The Social Health Authority (SHA) has announced major changes to maternity, cancer, and sickle cell treatment benefits under the national health scheme.
In a statement on Monday, May 11, SHA CEO Mercy Mwangangi said the development follows directives from President William Ruto and resolutions passed during the intergovernmental summit between national and county governments.
The authority noted that the revised packages were also informed by public participation and healthcare utilization data.
"As a culmination of His Excellency the President's Dr. William Samoei Ruto directive during the 2025 State of the Nation Address, the resolutions from the 12th Ordinary Session of the National and County Governments Coordinating Summit, and rigorous public participation and utilization data, the Social Health Authority (SHA) is pleased to announce the enhancement of selected health benefit packages," the statement read.
SHA added that the changes had been formalized through a legal notice issued by the Ministry of Health.
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"These enhancements, published by the Cabinet Secretary for Health in consultation with the SHA Board through Legal Notice No. 78 of 2026, mark a significant milestone in our commitment to Universal Health Coverage and leaving no Kenyan behind," the statement added.
Under the revised maternity care package, all registered beneficiaries will now access free delivery services at Level 2 and Level 3 health facilities on a walk-in, walk-out basis.
The services will be fully financed through the Primary Healthcare Fund allocation.
SHA stated that facilities will receive Ksh10,000 for normal deliveries and essential newborn care, while caesarean sections and newborn care will attract reimbursements of Ksh30,000.
The authority also expanded cancer treatment support, increasing the annual cancer benefits package from KSh550,000 to KSh800,000.
Funding under the Emergency, Chronic, and Critical Illness Fund was also raised from Ksh150,000 to Ksh400,000 for chronic illnesses.
Patients will now benefit from oncology consultations capped at Ksh2,500 per visit, chemotherapy administration at Ksh5,500 per session, and radiotherapy at Ksh3,600 per session for up to 30 sessions.
The revised package further includes advanced diagnostic services such as CT scans at Ksh6,900, MRI scans at Ksh11,000, PET scans at Ksh53,500, and PSMA PET scans at Ksh64,200.
SHA also introduced coverage for specialized cancer therapies, including brachytherapy at Ksh40,000 for three sessions and SBRT/SBRS treatment of up to Ksh70,000 for five sessions.
Patients undergoing treatment will additionally receive supportive care medicines of up to Ksh10,000 and remission follow-up care guided by the Kenya Cancer National Treatment Protocols.
For sickle cell disease patients, SHA announced coverage for selected specialized procedures, including apheresis platelets at Ksh20,000 and red cell exchange at Ksh70,000, each covered up to three times within a policy period.
This comes over a week after the Teachers Service Commission (TSC) announced a boost to teachers’ healthcare benefits after unveiling In-Vitro Fertilization (IVF) services under SHA's Mwalimu Comprehensive Cover.
In a statement on Thursday, April 30, TSC confirmed that IVF services have now been formally activated under the SHA scheme and are available to eligible teachers under the cover.
"The Teachers Service Commission (TSC) is pleased to inform all eligible members that the Social Health Authority (SHA) has formally activated In-Vitro Fertilization (IVF) services under the SHA," the statement read.
TSC announced that the service will initially be offered at The Nairobi Hospital, making it clear that access has already begun.
"This benefit is now accessible at The Nairobi West Hospital, a contracted and accredited healthcare provider under the scheme, with immediate effect," the statement added.
According to SHA, access to IVF services will be strictly limited to SHA-POMSF beneficiaries, including principal members and their lawfully declared spouses.
Applicants must meet strict medical requirements, including documented infertility defined as failure to conceive after 12 months of regular unprotected intercourse or as determined by a qualified specialist.
All cases must also be supported by a clinical diagnosis and a written recommendation from a registered specialist.
The commission has also outlined usage limits, including the maximum number of attempts allowed per beneficiary, as well as strict age restrictions for the female partner seeking treatment.
Each beneficiary will be allowed a maximum of two IVF attempts over their lifetime, while the female partner must be aged 41 years or below at the start of the treatment cycle.
Both primary and secondary infertility cases qualify, although couples seeking treatment for secondary infertility must not have any living child at the time of application.
The IVF benefit will be covered within the existing inpatient limits of the Mwalimu Comprehensive Cover, meaning all costs will be drawn from the allocated inpatient cover.
