The Ministry of Health has unveiled a series of major reforms to strengthen Universal Health Coverage (UHC) under the Taifa Care program.
Speaking during a media briefing, Cabinet Secretary for Health, Dr. Deborah Mlongo Barasa, outlined key updates on healthcare financing, service delivery, transparency measures, and digital transformation in the sector.
Dr. Barasa announced a shift in healthcare financing, where payments to facilities will now be based on the actual number of patients served rather than those insured under the former NHIF system.
“This is a significant shift from the old model, ensuring fairness, efficiency, and accountability. Payments for primary healthcare services are now fully tax-funded, a key principle in UHC service delivery,” she stated.
She added that this approach prioritizes patient needs over insurance status, ensuring that healthcare funds reach the right facilities and strengthen service delivery.
Describing Taifa Care as the most ambitious health program since independence, Dr. Barasa emphasized its importance in transforming Kenya’s health sector.
“Taifa Care’s success is not optional—it is a must. We are working closely with counties, healthcare workers, and development partners to ensure seamless implementation,” she affirmed.
She called on all stakeholders to support the initiative, as it will guarantee access to quality healthcare for all Kenyans, regardless of financial status.
The Ministry will finalize the Means Testing Model (MTM) by Friday, 7th March 2025, ensuring vulnerable groups receive financial support for healthcare.
A comprehensive manual is also being developed to guide counties, providers, and citizens on how to access services under the digital system.
Dr. Barasa highlighted that Primary Health Care (PHC) remains central to UHC, with utilization data from January 2025 confirming positive progress.
“We are prioritizing early disease detection and management to reduce pressure on referral hospitals. I urge all Kenyans to embrace primary healthcare services, which will now be more accessible, affordable, and effective,” she said.
To promote accountability and public trust, the Social Health Authority (SHA) will begin publicly disclosing payments made to health facilities on its website starting next week.
“Kenyans will now see which hospitals have received payments and how much, ensuring that funds meant for patient care are used appropriately,” Dr. Barasa explained.
She clarified that registration under Taifa Care is for planning and budgeting, while payments to facilities will be based on actual services provided.
The Ministry has launched a Claims Tracking Dashboard, enabling real-time monitoring of claims to streamline payments. While the law allows 90 days for claims processing, SHA is working to settle payments within 30 days to maintain smooth facility operations.
Additionally, nationwide training on claims processing is underway to help healthcare providers avoid errors, speed up processing, and ensure timely reimbursements. By the end of March 2025, 15 high-volume hospitals will be onboarded onto the Health Information Exchange (HIE) system.
“This digital system will enable seamless sharing of patient data across facilities, reducing duplication and improving efficiency in service delivery,” Dr. Barasa noted.
To sustain Primary Health Care (PHC) services, all SHA payments for PHC will be directed to PHC Fund accounts, ensuring dedicated financing for service delivery. Counties have been urged to strengthen Facility Improvement Fund (FIF) Committees for transparent and efficient management of healthcare funds.
The Ministry is setting up a 24-hour Call Center to assist the public and healthcare providers with accessing healthcare services, registration and adding dependents, and tracking claims and payments.
“This center will provide real-time assistance, helping Kenyans navigate the UHC system efficiently,” said Dr. Barasa.
The Ministry also announced significant improvements in health benefits under Taifa Care, including an increase in ICU/HDU coverage sixfold, from KES 4,600 to KES 28,000, ensuring better protection from out-of-pocket payments for families.
Additionally, the oncology care package has expanded from KES 400,000 to KES 550,000 per household, making cancer treatment more affordable. Dr. Barasa reiterated the Ministry’s commitment to ensuring that Taifa Care delivers on its promise of accessible, affordable, and high-quality healthcare for all Kenyans.
