SHA invites overseas healthcare providers for specialised treatment of Kenyan patients

The Social Health Authority (SHA) has invited qualified and licensed overseas healthcare providers to submit Expressions of Interest (EOIs) to offer specialised medical services to Kenyan patients seeking treatment not available locally.

In a contracting notice issued under the Social Health Insurance Act (SHI Act), No. 16 of 2023, SHA said the initiative is anchored in Sections 33 and 34 of the law.

The provisions mandate the Authority to contract and empanel healthcare providers for service delivery under the Primary Healthcare Fund (PHC), the Social Health Insurance Fund (SHIF), and the Emergency, Chronic and Critical Illness Fund (ECCIF).

The arrangement also applies to beneficiaries of the Public Officers Medical Scheme Fund (POMSF), which SHA administers under Legal Notice No. 195 of 2024.

SHA said the overseas benefit package forms part of the gazetted Benefits and Tariffs and will be limited to highly specialised medical interventions approved by the Benefits Package and Tariffs Advisory Panel (BPTAP).

“The Government of Kenya, through the Social Health Authority (SHA), invites Expressions of Interest (EOIs) from qualified and licensed overseas healthcare providers for the provision of specialised healthcare services not available in Kenya to beneficiaries of the Social Health Authority, in accordance with the Social Health Insurance Act, No. 16 of 2023,” the notice reads.

The full list of eligible interventions—those not readily available in Kenya—is published on the SHA website and will be updated from time to time.

For POMSF beneficiaries, the scope of services will extend beyond the BPTAP list to include specialised treatments sought upon referral, at negotiated costs.

SHA Chief Executive Officer Mercy Mwangangi said the initiative is aimed at ensuring equitable access to life-saving and highly specialised care for Kenyan patients.

She said covered expenses will include evaluation services such as laboratory investigations and imaging, treatment interventions, accommodation before, during and after treatment pending the issuance of a fit-to-fly certificate, inter-facility transfers arising from emerging medical conditions, and other incidental costs deemed medically necessary.

Interested overseas healthcare providers must meet strict eligibility and mandatory qualification requirements.

These include proof of registration or incorporation under applicable law, a valid power of attorney authorising the signatory, itemised cost lists for proposed treatments, a detailed provider profile, and accreditation by a recognised body in the country of origin.

Providers must also be recognised by relevant Kenyan authorities and demonstrate evidence of partnership with an empanelled Kenyan healthcare facility capable of providing follow-up care under the Kenya Essential Package for Health (KEPH) Level V or VI.

In addition, providers must show that their specialist doctors hold valid and up-to-date practising licences.

All mandatory documents must be submitted on the provider’s official letterhead and duly certified by a Notary Public.

Non-responsive submissions will be disqualified, although applicants may reapply once all requirements are met.

Applications must be completed and submitted within 14 days of commencement through the SHA website, the Public Procurement Information Portal, Kenyan embassies and high commissions, or via the Authority’s official email address.

Mwangangi said contracting and execution of agreements will initially be undertaken manually, with successful applicants notified in writing.

Selected providers will be required to execute contract documents within seven days, after which the contracts will be countersigned by the Authority’s Accounting Officer.

The contracting notice will remain continuously open and updated periodically, subject to approvals.

“This framework allows us to bridge existing gaps in specialised treatment by responsibly contracting accredited overseas providers, while ensuring value for money, continuity of care, and protection of beneficiaries under the social health insurance system,” Mwangangi said.

She added that the Authority reserves the right to verify submitted information, negotiate tariffs, and continuously empanel facilities during the contract cycle.

The final list of contracted overseas healthcare providers will be published in the Kenya Gazette, on the SHA website, and through other lawful platforms.