The Social Health Authority (SHA) has issued a stern directive to all healthcare facilities under its contract to offer emergency medical treatment promptly and without discrimination, regardless of a patient's financial status.
In a notice signed by SHA CEO Dr Mercy Mwangangi, the authority emphasized that emergency care is a constitutional right under Article 43(2) of the Kenyan Constitution and must be upheld by all providers.
Mandatory Emergency Services
- All SHA-contracted hospitals must not refuse, delay, or withhold emergency treatment due to lack of payment, benefit confirmation, or advance deposits.
- The Emergency, Critical and Chronic Illness Fund (ECCIF) will cover eligible emergency treatments for the first 24 hours.
- Subsequent care costs will be funded through the Social Health Insurance Fund (SHIF) or other payment mechanisms.
Referral and Stabilization
Facilities unable to manage a patient must stabilize them before referral to another contracted facility, following Ministry of Health guidelines and SHA contracts.
Enforcement and Compliance
- Hospitals violating these rules risk de-empanelment and contract termination.
- Relevant regulatory bodies may also take action against non-compliant providers.
- SHA has instructed facility leadership and emergency staff to disseminate the directive and ensure adherence.
The directive responds to growing concerns about some hospitals demanding upfront payments or benefit verification before administering emergency care, practices that conflict with constitutional and legal mandates. Healthcare providers have cited reimbursement delays and verification challenges as operational hurdles but are reminded that these issues cannot justify denying urgent treatment.
