NAIROBI, Kenya – The Social Health Authority (SHA) has opened the door for Kenyan patients to access highly specialised medical treatment abroad, inviting qualified and licensed overseas healthcare providers to apply for empanelment under the country’s social health insurance framework.
In a contracting notice issued under the Social Health Insurance Act, No. 16 of 2023, SHA said the move is aimed at bridging gaps in medical services that are not currently available in Kenya, particularly for life-saving and complex conditions.
The initiative, anchored in Sections 33 and 34 of the law, allows SHA to contract and empanel healthcare providers to deliver services under the Primary Healthcare Fund (PHC), the Social Health Insurance Fund (SHIF), and the Emergency, Chronic and Critical Illness Fund (ECCIF).
The arrangement will also benefit members of the Public Officers Medical Scheme Fund (POMSF), which is administered by SHA under Legal Notice No. 195 of 2024.
According to the Authority, the overseas treatment programme forms part of the gazetted Benefits and Tariffs Schedule and will be restricted to highly specialised interventions approved by the Benefits Package and Tariffs Advisory Panel (BPTAP).
“The Government of Kenya, through the Social Health Authority, invites Expressions of Interest from qualified and licensed overseas healthcare providers for the provision of specialised healthcare services not available in Kenya,” the notice states.
SHA said the full list of eligible interventions—covering treatments not readily accessible locally—is published on its website and will be reviewed periodically.
However, for POMSF beneficiaries, the scope will be broader, allowing referrals for specialised care beyond the BPTAP list, subject to negotiated costs.
SHA Chief Executive Officer Mercy Mwangangi said the programme is designed to ensure equitable access to critical care while safeguarding continuity of treatment and value for money.
She said the benefit package will cover medical evaluations such as laboratory tests and imaging, treatment procedures, accommodation before and after treatment while awaiting a fit-to-fly certificate, inter-facility transfers triggered by emerging complications, and other medically necessary incidental costs.
To qualify, overseas providers must meet strict eligibility criteria, including proof of registration under applicable laws, accreditation by a recognised body in their country of origin, and valid practising licences for specialist doctors.
Applicants must also demonstrate partnerships with empanelled Kenyan healthcare facilities at Kenya Essential Package for Health (KEPH) Level V or VI to ensure follow-up care once patients return home.
All submissions must be made on official letterhead and certified by a Notary Public. Incomplete or non-responsive applications will be disqualified, although providers may reapply after meeting all requirements.
Applications must be submitted within 14 days of commencement through the SHA website, the Public Procurement Information Portal, Kenyan embassies and high commissions, or via the Authority’s official email address.
Mwangangi said contracting will initially be done manually, with successful applicants notified in writing and required to execute contract documents within seven days.
“This framework allows us to responsibly contract accredited overseas providers while protecting beneficiaries and strengthening access to specialised care that is currently unavailable in Kenya,” she said.
The final list of contracted overseas healthcare providers will be published in the Kenya Gazette, on the SHA website, and through other legally recognised platforms.
