The newly appointed Social Health Authority CEO Robert Ingasira has issued a directive to Level 4 hospitals in the country willing to provide primary healthcare outpatient services under SHA.

In a statement on Friday, November 15, 2024, Ingasira indicated that while primary healthcare was initially provided by mostly Level 2 and Level 3 hospitals, the introduction of willing Level 4 hospitals would greatly ensure more citizens access primary healthcare.

“This is to inform all contracted KEPH Level 4 facilities of the opportunity to provide Primary Health Care (PHC) outpatient services under the Social Health Authority (SHA) Primary Health Care Fund,” Ingasira said.

Adding: “The Authority is committed to expanding access to quality healthcare services across the Country, and therefore KEPH Level 4 facilities are eligible to offer PHC outpatient services in addition to the existing services at KEPH Level 2 and 3 facilities. Further, expanding PHC services to include selected KEPH Level 4 facilities will enhance community access to quality healthcare services. We encourage your facility to participate in this initiative and contribute to improving health outcomes for all citizens.”

In the new directive, Ingasira says the Kenya Essential Package for Health (KEPH) Level 4 facilities interested in offering PHC outpatient services should confirm their participation in writing upon receipt of this communication.

Amended contracts

Additionally, he notes that health facilities which will opt to participate will have their contracts amended to include the new service and that the payment mechanism for primary healthcare outpatient services under SHA will be capitation based on the gazetted outpatient tariffs.

This means that facilities will be paid a fixed amount per patient enrolled under the primary healthcare scheme in line with the set outpatient capitation rates.

According to the SHA tariffs, capitation for primary healthcare will be done on a quarterly basis to the registered hospitals offering the services.

Each facility will be mapped into a primary care network and registered households mapped into the network.

Capitation to facilities

The distribution of the primary healthcare funds will be done at the end of each quarter to the networks depending on the number of patients treated and based on the number of registered users on the network.

“Only registered SHA members, including those who are part of the government-subsidized categories (such as expectant women, children, the elderly, and other vulnerable groups), are eligible for services under the PHC Fund,” Ingasira added.

Ingasira took over from former acting SHA CEO Elijah Wachira who was sent on a compulsory leave for 90 days as investigation on his conduct is done.