The newly appointed CEO of the Social Health Authority (SHA), Robert Ingasira, has issued a directive allowing Level 4 hospitals to provide primary healthcare (PHC) outpatient services under the SHA Primary Health Care Fund.
In a statement on Friday, November 15, 2024, Ingasira emphasized that expanding PHC services to include willing Level 4 hospitals will significantly increase access to healthcare across the country. Traditionally, PHC services have been offered by Level 2 and Level 3 facilities.
“This opportunity will enable KEPH Level 4 facilities to deliver PHC outpatient services in addition to their existing services, ensuring enhanced community access to quality healthcare,” Ingasira stated. He encouraged these hospitals to participate in the initiative to help improve healthcare outcomes for Kenyans.
Level 4 facilities interested in offering PHC outpatient services must confirm their participation in writing. Contracts for participating facilities will be amended to reflect the new services, with payments based on a capitation model linked to government-approved outpatient tariffs.
Under the capitation model, facilities will receive a fixed quarterly payment per patient enrolled in the PHC scheme. Payments will be determined by the number of patients treated and the total number of registered users within each hospital’s network.
Only registered SHA members, including those in government-subsidized groups such as expectant women, children, the elderly, and vulnerable populations, will qualify for services under the PHC Fund. Each facility will be integrated into a primary care network, and registered households will be mapped to these networks.
“The SHA is committed to expanding access to quality healthcare. This initiative will ensure that more Kenyans can access vital primary care services in their communities,” added Ingasira.
Ingasira’s directive comes shortly after he replaced former acting SHA CEO Elijah Wachira, who was sent on a 90-day compulsory leave pending an investigation into his conduct.
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