Expectant mothers to get free delivery services in enhanced SHA package

This follows the enhancement of benefit packages by the authority in a bid to expand healthcare access for registered members.

The new packages will also ease the burden on cancer patients and people living with sickle cell anaemia.

Pregnant mothers seeking services under the Social Health Authority previously needed to be fully paid-up members to access care at Level Two and Three hospitals.

However, under the newly revised package, all mothers registered under SHA will now receive delivery services free of charge.

According to the Ministry of Health, the government has allocated funds under the Primary Healthcare Fund to cushion expectant mothers who are unable to finance their SHA contributions.

"You can walk in and walk out in any Level Two and Three hospitals when you are expectant, you will get your ANC for free. When it comes to delivery, you will deliver for free. In a case you need referral, you will be referred for free," said Margaret Macharia, Deputy Director, Benefits Package and Tariffs Advisory Panel.

The Social Health Authority will reimburse facilities Ksh.10,000 for normal delivery and Ksh.30,000 for caesarean section procedures.

According to SHA, some Level Three facilities accredited by the Kenya Medical Practitioners and Dentists Council have been approved to conduct C-section services.

The authority says all mothers, including teenage mothers, deserve quality healthcare for themselves and their newborns, regardless of their financial status.

The revised SHA packages, gazetted Monday, also offer renewed hope to cancer patients, many of whom have long complained about the early depletion of their annual allocations.

It is now official that cancer patients will access a cover of up to Ksh.800,000, up from the previous Ksh.550,000.

"When it comes to diagnostics, it was just a loose definition that we will pay for your histopathology, but it didn’t say how many markers or times you will be done," stated Margaret Macharia, Deputy Director, Benefits Package and Tariffs Advisory Panel.

Under the package, cancer patients will also enjoy up to Ksh.2,500 per visit for holistic consultations, covering up to four visits. This includes access to oncologists, nutritionists, mental health support and palliative care.

Patients will also benefit from Ksh.5,000 for chemotherapy administration as per treatment plan, up to Ksh.15,000 for chemo port insertion procedures and equipment, as well as full blood count tests valued at Ksh.500 per visit, among other itemised services.

"The initial package had omitted supportive care treatment. You know when you undergo chemo or radiotherapy, you get illnesses like nausea, so now what has been defined in the package and capped at Ksh.10,000," said Margaret Macharia, Deputy Director, Benefits Package and Tariffs Advisory Panel.

Patients living with sickle cell disease are also expected to benefit from expanded support under the revised package. For the first time, SHA has introduced coverage for specialized procedures.

"What this gazette notice does is that every Kenyan is aware that those two interventions, the blood-related interventions, are for sickle cell patients and they are aphaeretic platelets and red cell exchange, and we are paying for at least three sessions in a policy period," stated Margaret Macharia, Deputy Director, Benefits Package and Tariffs Advisory Panel.

The package has also seen allocation for the Emergency, Chronic and Critical Illness Fund increase from Ksh.150,000 to Ksh.400,000.

The Kenyan Network of Cancer Organizations (KENCO) has welcomed the revised package, describing it as a step in the right direction.

However, the organisation is calling on the government to ensure seamless access to these services across all accredited healthcare facilities, while also eliminating delays in approvals, claims processing and administrative bottlenecks within SHA systems.