Private insurance companies will now complement government health services under a new partnership with the Social Health Authority (SHA), the Ministry of Health announced on Monday, August 18.
The agreement, unveiled after a meeting between Health Cabinet Secretary Aden Duale and medical insurance CEOs in Nairobi, will see private insurers introduce additional covers to expand access to healthcare. These complementary packages will include overseas care, elective procedures, and premium add-ons, which go beyond the standard SHA benefits.
A key highlight of the deal is the co-financing of treatment for chronic conditions through SHA’s Emergency, Chronic, and Critical Illness Fund (ECCIF). This joint approach is expected to ease the financial burden on patients with long-term illnesses while improving treatment outcomes.
To enhance efficiency and transparency, insurers will be integrated into SHA’s centralised claims platform. This system will allow for real-time verification of claims, faster processing, and prevention of double-billing issues that have previously undermined healthcare access. The partnership also promises harmonised accreditation criteria, ensuring Kenyans receive uniform quality care whether under SHA or private schemes.
The ministry and insurers further committed to implementing anti-fraud measures. These include biometric verification of patients, joint audits, and a shared database to identify and eliminate fraudulent health providers. Fraudulent claims and double billing have long been a challenge in Kenya’s health insurance sector, often driving up costs for both government and private players.
In his remarks, CS Duale acknowledged structural challenges within the health system but affirmed the government’s commitment to reforms. He urged a stronger Public–Private Collaborative framework involving the Ministry of Health, SHA, private insurers, and the Insurance Regulatory Authority (IRA). The collaboration, he said, will focus on tariff alignment, data sharing, and fraud elimination.
The announcement comes just hours after the ministry suspended the SHA overseas package for 30 days to allow for key policy adjustments. The pause, according to the ministry, will pave the way for a more sustainable and efficient package once it resumes.
This new partnership marks a significant step toward universal health coverage by leveraging private sector expertise to complement public health initiatives.