The Social Health Authority (SHA) has invited expressions of interest from qualified and licensed overseas healthcare providers to offer specialized medical services not available in Kenya to its beneficiaries, marking a major step in expanding access to advanced treatment under the country’s new health financing framework.
The contracting, anchored in the Social Health Insurance (SHI) Act of 2023, targets highly specialized interventions for beneficiaries of the Social Health Insurance Fund (SHIF) and the Public Officers Medical Scheme Fund (POMSF), with applications open for 14 days.
In a public advertisement, SHA said it is seeking to contract overseas healthcare providers capable of delivering complex medical interventions that are not currently available in the country.
“The Government of Kenya, through the Social Health Authority, invites Expressions of Interest from qualified and licensed overseas Healthcare Providers for the provision of specialized healthcare services not available in Kenya to beneficiaries of the Social Health Authority,” the notice states.
SHA noted that Sections 33 and 34 of the SHI Act mandate the Authority to contract and empanel healthcare providers for services delivered under the Primary Healthcare Fund, the Social Health Insurance Fund, and the Emergency, Chronic and Critical Illness Fund.
In addition, the Public Finance Management (Public Officers Medical Scheme Fund) Regulations, Legal Notice No. 195 of 2024, mandate SHA to “administer, manage and govern the Public Officers Medical Scheme Fund.”
The Authority explained that its gazetted Benefits and Tariffs include an Overseas Benefit Package guided by the Benefits Package and Tariffs Advisory Panel (BPTAP).
“The list of healthcare interventions which guide the SHA on what to purchase from healthcare provider facilities outside the country on behalf of SHA beneficiaries is available on the Authority’s website,” SHA said.
For POMSF beneficiaries, coverage will also include “interventions not readily available in Kenya and those negotiated and agreed between the Authority and the respective overseas healthcare provider.”
According to the notice, the scope of services will cover laboratory investigations, imaging services, treatment interventions, accommodation before, during and after treatment, post-discharge reviews, transfers between facilities where medically necessary, and other incidental medical costs.
However, SHA emphasized that for SHIF beneficiaries, services will be limited to procedures listed and updated by BPTAP from time to time.
Interested overseas healthcare providers must meet strict eligibility requirements, including proof of registration, accreditation in their country of origin, valid specialist licences, itemized cost lists, and evidence of partnership with a Level V or VI healthcare facility in Kenya to support post-treatment follow-up.
Applications must be submitted within 14 days via SHA’s official email, with successful applicants required to execute contracts within seven days of notification.
SHA added that “the overseas contracting notice shall remain continuously open and will be updated periodically,” and that the list of contracted providers will be published in the Kenya Gazette.
