Nairobi, Kenya- The Ministry of Health has announced a temporary suspension of the Social Health Authority (SHA) overseas treatment package, giving room for critical policy adjustments aimed at strengthening Kenya’s healthcare system.
The pause, which will last 30 days, means patients seeking overseas medical assistance through SHA will have to wait until the new framework takes effect.
Focus Shifts to Local Capacity
Health Cabinet Secretary Aden Duale said the revised policy is designed to reduce unnecessary referrals abroad by ensuring that only procedures unavailable in Kenya qualify for overseas coverage.
“Many treatments Kenyans have been travelling for — including PET scans, advanced imaging, kidney transplants, open-heart surgeries, and joint and spinal injury care — are now available locally,” Duale noted.
To qualify under the new system, foreign hospitals must:
- Be formally contracted by SHA.
- Hold accreditation in their home country.
- Be recognised in Kenya.
- Have a Memorandum of Understanding (MoU) with a Kenyan empanelled and contracted health facility.
The cap on overseas benefits remains unchanged at Sh500,000 per year.
New Process for Overseas Coverage
The Ministry outlined a stricter four-step process for patients seeking care abroad under SHA:
- Pre-Authorisation – overseas hospitals must request approval before travel.
- Notification – SHA must be notified at admission and discharge.
- Claims – hospitals will submit claims online for verification and payment.
- Follow-up Care – patients must continue treatment at their linked Kenyan facility upon return.
Duale stressed that the changes are meant to improve accountability and coordination:
“SHA is aligning with the law, contracting hospitals, and rolling out a new system to strengthen collaboration among all stakeholders.”
Background and Next Steps
The overhaul follows mounting complaints from Kenyans about delays and inefficiencies in accessing the SHA overseas package.
Initially, the Ministry had planned to review the package two years after implementation. However, Director General Patrick Amoth confirmed the review was brought forward due to public pressure.
“The Cabinet Secretary and the Principal Secretary have already initiated steps to ensure the Benefit Package Tariffs Advisory Panel, envisioned in law, is operational,” Amoth said.
He emphasised that the review will ensure the package remains true to its core purpose — providing universal coverage without discrimination.
