Kenya’s Universal Health Coverage (UHC) reforms have expanded access to healthcare, with more than 32.3 million people registered under the Social Health Authority (SHA) as the government continues implementing changes to health financing and primary care.
Presidential Adviser on Health Financing Dr Daniel Mwai said the reforms have established a legal framework for Kenya’s long-term UHC agenda, with the government shifting towards a system that combines primary healthcare, social health insurance and support for emergency and chronic illnesses.
The framework is anchored on four laws passed in 2023 covering social health insurance, primary healthcare, digital health and facility improvement financing.
The World Health Organisation has also recognised the four laws as underpinning Kenya’s current UHC reforms.
Mwai said one of the major changes has been the expansion of community and primary healthcare, including government support for Community Health Promoters (CHPs).
The government has deployed more than 107,000 CHPs to strengthen preventive and promotive healthcare at the household level.
The Ministry of Health has also reported that primary healthcare is now funded by the national government, with more than USD210 million committed to community and primary-care services.
The new financing structure has also enabled SHA to pay contracted lower-level facilities directly for eligible primary healthcare services.
The Ministry reported in June that 31.39 million Kenyans had been registered under SHA, with 11,034 health facilities contracted and KSh147.37 billion paid in claims.
By August, registration had risen to more than 32.3 million, while more than 10,000 facilities had been accredited to provide services under the new framework.
Mwai also pointed to changes in healthcare benefits, citing intensive care as an example of expanded financial protection under SHA.
He said ICU care had not been covered under the former National Hospital Insurance Fund (NHIF), while SHA now provides a daily ICU reimbursement of up to KSh28,000.
The reforms have also changed how Kenyans contribute towards social health insurance.
The Social Health Insurance Fund requires a contribution of 2.75 per cent of gross monthly income, subject to a minimum contribution of KSh 300.
Mwai said the change was intended to make contributions more proportional to income, particularly for lower-income earners who previously contributed a larger share of their earnings under the former system.
Emergency care has also received a new national response system.
The National Ambulance Dispatch Centre, launched in August, operates through the SHA 922 Lifeline and coordinates ambulance deployment, referrals and communication between emergency responders and health facilities across all 47 counties.
Under the new arrangement, ambulance evacuation and the first 24 hours of emergency treatment are financed through the Emergency, Chronic and Critical Illness Fund at approved tariffs.
The service is intended to ensure emergency patients receive treatment without delays linked to their ability to pay.
Mwai also highlighted digital systems as an important part of the reforms, saying they allow authorities to track registration, contributions, healthcare utilisation and payments to facilities.
The Ministry reported in August that more than 95 per cent of health facilities in its cited network had been digitised, with SHA registration, pre-authorisation and claims processing increasingly automated.
Deputy Secretary General of the Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) Dr Dennis Miskellah pointed to infrastructure expansion as another area of progress, saying healthcare facilities were becoming more accessible across the country.
The government has continued investing in health infrastructure, including plans for 13 new Level Five hospitals and the deployment of specialised medical equipment to county facilities.
The availability of medicines has also improved, with KEMSA reporting an order fill rate above 90 per cent in August, following supply-chain reforms aimed at reducing stock-outs in public health facilities.
The next test for Kenya’s UHC reforms will be whether the expanded financing and infrastructure translate into consistent services at health facilities, timely provider payments and reliable access to medicines for patients.
