KNH Issues New 3-Step Guide for Patients Using Social Health Authority (SHA)
In response to widespread public concern and confusion, Kenyatta National Hospital (KNH) has issued an official guide to help patients seeking inpatient services through the Social Health Authority (SHA). This follows an uproar over failed systems, unexpectedly high hospital bills, and difficulties in accessing care despite patients being registered under the new government-backed health scheme in Kenya.
The SHA, which replaced the National Health Insurance Fund (NHIF), has come under scrutiny for technical issues, especially at top-tier public hospitals such as KNH — the largest referral and teaching hospital in East and Central Africa.
In an official notice dated Tuesday, July 8, 2025, KNH clarified the steps patients must follow to ensure they benefit from their SHA inpatient medical cover. Here’s a breakdown of the three-step process, what patients need to know, and a closer look at the SHA inpatient package at KNH.
Why SHA Patients at KNH Faced Challenges
Since the full rollout of SHA services in Kenyan public hospitals, patients have increasingly raised concerns about access to healthcare using SHA at KNH. Some of the most frequent complaints include:
- Patients being charged full admission fees despite being SHA members
- System delays and technical failures during registration or admission
- Lack of clarity on how SHA verification works
- Maximum admission charges being applied even in non-critical cases
These issues have left many Kenyans — especially low-income families — footing hefty inpatient bills out-of-pocket, despite paying premiums under SHA.
The 3-Step Process to Access Inpatient Services at KNH Using SHA
To address the confusion, KNH has now outlined a clear 3-step process for SHA patients. Below is a step-by-step guide on how to access your Social Health Insurance Fund (SHIF) benefits when visiting KNH.
✅ Step 1: Carry Your SHA-Registered National ID
Patients must bring the same National ID card used during SHA registration. This is because the SHA system is tied directly to your personal ID data, and KNH uses it to validate membership status.
Tip: Double-check that your ID number is correctly linked to your SHA profile before visiting the hospital.
Requirement:
- Valid National ID (original)
- SHA-registered and active membership
✅ Step 2: Get a Reference and Confirmation Number from SHA
Before being admitted, patients must initiate a visit through SHA and obtain two key identifiers:
- Reference Number: This number confirms that your visit is logged into the SHA system.
- Confirmation Number: This confirms that SHA has acknowledged your request and initialized your admission process.
Patients are advised to get these numbers before reaching the admission desk. If either of these numbers is missing, the SHA system at KNH may not recognize your entry — meaning the bill may not be covered.
Important: Without both the reference and confirmation numbers, your SHA cover may be invalidated for that visit.
✅ Step 3: Check Your SHIF Status and Activate if Needed
The final step involves checking your Social Health Insurance Fund (SHIF) status to confirm that your membership is currently active. If your status is inactive:
- Visit the SHA portal or mobile platform to activate your SHIF.
- Return to KNH’s Health Information Desk for a new reference number.
- Wait for confirmation that your status has been updated and is active.
KNH warns that any admission entry not properly referenced at the time of entry will not be covered. Patients will be fully liable for their bills if they bypass these checks.
What the SHA Inpatient Package at KNH Covers
KNH clarified what the SHA inpatient benefit package includes. Patients admitted under the SHA general ward inpatient package at Level 6 hospitals like KNH are entitled to the following:
- Disease/condition management during admission
- Pre-admission evaluation and diagnostics
- Hospital accommodation in general ward beds
- Daily meals and nursing care
- Intra-admission reviews and specialist consultations
- Imaging, lab tests, and diagnostic procedures
- Essential medicines and treatments
- Bedside services such as:
- Physical therapy
- Occupational therapy
- Oxygen supply
- Therapeutic nutritional support
- Blood transfusions
- Post-discharge medication and scheduled follow-up
This package reflects the government’s effort to provide comprehensive inpatient care to all insured members under SHA.
SHA Inpatient Pricing and Coverage Limits at KNH
The SHA pricing model for inpatient services offers partial financial relief to households. As of July 2025, the following rules apply:
- SHA waives Ksh 5,000 per day of inpatient care
- The cover applies for up to 50 days per household annually
- Once 50 days are used up, future bills are transferred to the:
- Emergency, Chronic, and Critical Illness Fund (ECCIF)
However, ECCIF usage may depend on the condition, hospital classification, and urgency of the medical case. SHA warns that any missteps during the admission process — such as missing reference numbers or inactive SHIF accounts — may lead to automatic out-of-pocket charges.
What Should Patients Do Before Going to KNH?
To avoid complications and ensure your SHA insurance covers your KNH admission, here’s a checklist:
- ✅ Ensure your ID is SHA-registered
- ✅ Confirm your SHIF status is active
- ✅ Log your visit through SHA and get your reference + confirmation numbers
- ✅ Carry all documents and proof of SHIF activation
- ✅ Visit the Health Information Desk first upon arrival
Final Thoughts: SHA Access Still a Work in Progress
While the SHA represents a major shift in Kenya’s healthcare financing, many patients — particularly those with urgent or critical conditions — continue to face roadblocks. KNH’s move to simplify the process is welcome, but there’s still a need for nationwide digital improvements and real-time system access.
For now, patients are advised to double-check SHA details before visiting any Level 6 facility, especially KNH, to avoid unexpected expenses. As more Kenyans adopt SHA, clarity and education around these steps will remain crucial to the program’s success.