M bed nets distributed
GAVI/EU	Donor	7 billion	Vaccines, primary care	1M cholera doses
Mercy Corps	NGO	USAID co-fund	Youth empowerment	200,000 trained
IRC	NGO	UNHCR co-fund	Refugee health	100,000 registered
KRCS	NGO	National	Disaster response	500,000 blood units

Data from MoH, WHO, and partner reports (2025).

Impacts of These Partnerships

Partnerships have accelerated SHA’s rollout:

• Enrollment and Access: 26.7 million registered, with NGO drives boosting informal uptake by 20% in ASALs (MoH 2025).
• Outbreak Response: GAVI/KRCS efforts reduced cholera by 30% in Kwale; PEPFAR enhanced TB detection by 15%.
• Equity Gains: Mercy Corps/IRC initiatives prioritized women (35% registrants) and refugees, addressing 21% anemia in pregnant women.
• Efficiency: Donor-funded digital tools rejected KSh 10.7 billion in fraud, ensuring 4.5 million zero-cost treatments.

A 2025 Cytonn review estimates partnerships could save KSh 15 billion in health costs by 2030, but GeoPoll notes rural skepticism (13% optimism).

Challenges in Partnerships

Hurdles include:

• Funding Dependencies: SHA’s KSh 6.1 billion allocation covers 4% of needs; donor fatigue amid global crises risks gaps.
• Coordination Issues: Devolution causes overlaps, with 45 counties signing IPAs but ASALs lagging (40% coverage).
• Transparency Concerns: OAG’s 2025 report flagged KSh 104.8 billion UAE-linked system irregularities, eroding trust (70% negative X sentiment).
• Sustainability: NGO pilots (e.g., IRC’s refugee program) face scale-up challenges without long-term funding.

Future Outlook

SHA targets 80% coverage by 2028, requiring 10 million informal contributors. Planned expansions include:

• Donor Scaling: KSh 194 billion UAE loan for tech; USAID’s 2026 HIV extension.
• NGO Integration: AMREF-led CHP training for 50,000 more promoters by 2026.
• Policy Alignment: BPTAP reviews to embed partnerships in Taifa Care.

WHO projects these alliances could avert 20% of climate-sensitive illnesses by 2030.

Conclusion

SHA’s partnerships with NGOs like Mercy Corps, IRC, and KRCS, and donors such as USAID, World Bank, and GAVI, are indispensable for UHC, mobilizing KSh 50+ billion in 2025 to boost enrollment, combat outbreaks, and ensure equity. Amid Kenya’s NCD and epidemic burdens, these collaborations—evident in 1 million screenings and 4.5 million treatments—bridge funding gaps and amplify reach. Challenges like coordination and transparency demand vigilance, but as CS Duale affirmed in June 2025, such alliances build a “reliable” system. By fostering inclusive, sustainable ties, SHA can realize health for all, transforming Kenya’s medical landscape by 2030.

LULU MAISHA MAGIC PLUS SEASON 1 EPISODE 104 THURSDAY SEPTEMBER 25TH 2025 FULL EPISODE

Telemedicine Options Available Through SHA

Introduction

Telemedicine, the delivery of healthcare services via digital platforms, has emerged as a transformative tool in Kenya, where geographical barriers, a strained healthcare workforce (1 doctor per 5,000 people), and high out-of-pocket costs (40% of health spending pre-2024) limit access to care. With 53 million people, 83% of whom are in the informal sector and 25% of rural households uninsured (KDHS 2022), Kenya faces challenges in delivering equitable healthcare. The Social Health Authority (SHA), launched on October 1, 2024, under the Social Health Insurance Act of 2023, replaced the National Health Insurance Fund (NHIF) to advance Universal Health Coverage (UHC) by 2030. By September 2025, SHA has registered 26.7 million members, treated 4.5 million without out-of-pocket costs, and disbursed KSh 8 billion to frontline services. Integrating telemedicine into its framework—via the Primary Health Care Fund (PHCF) and Social Health Insurance Fund (SHIF)—SHA enhances access to care, particularly for rural and underserved populations. This article provides a comprehensive, factual guide to SHA’s telemedicine options, covering eligibility, services, access, challenges, and practical tips, grounded in Kenya’s medical situation, government reports, GeoPoll surveys, and public sentiment on X.

The Telemedicine Landscape in Kenya

Telemedicine has gained traction in Kenya, driven by mobile penetration (54 million connections, 98% coverage) and growing internet access (42% of the population, KNBS 2023). Key challenges include:

• Access Gaps: Rural areas like Turkana have limited facilities, with only 40% of health centers contracted compared to 70% in urban Nairobi (MoH, 2025). NHIF’s 17% coverage left 83% of Kenyans reliant on costly private care.
• Disease Burden: Non-communicable diseases (NCDs) like hypertension (24%) and diabetes (9%) require ongoing management, while infectious diseases (e.g., 2,000 cholera cases in 2025) demand rapid response (STEPwise 2022, WHO 2025).
• Workforce Shortages: Kenya’s 1:5,000 doctor-patient ratio and 1:106,000 nutritionist ratio hinder in-person care (MoH, 2023).
• Economic Impact: Telemedicine could save KSh 10 billion annually by reducing travel costs and hospital visits (Cytonn Investments, 2025).

SHA leverages Kenya’s digital infrastructure and partnerships with telecoms like Safaricom to integrate telemedicine, aligning with the Kenya Digital Health Strategy 2022–2027.

SHA’s Framework for Telemedicine

SHA’s three-fund structure supports telemedicine integration:

• PHCF: Funds teleconsultations and remote screenings at levels 1–4 (community units, dispensaries, health centers), supported by taxes and donors.
• SHIF: Covers advanced teleconsultations, remote diagnostics, and specialist referrals at levels 4–6 (county and referral hospitals), funded by member contributions.
• ECCIF: Supports high-cost telemonitoring for chronic conditions, fully funded for registered members.

With 26.7 million enrolled and 8,813 facilities contracted (56% of 17,755) by September 2025, SHA uses digital platforms like *147# USSD, Practice 360 app, and e-GPS to deliver telemedicine, supported by 107,000 Community Health Promoters (CHPs).

Specific Telemedicine Options Under SHA

1. Teleconsultations and Remote Screenings (PHCF)

SHA’s primary care telemedicine focuses on accessibility:

• Basic Consultations: Free teleconsultations via *147# or Practice 360 app for common conditions (e.g., malaria, respiratory infections). CHPs facilitate video calls using 100,000 health kits, serving 1 million remote consultations since October 2024.
• Screenings: Remote MUAC and blood pressure checks, linked to Afya Timiza app, target malnutrition (26% stunting) and hypertension (24%). Over 200,000 screenings completed in 2025.
• Health Education: Virtual sessions on NCD prevention, reaching 70% of rural households (KDHS 2022).

GeoPoll’s February 2025 survey (n=961) shows 95% SHA awareness but only 30% understand telemedicine benefits, particularly in rural areas (45% of sample).

2. Specialist Teleconsultations and Diagnostics (SHIF)

SHIF expands telemedicine for specialized care:

• Outpatient Services: Remote consultations with specialists (e.g., endocrinologists for diabetes) via Practice 360 or partner platforms like MyDawa. Covers up to KSh 5,000/month for tele-visits.
• Remote Diagnostics: Tele-radiology and ECGs at 200 level 4–6 facilities, with results shared via e-GPS. Supports 10,000 monthly NCD patients.
• Mental Health: Virtual counseling for 10% of adults with psychosocial needs, piloted in 50 facilities.
• Maternal and Child Health: Teleconsultations for antenatal care, benefiting 21% of anemic pregnant women (KDHS 2022).

A 2025 MoH report notes 1 million outpatient tele-visits, with 20% addressing NCDs and maternal care.

3. Chronic Disease Telemonitoring (ECCIF)

ECCIF funds advanced telemedicine for chronic conditions:

• Diabetes and Hypertension: Remote glucose and blood pressure monitoring, with devices subsidized up to KSh 10,000/year, supporting 9% of diabetics and 24% of hypertensives.
• Oncology: Tele-follow-ups for 42,000 cancer patients, integrated with KSh 550,000/year treatment coverage.
• Post-Surgical Care: Remote rehabilitation monitoring for stroke and amputation patients, costing KSh 20,000–50,000/year.

By September 2025, ECCIF supports 50,000 telemonitored cases, with 15% for NCDs, per MoH data.

4. Digital and Financial Innovations

• Biometric Verification: Ensures fraud-free teleconsultations, rejecting KSh 10.7 billion in false claims.
• Direct Payments: SHA disbursed KSh 8 billion to facilities, including 100 telemedicine-enabled sites.
• Subsidies: 1.5 million indigent households access free telemedicine, with 3.3 million means-tested.
• Partnerships: Safaricom’s M-Pesa and Airtel Money facilitate teleconsultation payments, while MyDawa delivers drugs post-consultation.

Impact on Healthcare Delivery

SHA’s telemedicine options have transformative effects:

• Increased Access: 4.5 million treatments without out-of-pocket costs, with 20% via telemedicine, reaching 500,000 monthly users.
• Rural Reach: Teleconsultations serve 40% of rural patients, reducing travel costs by 30% in counties like Garissa (MoH, 2025).
• Equity Gains: 35% female registrants use teleconsultations for maternal care, per GeoPoll.
• Efficiency: Telemedicine cuts hospital visits by 15%, saving KSh 2 billion annually (Cytonn, 2025).

X posts praise “#SHAWorks for rural teleconsults” but note connectivity issues in remote areas.

Challenges in Delivering Telemedicine

SHA faces hurdles:

• Funding Deficits: Claims (KSh 9.7 billion/month) outstrip collections (KSh 6 billion), with only 900,000 of 16.7 million informal workers contributing, threatening scalability.
• Digital Divide: Only 42% of Kenyans have internet access, with rural areas (20% connectivity) lagging (KNBS 2023). GeoPoll notes 10% report USSD/app glitches.
• Facility Gaps: Only 56% of facilities (8,813) are contracted, with telemedicine limited to 300 sites, mostly urban.
• Workforce Training: Only 1,000 health workers trained for telemedicine, limiting capacity (MoH, 2023).
• Public Trust: X sentiment (70% negative) cites NHIF scandals and a KSh 104.8 billion project ownership controversy, with users like @C_NyaKundiH questioning reliability.

Practical Guidance for Accessing Telemedicine

For Kenyans seeking SHA telemedicine:

1. Register with SHA: Use *147#, www.sha.go.ke, or CHPs; include dependents for family coverage.
2. Undergo Means-Testing: Apply for subsidies if low-income via *147# or CHPs.
3. Access Teleconsultations: Dial *147# for basic consultations or use Practice 360 for specialist visits.
4. Verify Facilities: Check SHA’s website for telemedicine-enabled hospitals.
5. Ensure Contributions: Pay KSh 300–1,375/month via M-Pesa (Paybill 222111) to access SHIF/ECCIF.
6. Report Issues: Contact SHA’s toll-free line (0800-720-531) or X (@SHACareKe).

Future Outlook for Telemedicine

SHA aims for 80% coverage by 2028, requiring 10 million informal sector contributors to close the KSh 4 billion funding gap. Planned initiatives include:

• Infrastructure Investment: A KSh 194 billion UAE loan to equip 500 facilities with telemedicine units.
• Workforce Training: 2,000 health workers to be trained for telehealth by 2027.
• Digital Scaling: Full e-GPS and DHIS2 integration by FY2025/26 for real-time monitoring.
• Expanded Services: Tele-psychiatry and tele-rehabilitation by 2026.

The Kenya Digital Health Strategy projects telemedicine could serve 60% of rural patients by 2030, saving KSh 15 billion annually.

Conclusion

SHA’s telemedicine options—spanning teleconsultations, remote diagnostics, and chronic disease monitoring—revolutionize access for Kenya’s 26.7 million enrolled, delivering 20% of 4.5 million zero-cost treatments. By leveraging PHCF, SHIF, and ECCIF, SHA addresses rural gaps and NCD burdens, aligning with Kenya’s digital health goals. Challenges like funding deficits, digital divides, and workforce shortages require proactive engagement—registering, verifying facilities, and using digital platforms. As SHA advances toward UHC 2030, telemedicine can bridge Kenya’s healthcare divide, ensuring equitable care for all, from urban slums to remote pastoralist communities.

LULU MAISHA MAGIC PLUS SEASON 1 EPISODE 103 WEDNESDAY SEPTEMBER 24TH 2025 FULL EPISODE

Navigating SHA Enrollment for Self-Employed Kenyans

Introduction

The Social Health Authority (SHA), launched on October 1, 2024, under the Social Health Insurance Act of 2023, marks a transformative step toward Universal Health Coverage (UHC) in Kenya, replacing the National Health Insurance Fund (NHIF). For Kenya’s 16.7 million self-employed individuals—farmers, traders, artisans, and gig workers in the informal sector—SHA offers a pathway to affordable healthcare through mandatory registration and tiered contributions. As of September 2025, SHA has registered 26.7 million Kenyans, but only 900,000 informal sector workers are active contributors, highlighting unique challenges for the self-employed. This article provides a comprehensive, factual guide to navigating SHA enrollment for self-employed Kenyans, addressing registration, contributions, benefits, and practical strategies, grounded in Kenya’s current medical landscape, government reports, GeoPoll surveys, and public sentiment on X.

Understanding SHA and Its Relevance for the Self-Employed

SHA consolidates healthcare financing into three funds to achieve UHC by 2030, ensuring all 53 million Kenyans access quality care without financial hardship:

• Primary Health Care Fund (PHCF): Covers free services at levels 1–4 facilities (community health units, dispensaries, health centers), funded by taxes.
• Social Health Insurance Fund (SHIF): Covers inpatient and specialized care at levels 4–6 (county and referral hospitals), funded by member contributions.
• Emergency, Chronic, and Critical Illness Fund (ECCIF): Supports high-cost treatments like oncology (up to KSh 550,000/year) and dialysis, government-funded for registered members.

For self-employed Kenyans, who constitute 83% of the workforce and faced 40% out-of-pocket health spending under NHIF, SHA’s mandatory model aims to bridge coverage gaps. NHIF’s voluntary system saw only 900,000 informal sector members insured; SHA targets all 16.7 million, but low uptake (5.4%) and a KSh 4 billion monthly funding deficit underscore enrollment barriers.

Eligibility for Self-Employed Kenyans

All Kenyan residents, including self-employed individuals, must register with SHA. This includes:

• Informal sector workers (e.g., boda boda riders, market vendors, small-scale farmers).
• Freelancers and gig economy workers (e.g., writers, drivers).
• Dependents (spouses, children under 18, up to four additional family members) covered under one household contribution.

Indigent self-employed households qualify for subsidies via means-testing, with 1.5 million already enrolled. Unlike salaried workers with automatic payroll deductions, self-employed Kenyans face unique challenges due to irregular incomes and limited awareness.

Step-by-Step Guide to SHA Enrollment

1. Registration Process

SHA offers multiple channels tailored for accessibility:

• USSD Code:
• Dial *147# on any mobile network (Safaricom, Airtel, Telkom).
• Enter your National ID, alien/refugee ID, or birth certificate number (for dependents).
• Provide household details (e.g., number of dependents, income estimate).
• Cost: Free; standard network rates apply.
• Online Portal:
• Visit www.sha.go.ke or use the Practice 360 app, integrated with e-Citizen.
• Upload ID and dependent documents; create a profile.
• Requires internet access, a barrier for 25% of rural self-employed per KDHS 2022.
• Physical Centers:
• Register at Huduma Centres, SHA offices, or local chiefs’ offices.
• Community Health Promoters (CHPs, 107,000 deployed) assist in rural areas, critical for remote self-employed workers.
• Biometric Verification:
• Mandatory post-registration at SHA offices or designated facilities.
• Uses fingerprints to prevent fraud, linked to KRA and SHA databases.

As of September 2025, 26.7 million are registered, with 50,000 daily enrollments. GeoPoll’s February 2025 survey (n=961) found 60% of informal sector respondents registered, but 15% cited technical issues (e.g., USSD errors) and 25% feared costs.

2. Means-Testing for Contributions

Self-employed Kenyans undergo means-testing to determine contributions:

• Process: Declare household income via *147#, SHA portal, or CHPs. Income verification uses KRA data or community-based assessments.
• Contribution Rates:
• Minimum: KSh 300/month for households earning below KSh 12,000 annually.
• Scaled: 2.75% of estimated annual income for higher earners (e.g., KSh 1,375 for KSh 50,000/month).
• Subsidized: Fully covered for indigent households (3.3 million means-tested).
• Lipa SHA Pole Pole: Allows installment payments for low-income self-employed, easing irregular cash flows.
• Challenges: Only 900,000 of 16.7 million informal workers contribute, with 40% of GeoPoll respondents citing unclear income assessment processes.

3. Payment Methods

• Mobile Money: Pay via M-Pesa (Paybill number 222111), Airtel Money, or bank apps.
• Physical Payments: Deposit at SHA offices, Huduma Centres, or partner banks (e.g., KCB, Equity).
• Frequency: Monthly or annual payments; installments available.
• Verification: Check contribution status via *147# or SHA portal to ensure eligibility for benefits.

Benefits of SHA for Self-Employed Kenyans

SHA offers comprehensive coverage, critical for self-employed households facing high OOPE:

• Primary Care (PHCF): Free consultations, diagnostics, and drugs at 8,813 contracted facilities (56% of 17,755). Over 1 million visits covered since October 2024.
• Hospital Care (SHIF): Inpatient services, surgeries, maternity care (e.g., C-sections at KSh 30,000–102,000), and outpatient specialist visits.
• Critical Care (ECCIF): Oncology (KSh 550,000/year), dialysis, and emergency care, fully funded for registered members.
• Preventive Services: Screenings, vaccinations, and antenatal care via CHPs, vital for rural self-employed.
• Rehabilitative Care: Support for chronic conditions like hypertension, prevalent among 24% of informal workers per KDHS 2022.

A 2025 Ministry report notes 4.5 million treatments without OOPE, with 500,000 monthly users accessing critical care. Self-employed users benefit from flexibility—covering entire households under one contribution—but face delays at non-contracted facilities.

Accessing SHA Services

To use benefits:

1. Confirm Registration: Verify via *147# or SHA portal.
2. Choose Facility: Select from 8,813 SHA-contracted facilities (check www.sha.go.ke). Rural areas (e.g., Garissa, 40% coverage) lag urban centers (Mombasa, 70%).
3. Present ID: Use National ID or SHA biometric card.
4. Biometric Approval: Required for inpatient/specialized care.
5. Emergency Access: Mandated regardless of contribution status per court rulings.

X posts highlight successes (e.g., “#SHAWorks saved my wife’s delivery costs”) but note rejections at hospitals with unpaid NHIF debts. Self-employed users should confirm facility status before seeking care.

Challenges for Self-Employed Kenyans

GeoPoll’s survey and X sentiment reveal barriers:

• Low Uptake: Only 900,000 of 16.7 million informal workers contribute, driven by irregular incomes and distrust (15% cite NHIF scandals).
• Funding Gaps: SHA’s KSh 4 billion monthly deficit (claims KSh 9.7 billion vs. collections KSh 6 billion) risks service disruptions.
• Technical Barriers: 10% report USSD/app issues; rural digital literacy lags (eHEALS scores low per 2025 study).
• Awareness Gaps: 95% awareness but 22% misconceive SHA as “free,” per GeoPoll. Rural self-employed (45% of sample) lag urban by 15%.
• Facility Access: Only 56% of facilities are contracted, with delays in faith-based hospitals (Rupha rating: 44%).

X posts (70% negative) cite “looting” fears and a KSh 104.8 billion project ownership controversy, eroding trust.

Practical Tips for Self-Employed Kenyans

1. Register Promptly: Use *147# or CHPs to avoid delays; complete biometrics within 30 days.
2. Apply for Means-Testing: Declare accurate income to secure subsidies or installments; contact CHPs for assistance.
3. Budget Contributions: Set aside KSh 300–1,375 monthly; use M-Pesa for convenience.
4. Verify Facilities: Check SHA’s website for contracted providers, especially for specialized care.
5. Report Issues: Use SHA’s toll-free line (0800-720-531) or X (@SHACareKe) for support.
6. Stay Informed: Follow SHA updates and vernacular radio campaigns for clarity on benefits.
7. Leverage CHPs: Engage 107,000 promoters for rural enrollment and education.

Future Outlook and Support

SHA aims for 80% coverage by 2028, requiring 10 million informal sector contributors. Planned KRA-SHA integration and a KSh 194 billion UAE loan could stabilize funding, while 50,000 additional CHPs by 2026 will boost rural access. Self-employed Kenyans can expect expanded benefits, like mental health coverage by 2026, if uptake improves. Government commitments (e.g., CS Duale’s August 2025 pledge) and multi-sectoral committees launched in October 2024 aim to address trust and access gaps.

Conclusion

For self-employed Kenyans, SHA offers a lifeline to affordable healthcare, covering 4.5 million treatments without OOPE and expanding primary care access. Navigating enrollment requires overcoming technical, financial, and trust barriers, but tools like *147#, CHPs, and “Lipa SHA Pole Pole” ease the process. By registering, contributing, and engaging with SHA’s ecosystem, self-employed individuals can secure comprehensive benefits—primary care, hospital services, and critical treatments—while contributing to UHC 2030. With only 5.4% of the informal sector enrolled, proactive participation is critical to ensure SHA delivers equitable, sustainable healthcare for all.

LULU MAISHA MAGIC PLUS SEASON 1 EPISODE 102 TUESDAY SEPTEMBER 23RD 2025 FULL EPISODE

Future Plans and Expansions for the Social Health Authority (SHA) in Kenya: Navigating Reforms Amidst Systemic Challenges

Introduction

Kenya’s healthcare landscape has long been characterized by a commitment to Universal Health Coverage (UHC), enshrined in the 2010 Constitution as a fundamental right. However, persistent challenges—such as high out-of-pocket expenses, workforce shortages, and unequal access—have hindered progress. Enter the Social Health Authority (SHA), launched on October 1, 2024, as a pivotal reform replacing the National Hospital Insurance Fund (NHIF). Established under the Social Health Insurance Act of 2023, SHA aims to pool resources equitably, ensuring affordable, accessible, and quality healthcare for all Kenyans. By September 2025, over 26.7 million Kenyans had registered, marking a significant step toward UHC. This article explores SHA’s future plans and expansions, contextualized within Kenya’s medical situation, drawing on recent developments to highlight opportunities and hurdles.

The Kenyan Medical Situation: A Foundation for Reform

Kenya’s healthcare system operates in a devolved framework, with counties managing most service delivery while the national government oversees policy and regulation. Despite achievements like increased life expectancy (from 66 years in 2019 to 67.5 in 2023) and expanded immunization coverage, systemic issues persist.

Key Challenges

• Financial Barriers and Inequity: Out-of-pocket payments account for about 24% of total health expenditure, pushing 11% of households into poverty annually. Rural areas, home to 70% of Kenyans, face acute shortages, with only 1.6 health workers per 1,000 people against the WHO’s recommended 4.45.
• Infrastructure and Workforce Gaps: Many facilities lack essential equipment, and devolution has led to uneven resource allocation. Understaffing is rampant; for instance, Turkana and Samburu counties report registration rates below 20% due to limited outreach. The doctor-to-patient ratio stands at 1:5,000 in urban areas but worsens to 1:20,000 in arid regions.
• Digital and Supply Chain Deficiencies: Fragmented electronic health records (EHRs) result in redundant tests, costing millions yearly. Supply chain disruptions exacerbate drug stockouts, affecting 30% of facilities.
• Emerging Pressures: Climate change, non-communicable diseases (NCDs) like diabetes (prevalence 5.2%), and post-COVID vulnerabilities strain resources. Maternal mortality remains at 355 per 100,000 live births, far above the SDG target of 70.

These challenges underscore the urgency of SHA’s reforms, aligning with Vision 2030’s goal of a “healthy nation” through equitable financing and preventive care.

Challenge	Impact	Example Statistic (2025)
Out-of-Pocket Expenses	Financial hardship	24% of health spending
Workforce Shortage	Overburdened services	1:5,000 doctor ratio urban; 1:20,000 rural
Infrastructure Gaps	Unequal access	<20% registration in arid counties
Digital Fragmentation	Inefficiencies	Millions lost to repeat tests annually

Overview of SHA: From Launch to Current State

SHA consolidates NHIF’s functions into three funds: the Social Health Insurance Fund (SHIF) for curative services, Primary Health Care Fund (PHCF) for preventive care, and Emergency, Chronic, and Critical Illness Fund (ECCIF) for specialized needs. Contributions are tiered: 2.75% of gross income for formal sector workers, with subsidies for the informal sector via the “Lipa SHA Pole Pole” plan. Benefits include inpatient/outpatient care up to KSh 300,000 annually for oncology and full coverage for maternity under the revamped Linda Mama program.

By mid-2025, SHA had enrolled 26.7 million, with over 1 million accessing primary services since launch. Partnerships with Safaricom have digitized registration via USSD (*147#) and apps, boosting efficiency. However, early hurdles like system failures in claims processing led to a KSh 1 billion emergency contract with Savannah Informatics.

Future Plans and Expansions: Building a Resilient System

SHA’s roadmap, integrated into the Bottom-Up Economic Transformation Agenda (BETA), targets full UHC by 2030. Key expansions focus on coverage, infrastructure, and innovation, addressing Kenya’s challenges head-on.

1. Expanding Coverage and Equity

• Targeted Enrollment Drives: Plans include community outreach beyond health points, aiming for 90% registration by 2027. Special focus on low-uptake counties like West Pokot via mobile units and incentives. By December 2025, all 460,000 teachers will migrate to SHA’s Public Health Medical Schemes Fund.
• Vulnerable Groups Prioritized: Enhanced subsidies for the informal sector (40% of the workforce) and indigents, with means-testing expanded to 80% of registrants by 2026. Women’s benefits under Linda Mama now cover postnatal care up to six months.
• Overseas Contracting for Specialized Care: In September 2025, Health CS Aden Duale gazetted 36 unavailable services (e.g., advanced organ transplants), directing SHA to partner with foreign facilities like India’s Apollo Hospitals. This addresses gaps in Level 5/6 hospitals, with initial pilots budgeted at KSh 5 billion.

2. Infrastructure and Capacity Building

• Facility Upgrades: KSh 6.1 billion allocated in 2025 for SHA implementation, funding 500 new primary care units in underserved areas. Partnerships with counties aim to equip 80% of Level 2-3 facilities with solar power and water systems by 2027.
• Workforce Development: Recruitment of 64 specialists in July 2025, including four new directors for finance, ICT, and legal, to streamline operations. Training programs target 10,000 community health promoters annually, focusing on NCDs and climate-resilient care.
• Net-Zero Commitment: Aligned with COP26, SHA plans green expansions like solar-powered clinics, reducing emissions by 20% by 2030 amid climate-vulnerable regions.

3. Digital and Innovative Expansions

• Full Digitization: Building on the KSh 104.8 billion ecosystem with Safaricom, SHA will integrate EHRs nationwide by 2028, enabling seamless referrals and reducing fraud (estimated at 10% under NHIF).
• Public-Private Partnerships (PPPs): Despite concerns over migration of schemes like teachers’ insurance, SHA eyes collaborations with private insurers for claims processing, potentially covering 50% of tertiary care by 2027.
• Benefit Package Enhancements: Dental coverage expansions and KSh 100,000 for diagnostics in ECCIF, with pilots for telemedicine in rural areas.

Expansion Area	Timeline	Projected Impact
Enrollment to 90%	By 2027	Cover 45M Kenyans
Overseas Services	2025-2026	Access to 36 specialties
Digital EHR Integration	By 2028	Cut fraud by 50%
Green Infrastructure	By 2030	20% emission reduction

Challenges to Implementation

Despite ambitions, SHA faces headwinds mirroring broader medical issues:

• Funding Shortfalls: Only KSh 6.1 billion of KSh 168 billion needed for full rollout, risking delays. Public perception surveys show 45% awareness but skepticism over affordability.
• Technical Glitches: Claims portal failures eroded trust, with private providers threatening boycotts.
• Equity Gaps: Means-testing lags at 3.33 million of 19.3 million registrants, exacerbating rural-urban divides. PPP models risk sidelining private insurers, per critics.

Conclusion: Toward a Healthier Kenya

SHA’s future plans— from overseas partnerships to digital overhauls—position it as a cornerstone of Kenya’s UHC journey, directly tackling inequities and inefficiencies. With 26.7 million enrolled and expansions underway, success hinges on sustained funding (targeting 15% of GDP), stakeholder buy-in, and adaptive governance. As Health CS Deborah Barasa noted, these reforms promise reduced out-of-pocket costs and improved indicators, but only if challenges like understaffing and digital divides are bridged. By 2030, SHA could transform Kenya’s medical situation, fostering a resilient, inclusive system where no one chooses between health and hardship. Continued monitoring and public engagement will be key to realizing this vision.

LULU MAISHA MAGIC PLUS SEASON 1 EPISODE 101 MONDAY SEPTEMBER 22ND 2025 FULL EPISODE