Social Health Fund, Primary Healthcare, Digital Health & Facility Improvement Financing Acts
Author : Marren Adunga
- [email protected]
- Rachier & Amollo LLP, Mayfair Center 5th Floor
Social Health Fund, Primary Healthcare, Digital Health & Facility Improvement Financing Acts
Marren Adunga
Article Overview
This insight reviews Kenya’s new “universal health care” legal package enacted on 19 October 2023, namely the Social Health Fund and the Primary Healthcare, Digital Health, and Facility Improvement Financing Acts. It explains how the reforms are designed to expand Universal Health Coverage by restructuring health financing, strengthening primary care delivery, building a national digital health backbone, and enabling public facilities to retain and manage revenue for service improvements.
The piece highlights key implementation features, compliance duties for individuals and employers, governance and oversight structures, and the early constitutional litigation that has already shaped how parts of the financing regime can be enforced.
Key takeaways
- UHC framework (19 Oct 2023): the four Acts were introduced to reduce financial barriers to healthcare, extend coverage, and prioritise vulnerable and marginalised groups.
- Social Health Insurance Act (SHIA): establishes the Social Health Authority, replacing the NHIF Board, with powers to register members, manage funds, contract providers, and pay empanelled facilities.
- Registration and access to services: the article notes provisions that linked registration and up-to-date contributions to access to government services and healthcare, and explains that sections 26(5) and 27(4) were suspended following constitutional litigation and an appellate application.
- Contribution model: employees and self-employed persons contribute 2.75% of gross income (minimum KES 300). Employers submit employee contributions and are required to match them, and must notify status changes within set timelines.
- Primary Healthcare Act: creates a structured primary healthcare system, distinguishing community-level services (education, surveillance, hygiene, minor treatments, household monitoring) from facility-based services (promotive, preventive, curative, rehabilitative, palliative). It also clarifies national versus county roles under devolution.
- Digital Health Act: establishes standards for digital health, creates an agency to run an integrated health information system and registries, and requires a health data governance framework. It expressly complements the Data Protection Act and imposes compliance duties on health data controllers.
- Facility Improvement Financing Act: provides mechanisms for public facilities to collect, retain, and manage revenue to fund operations, urgent purchases, service quality improvements, and ambulance services, within a defined governance and financial management framework.
- Implementation emphasis: the conclusion stresses that outcomes will depend on financing reliability, service delivery and governance, referral pathways, facility-level accountability, and a trusted digital backbone with strong privacy protections.
About the author
Marren Adunga is an Associate at Rachier & Amollo LLP. In this insight, she analyses the new UHC laws and the practical governance, financing, and data protection issues that will determine whether the reforms translate from policy into real access to quality care.