- The Ministry of Health (MOH) is expediting the review of the Ksh 500,000 overseas treatment benefit under the Social Health Authority (SHA).
- Public complaints over the inadequacy of the package for high-cost treatments prompted the review.
- Health Director General Dr. Patrick Amoth acknowledged the cap is insufficient, as many treatments exceed Ksh 1,000,000.
- The review comes after the tragic death of an infant, Callum, whose family was unable to access the benefit.
- The SHA scheme is currently being integrated into the Universal Health Coverage (UHC) system to ensure equitable access for all Kenyans.
The Ministry of Health has announced plans to fast-track the review of the Ksh 500,000 overseas treatment benefit package provided by the Social Health Authority (SHA). Originally slated for review after two years, the process has been expedited following numerous public complaints.
Health Director General Dr. Patrick Amoth confirmed the move, stating that many high-cost overseas treatments, particularly high-risk surgeries, exceed the current cap. “The review will be done much sooner due to calls from Kenyans regarding their experience with SHA,” he remarked.
The urgency of the review was underscored by the tragic case of eight-week-old Callum, who required corrective heart surgery in India but was denied access to the SHA benefit. Callum’s family, not being public servants, claimed they were excluded from accessing the package. The infant’s passing has intensified public calls for reforms within the SHA system.
Concerns have also been raised about disparities in benefits between civil servants and informal sector workers. SHA CEO Robert Ingasira clarified that the overseas treatment benefit is designed to be universal. He assured Kenyans that the SHA scheme’s integration into the Universal Health Coverage (UHC) system aims to address these inequalities.
Dr. Amoth added that the Ministry has taken steps to operationalize the benefit package tariffs advisory panel, as envisioned in the law. The Ministry’s review of the overseas treatment package is expected to improve access and equity, ensuring all Kenyans can benefit from comprehensive healthcare services.
This move reflects the government’s commitment to addressing gaps in healthcare financing and enhancing support for critical medical needs.
