Kenya's SHA-Funded Overseas Treatment Programme: How Diaspora Patients and Families Can Access It

From 14 April 2026, the Social Health Authority (SHA) began funding specialised medical treatment abroad for Kenyan patients whose conditions cannot be managed within local facilities. The programme is capped at Ksh 500,000 per patient per year and is administered as part of Kenya's transition from the National Hospital Insurance Fund (NHIF) to SHA under the Social Health Insurance framework. For diaspora Kenyans whose elderly parents, siblings, or children may need treatment in India, South Africa, the United Kingdom, or the United Arab Emirates, understanding the rules is critical — especially the eligibility tests, the documentation requirements, and what the programme does and does not pay for.

Background: From NHIF to SHA

Kenya transitioned from NHIF to the Social Health Authority under the Social Health Insurance Act, 2023, with the goal of delivering Universal Health Coverage. The new framework consolidates three funds: the Primary Healthcare Fund, the Social Health Insurance Fund, and the Emergency, Chronic and Critical Illness Fund. The overseas treatment benefit is administered through the latter fund and is reserved for cases that require specialised intervention not available at any Kenyan facility currently approved by SHA.

The Ministry of Health publishes implementation progress on the official Ministry of Health website, including which referral hospitals are accredited to recommend overseas treatment and which conditions are currently within scope.

Who Is Eligible

To access the overseas treatment benefit, the patient must be a registered SHA member in good standing. This means: enrolment is complete; the contribution status is current; and the household has been verified at a primary-care facility within the SHA network. For employed Kenyans, the 2.75% statutory contribution is deducted monthly and remitted by the employer. For non-salaried Kenyans, the contribution is paid voluntarily based on income. Diaspora members can register voluntarily and contribute from abroad, which keeps coverage alive for the diaspora member as well as enrolled dependants resident in Kenya.

How the Referral Pathway Works

The programme is referral-based. A patient cannot apply directly for overseas treatment. The treating specialist at a SHA-accredited Kenyan facility must first determine that the condition cannot be managed locally. The specialist then completes a referral form, attaches diagnostic reports, and forwards the case to a multi-disciplinary review panel that evaluates clinical necessity. If the panel approves overseas treatment, SHA identifies an appropriate foreign facility, processes the payment authorisation, and coordinates with the patient or family on logistics.

For diaspora family members supporting a patient back home, the practical implication is that the process must begin in Kenya, with a Kenyan specialist who has examined the patient. Pushing the process from abroad will not work; the referral panel needs domestic clinical evidence. Your role from abroad is to ensure the patient reaches the right Kenyan facility quickly, that all medical records are available, and that follow-up paperwork is completed.

What the Programme Pays For

The Ksh 500,000 annual cap applies only to medical expenses related to the approved treatment — including hospital fees, surgical fees, anaesthesia, and post-operative care within the approved treatment plan. Travel costs, accommodation, food, and personal expenses for the patient and any companion are not covered. Families therefore need to plan for the non-medical costs, which for many overseas destinations can equal or exceed the medical bill itself.

The programme does not cover elective procedures, treatments that are available in Kenya but that the patient prefers to receive abroad, or treatments where the foreign facility is not on SHA's approved network. Cosmetic procedures, fertility treatments not classified as medically necessary, and most experimental therapies are out of scope.

Documentation Required

Patients and families should be prepared to produce: a valid Kenyan national identification document; SHA membership confirmation; full medical history from the referring Kenyan facility; diagnostic imaging and laboratory reports; a treatment plan from the proposed foreign facility (or SHA's selected facility); a valid passport for travel; and any visa documentation required by the destination country. Diaspora family members supporting the process should help collect, scan, and securely share these records with the referring physician and the SHA case manager.

SHA Registration for Diaspora Members

Diaspora Kenyans who are not currently SHA members and who want coverage — for themselves or for dependants in Kenya — can register voluntarily. The registration process is online through the SHA portal and can be completed using a valid Kenyan ID or passport. Payment options for diaspora contributors include M-Pesa Global, international bank transfer to the SHA collection account, authorisation of a trusted person in Kenya to pay on your behalf, and the eCitizen platform which accepts international card payments. Registering voluntarily before there is a medical emergency is the single most important step a diaspora Kenyan can take to safeguard the family's access to the overseas-treatment benefit when it is needed.

Sensitisation and Diaspora Engagement

The State Department for Diaspora Affairs, in collaboration with SHA, has conducted sensitisation webinars dedicated to the Kenyan diaspora about the new Social Health Insurance framework. Kenya High Commissions and Embassies in countries with large diaspora populations have hosted virtual town halls in 2026, and recordings are typically published on the diplomatic missions' websites. Diaspora associations have also organised community meetings to walk members through registration and contribution mechanics.

Practical Action Steps

If you are a diaspora Kenyan and your loved ones in Kenya are not yet SHA members, start with three actions. First, help them register through the SHA portal or by dialling *147# on their phones, which initiates the USSD registration flow. Second, set up a contribution arrangement — either M-Pesa Global from your end, or a standing M-Pesa transfer to a trusted relative who will pay on the family's behalf. Third, make sure your loved ones have identified an SHA-accredited primary-care facility close to where they live. Without a primary-care facility on the system, downstream referrals are slower and more complicated.

If you are already a SHA member and you want to maintain status from abroad, log into the SHA portal periodically to confirm that your contributions are being recorded against your account. Discrepancies are easier to fix early. Keep a record of your transactions and download your annual statement when it becomes available.

What to Expect Going Forward

The overseas-treatment programme is new and will evolve. Expect tighter clinical criteria as the SHA reviews case data, expanded networks of approved foreign facilities, and updated annual caps tied to fiscal capacity. Diaspora Kenyans should track changes via the SHA and Ministry of Health channels, and through their nearest Kenyan diplomatic mission. For complex cases — particularly cancer, advanced cardiac surgery, organ transplantation, and rare disorders — the overseas-treatment benefit is now one of the most important financial protections available to Kenyan families, but it works only for those who are properly registered and current on contributions.

Final Word

Universal Health Coverage in Kenya is being built one programme at a time, and the overseas treatment benefit is a meaningful step. For Kenyans in the diaspora, the most useful contribution is not to navigate the clinical process from abroad — that is the job of Kenyan specialists — but to ensure that your loved ones at home are enrolled, current on contributions, and connected to a primary-care facility. That preparation, done in calm times, makes all the difference when a medical crisis arrives.