Faith based health service providers under the banner of the Kenya Faith Based Health Services Consortium have issued a 14-day ultimatum to the Government to pay pending SHA, NHIF and MAKL debts totaling to Ksn10 billion. Faith leaders from CHAK, KCCB, MEDS and SUPKEM, which together provide health services through a total of 1,300 health facilities in all 47 counties of Kenya (40 per cent of health care in Kenya) issued the demands during a press conference held at Ufungamano House in Nairobi. 

KENYA FAITH-BASED HEALTH SERVICES CONSORTIUM (KCCB, CHAK, MEDS & SUPKEM)

PRESS STATEMENT ON OUTSTANDING NHIF, SHA & MAKL DEBTS

DATE:  March 06, 2025

VENUE: Ufungamano Christian Students Center, Nairobi

Preamble

The Faith Based Health Service providers comprise all Health facilities under KCCB, CHAK and SUPKEM totaling 1,300 health facilities distributed in all 47 counties in Kenya, but only less than 500 FBO health facilities have been empaneled by SHA, and even less had NHIF contracts.

In addition, the FBOs operate 38 Medical Training Colleges and own MEDS, the pharmaceutical supply chain organization that supports access to quality essential medicines and other Health Products and Technologies countrywide and beyond borders. In all, FBOs contribute approximately 40% of healthcare in the country,

Recognizing that Hospitals received small amounts of payment from SHA in the month of February 2025, and that all Hospitals and MEDS are in serious cash distress; -

Appreciation: H.E The President pledge on March 5^th 2025 to pay those owed less than 10m; However this is grossly inadequate to relief the cashflow distress among the faith-based Hospitals. The ones left unpaid handle the more complicated diseases, specialized surgeries, Critical patients which are costly and life- saving.

The Faith Based health facilities are currently experiencing serious financial distress even as they struggle to continue offering health care services, due to huge outstanding debts owed to them by the defunct NHIF and the current SHA and MAKL. The situation is very dire because we are unable to pay staff salaries, suppliers and cater for other operational expenses necessary for providing the health care services to the deserving communities.

The situation in reference to the above scenario is as follows:

1. NHIF claims

Kes 8 Billion (CHAK 2.4B and KCCB 4.4B) worth of claims remain unpaid under NHIF, some dating back to 2016 to the period of September 2024 when SHA took over NHIF claims:

Recommendation:

We demand, All NHIF pending claims be paid fully by 21^st March 2025.

2. SHA claims

Kes 15Billion (KCCB 1.1B while CHAK is 1.05B) worth of claims remain unpaid under SHA for the 3 months period of October-February 2025. Some of these claims have exceeded the 90-day period.

Recommendation:

We demand, All SHA pending claims be paid by 21^st March 2025 in line with the Social Health Insurance Act 2023.

3. SHA claim stages

The SHA Claims processing has several stages (about 10 stages) which include pre-authorization, under review, under technical review, returned, rejected, approved, loaded to payer, Paid, EFT and then closed. There are roughly 10 stages. This mimics the lengthy bureaucratic stages of the past NHIF HICS system that was intended to be cured under SHA. Clinical review claims can be stagnant for up to 5 months or more based on our experience to-date, and this is an area that requires much improvement.

Recommendation:

Reduce SHA claims processing stages and resolve all claims within 14 days from invoice claim date.

4. SHA payments

Kes 2.18B paid for FBO claims for the period October-December 2024, approximately 50% of all claims made for that period. Most of the remaining claims are held in the other stages mentioned above, especially under clinical review. The current Quarter claims are being paid at approximately 48% based on sample data of January and February 2025 (We have collected data for 217 KCCB facilities as you will see in the attached power-point presentation).

Recommendation:

Add key staff to address the clinical review stage, and/or resolve all cases under this stage within the recommended 14 days.

5. SHA staff capacity

Hospitals are unable to get adequate help from SHA regional offices. They seem not to have been trained or empowered to make any decisions. They always refer all questions/support requests to the system developer who appears to be outside of SHA, unreachable and with all authority.

This is collaborated by media reports quoting the Government Auditor General that the vendor of the 104Billion digital superhighway owns the system, the data, the reports and makes far-reaching decisions.

Recommendation:

SHA staff should be empowered with the necessary capacity and access to manage the SHA system for efficient services to clients and service providers.

6. Reconciliation

SHA system has no reconciliation function for claims inherited from November 2023 to September 2024.

Recommendation:

SHA to provide a transparent portal/dashboard for invoice tracking that can be downloaded for review by Hospitals. NHIF had good reconciliation reports. Provide access to that portal to resolve this portion of the transition reconciliations.

7. PHC and ECCIF

National budget allocated 4Billion (PHC) in July 2024 against a projection of Kes 61Billion; and a 107Billion for ECCIF. Primary health care is virtually collapsed in levels 2-3 and some level 4 facilities that opted to offer services-due to lack of capitation funds. The Quarter of January-March 2025 has not been paid to-date while capitation is expected to be paid upfront.

Recommendation:

Parliament to make adequate budgetary provision and address primary healthcare cash needs promptly. SHA to roll out a workable PHC services payment system, but in the interim use the old capitation model that was simple, predictable and enhanced patient follow-up as they selected a facility every Quarter. Parliament should increase ECCIF funds allocation and gazette appropriate ECCIF tariffs on priority basis.

8. MAKL Claims

The schemes for Teachers, Police and Prisons funded by Government at approximately Kes 20Billion now 10 years on and counting with the same vendor.

FBO Hospitals on MAKL medical scheme have not been paid for periods since July 2024 to date, and for some hospitals, even more months; with a very complicated process of payment, intimidation of Hospitals, unfair business practices and apparent conflict of interest where specific private Hospitals are favored in payments and contract terms.

Recommendation:

The Teachers, Police and Prisons schemes being funded using public funds; be transferred and placed under SHA to strengthen SHA financial sustainability due to economies of scale. This happened for the Civil servant’s medical scheme:

The current MAKL scheme has some bad experiences in cases where the insurer rejects admissions, surgeries and other critical interventions for financial rather than medical reasons.

We demand that all MALK debts paid up by March 21, 2025.

Conclusion

The Faith-based leaders have reached a painful decision, since we cannot afford to take in more debt after numerous engagements with the Ministry of Health, SHA and all necessary Government leaders.

Consequent to the insufficiencies above, there is serious financial distress in FBO Health facilities; This has caused loss of jobs due to redundancies, unpaid vendors for medications and other commodities, threats of collapse and closure of Health facilities, Court cases by creditors, expensive bank loans, listing in CRB (credit reference bureaus) attachment of assets by creditors and inability to get further credit facilities.

Thus, the Kenya Faith Based Health Services Providers are issuing a 14-days ultimatum demanding for immediate payment of outstanding NHIF, SHA & MAKL debts totaling to Ksh.10 billion plus (NHF 6.8Billion, SHA 2.2Billlion and 1Billion for MAKL) to FBO health facilities failure to which, we will be forced to suspend offering services to beneficiaries of the said scheme and offer the services to them on cash payment basis.

Statement from Religious Leaders of Kenya Faith Based Health Services Providers

 

 

 

 

In a bustling village in Homa Bay County, Kenya, Frida Akinyi, 51, sat at her wooden workbench, her hands trembling over the familiar fabric. For almost 10 years, she had been the to-go-to seamstress in her community. Her skill with a needle and thread brought life to weddings, festivals, and everyday wear.

But in recent months, Frida had faced an unsettling reality — her eyes were failing her. Being the sole provider of her nine children, six of who were in school, she felt disheartened. She squinted, struggling to thread the needle that had always felt so at home in her hands.

Mean while, the frustration was mounting, not only in her but more so in the community. Customers began to seek other tailors, and her income dwindled. Frida did not have the money to see an ophthalmologist but was hoping for a solution to her poor vision.

One day, she heard about a free eye screening that was taking place at Kendu Adventist Hospital. Though she was skeptical, she decided to give it a try, as she would do anything for her family.

 She patiently waited in line early in the morning trying to be as optimistic as possible. Finally, it was her turn. The nurse explained the screening process and handed her a reading glasses self-screening chart in Luo, her native tongue. Her eyes glanced over the page as she realized she was unable to make out any of the words. She nervously told the nurse, “I can’t see anything.”

The nurse handed her a pair of reading glasses and, to her amazement, after putting then on, she was able to read the smallest line with no problem at all! She could do nothing else but smile; she was so grateful that this one pair of glasses could help her and her family. All a long, she had been suffering from Presbyopia, a refractive error that occurs when the lens of the eye hardens and loses elasticity, making it difficult to focus light on the retina. The condition usually begins around age 40 and worsens over time. It has no cure but can be corrected with glasses, contact lenses, or surgery. 

With a renewed sense of hope, Frida thanked the nurse and told her just how much this would changed her life. Her gratitude to the Africa Clear Sight Project was boundless. The Kendu Adventist Hospital staff took time to follow up on Frida, who narrated to them the difference that pair of glasses had made in her life.

She feels more confident in her work, adeptly manipulating the thread and needle as she had always done before she got Presbyopia. The reading glasses not only restored her vision but also provided her with the ability to work again and provide for her family.

Frida began telling her story to her family and friends, encouraging them to seek help for their vision problems. Now, her shop stands as a testament to the power of interventions that might seem small but make a huge difference in the lives of the people they touch. She not only threads needles but sews hope into her community, one stitch at a time.

Click here to learn more about the Africa Clear Sight Partnership Project 

It is nearly 10am in Olasiti Village in Narok County and most people are already busy with their daily chores. Today is, however, not an ordinary day. By 10:30am, the men begin trickling into the AIC Olasiti Church compound. By 11am, the crowd is sizeable, and goat meat is boiling away merrily in a large pot set on an open fire.

As the men arrive, they sit on plastic chairs under a huge tree in the Church compound. Soon all the plastic chairs are filled and the late comers either lean on something, perch on rocks, logs or whatever is available to be used as a seat.
The Clinical Officer In Charge at AIC Olasiti Dispensary, Julius Pion, locally known as Daktari Pion, calls the meeting to order and the men quickly heed his calls to pay attention.

Daktari Pion has organized a male dialogue day where the men in Olasiti Village will discuss reproductive health and other health challenges facing their community. Daktari Pion holds the male dialogue forums at least one day every month in different villages within the health facility catchment area. With 16 villages in his facility catchment area, he has a lot of ground to cover.

The male dialogue forums are part of CHAK efforts to strengthen community-based interventions towards increasing demand for essential reproductive, maternal, newborn, child and adolescent health services such as Antenatal Care (ANC) and Skilled Birth Attendance (SBA). This includes rallying men to support the continuum of maternal and child health services.

The AIC Olasiti male dialogue forum is one of over 50 such meetings supported by the CHAK RMNCAH Programme in the four counties of Narok, Turkana, West Pokot and Marsabit over the past two years of implementation, reaching over 2000 men. The counties were selected for support due to poor maternal and newborn health outcomes, inadequate access to maternal health and newborn services and information, cultural practices such as Female Gentile Mutilation (FGM) and early marriages leading to increased dangers during pregnancy and childbirth, thus contributing to Kenya’s high maternal mortality rate.

Data shows that the performance of Narok County is lower than the national average for most reproductive health indicators.
Comparison of Narok County and national reproductive health indicators (KDHS 2022)

In organising the male dialogue forums, Daktari Pion works closely with the Sub County Community Health Assistant (CHA), Community Health Promoters (CHPs), area chiefs, faith leaders and other health care workers. The CHPs begin mobilizing the men to attend the meeting three days prior to the arranged date. Religious leaders support in dissemination of messages to the men in the local community to attend the dialogue days. The chief provides security and encourages the men to attend the meeting, including informing the village elders of the intended forum.

The health topics discussed during the men dialogue forums that on average last two to three hours are quite diverse and include early ANC attendance, attendance of eight ANC contact visits, preparation for Skilled Birth Attendance (SBA), child immunization, nutrition for pregnant women, breast feeding, postnatal care, post partum family planning, personal hygiene, relationships, child spacing and family planning, female genital mutilation and its risks, early pregnancies and sexually transmitted infections. The men are also given information on and screened for diabetes, hypertension and HIV.

As evidence of progressive change, Daktari Pion says AIC Olasiti Health Centre currently sees 50 plus ANC cases and does 15-22 deliveries monthly, compared to one delivery when the health facility began offering maternity services in 2018.
Today, Daktari Pion will be giving information on modern family planning methods to the men to address myths and misconceptions and encourage uptake of the contraceptive methods. Support from the men, who are the heads of their families, can go a long way in improving uptake of the methods.

The Clinical Officer also hopes to encourage the men to actively participate in their partners’ pregnancy journeys by giving financial assistance for health care and nutrition, taking a keen interest in the health of the mother and baby and ensuring adequate rest for their pregnant and lactating wives.

The men listen keenly as Daktari Pion goes skillfully through each topic, nodding in agreement with some of his statements but completely disagreeing with others. Many of them disagree that they should accompany their wives to the health facility for ANC visits, but they are united in agreeing that girls should be allowed to complete schooling before being married. Daktari says that although the men are reluctant to accompany their wives to ANC and PNC visits, most of them give financial support and even follow up on their wives’ visit to the health facility through phone calls to him.

Addressing myths and misconceptions about family planning 
Moving swiftly to the discussion on modern contraceptives, Daktari explains each method in detail. The CHAK team, led by RMNCAH Programmes Coordinator Jane Kishoyian, are present in today’s meeting and have carried with them samples of each contraceptive method. The samples are circulated among the men who get to see them up close and touch them.

While 99.5 per cent of the men have seen a condom, other modern contraceptive methods such as the IUCD, implant and female condom attract a lot of attention from the men, many taking time to examine the samples closely and exclaim at their appearance.

Many of the men admit to having used the male condom but believe modern contraceptives have serious side effects on the health of their wives and negative implications on their fertility. Some of the men say modern contraceptives cause pain to the male during sexual intercourse. However, the CHAK team and Daktari Pion are on hand to give the correct information about modern contraceptives to the men.

The older men have a hard time accepting the use of modern family planning methods, while the younger ones are more interested in establishing whether the myths and misconceptions are true. Acceptance of modern family planning methods is still very low in the Olasiti community although this is changing slowly as more people get information from reliable sources, including health care workers in the CHAK RMNCAH programme which began in 2022. Short term methods (depo) are preferred by the women who are currently using modern family planning methods.

The CHAK RMNCAH programme has trained health workers from the 60 implementing health facilities on Focus Antenatal care, Adolescent and Youth friendly training, NCDs (Diabetes and hypertension) in pregnancy, essential newborn care, post-natal care and management of pregnancy related complications and baby friendly health initiatives (BFHI). Additionally, Community Health Promoters from 15 counties have been trained on community package of care.

The programme supports the male dialogue meetings by ensuring the men have something to eat on the day of the meetings. The programme also provides the health care workers and Community Health Promoters with transport and lunch on the day of the event. The CHPs mobilise the men to attend the event and provide blood pressure and diabetes screening services for the men who attend the event. The CHPs are equipped with a kit containing a digital blood pressure machine, a glucometer machine and 50 strips as well as a thermometer. The CHPs are well trained to screen for these conditions. Men suspected to have any of these conditions are reviewed at a later date and if the readings remain abnormal are referred to the nearest health facility.

At the end of the discussion, the men sit together, each with a piece of boiled meat in his hand, using a traditional Maasai knife to cut meat held at one end by the teeth.

The age-old Maasai practice of men sharing goat meat continues but some things are slowly changing. Despite challenges the of poor transport infrastructure, especially felt during the rainy season and long distances to health facilities, a large majority of the men are ensuring their wives and babies receive antenatal and post-natal care and births take place in a designated health facility. They also ensure that their women get nutritious food and children are immunized. Additionally, the men are slowly being convinced of the need to adopt modern family planning methods.

HIV testing is a crucial entry point to both HIV prevention and treatment efforts. Early detection through testing allows individuals to know their status, seek timely medical interventions, and adopt preventive measures to reduce the risk of transmission. Testing also plays a pivotal role in connecting people to life-saving antiretroviral therapy (ART) and support services.

For men, who are often part of high-risk populations due to factors such as lower testing rates and higher engagement in certain risky behavior, regular HIV testing, with linkage to prevention or treatment services as appropriate is especially critical.

According to the Kenya Demographic Health Survey 2022, men were less likely to test for HIV/AIDS despite being more likely to have multiple sex partners than women. The document reveals that 67 per cent of men aged 15 to 19 years have never tested while 27 per cent of those aged between 20-24 years do not know about their HIV status. Eleven per cent of men aged 25 to 29 have never been tested, 10 per cent of those between 30 to 34 have never tested, while 15 per cent of men aged 40 to 49, have never been tested. Of the men who have ever had sex, 31 per cent have never tested for HIV.

The Red Carpet Strategy innovation
To encourage men to test for HIV, CHAK, through its CHAP Stawisha project implemented an ambitious strategy dubbed the ‘Red Carpet Strategy’. This Differentiated Service Delivery (DSD) approach involves rolling out the red carpet to receive and welcome men seeking health services, simulating a VIP approach to HIV testing and prevention. The strategy seeks to provide a holistic service to improve access, mitigate stigma and ensure value addition by incorporating Non-Communicable Diseases (NCDs) and mental health screening, management and referral into the HIV testing and prevention package.

 

To implement the strategy, CHAP Stawisha works with high-volume health facilities with over 500-1000 clients current on HIV/AIDS care and treatment. The project also works closely with community leaders who avail spaces such as churches or public grounds for the VIP services, ensuring not only local ownership of the strategy but also cutting costs. Sometimes, the event is held within a health facility.

The process begins with mobilization of the men in the target community for the VIP health services, as they are known. Male champions do the mobilization, reaching out to their fellow men. CHAP Stawisha collaborates with health facilities in the target communities, Community Health Promoters, faith leaders, social and business groups to mobilize the men. The health facilities may print fliers or use other means for mobilization while the Community Health Promoters do door-to-door mobilization. The faith leaders involved also make announcements about the free services during the worship days closest to the Red Carpet Day. Additionally, leaders of social-economic groups, e.g. boda boda and women’s chamas are looped in and asked to sensitize their members on the event. The women play the critical role of relaying information to the men around them. Some women also escort their partners to receive the services.

As the men arrive, they walk on the red carpet to the entry point where they are received and directed to a screening point. At the screening point, those eligible for HIV testing are segregated after being screened for NCDs and mental health. A screening tool is used to determine who is eligible for HIV testing.

Those eligible proceed for HIV testing and blood sugar monitoring. If found to be HIV-negative, the men are initiated on either event-based prep or daily oral prep based on their HIV risk profile, while those identified as HIV-positive are escorted to the health facility to be initiated on ART.

HIV self-test (HIVST) complements existing testing approaches such as the rapid test. Directly Assisted HIV Self Test service delivery approach is utilized during red carpet; trained health service providers and peer educators demonstrate to the client how to perform and interpret the HIVST test. The client then does the self-test and interprets the results. Clients who are found to be HIV-positive are taken through counselling, a confirmation retest using rapid test and treatment started.

The Social Network Strategy (SNS) has been incorporated within the Red-Carpet Strategy to reach more men with HIV services. The SNS strategy is based on the principles that people in the same social network share the same behavior that increases the chances of getting or transmitting HIV, and, in addition, that people in the same social network know and trust each other; summarized as screen me, test me, know my background, identify more people. In the Red-Carpet Strategy, men initiated on PrEP and ART are oriented on SNS and become recruiters who reach out to others who are at substantial ongoing risk of exposure to HIV within their social circles. The recruiters either refer or escort the men for HIV testing during a planned Red Carpet community event or to the facility

The project liaises with the sub-counties to provide condoms during the event where possible.

Red Carpet outcomes
The red carpet strategy has proven to be an effective strategy in reaching men for HIV prevention and treatment services. Through the strategy, a total 4,515 men utilized the VIP services over a 12-month period. A total of 10 New HIV positive clients were identified and initiated on ART, while a further 1,663 men were started on PrEP, an 8-fold increase in PrEP uptake among men.

For diabetes management, hypertension and mental health, referrals are made to the nearest county health facilities. A total of 52 new Hypertension (HTN) clients, 25 new Diabetes Mellitus (DM) clients, and 18 mental health (depression and generalized anxiety disorder) cases have been referred for treatment.

Overall, men express satisfaction and demonstrate high acceptance of the community level VIP services.

Challenges and mitigation measures
A key challenge faced by the strategy is the men not returning to the health facility for retest and PrEP refills. HIV retest is recommended as a follow up to ensure those continuing PrEP are still HIV negative. The program has developed a patient survey questionnaire to elicit patient perceptions of barriers and enablers to male prevention programming, and to complement the client centered red carpet approach, client education and to inform differentiated service delivery that responds to the client unique needs. This survey is administered by the healthcare workers to better understand client's response to the services being offered, understand where, what, and how to improve service provision, understand challenges faced by the clients in accessing services, as well as client's preference on service model to scale up uptake and strengthen retention.

Additionally, there is still low knowledge and awareness about HIV prevention, treatment and care services in communities. For example, most men are unaware of interventions such as event driven Prep (ED Prep) to prevent HIV infection as well as additional bio medical ARV based prevention such as injectable PrEP. Interventions such as the Red Carpet Strategy serve to cascade such knowledge from the facility to the community level.

Next steps
The red carpet strategy has shown demonstrable success, posing a best practice that needs to be scaled up beyond the high volume facilities initially targeted by this initiative, for a men-responsive HIV prevention programming at all levels of the healthcare system. To scale up and replicate this community-based HIV testing and PrEP provision service targeting men, several key steps are essential. First, partnerships with the government, local hospitals, community leaders, and men's groups should be strengthened to ensure culturally sensitive outreach and trust-building. Expanding access points in male-dominated settings such as workplaces, sports clubs, and social venues can increase testing uptake and PrEP access. Providing integrated community HIV services will enhance convenience, appeal and acceptance. Training healthcare providers to deliver gender-sensitive care and addressing stigma around HIV in these communities is vital. Regular monitoring and evaluation of these programs will help adapt strategies, ensuring scalability and sustainability for broader impact.

 

The Government has assured CHAK health facilities of a smooth transition to the Social Health Authority (SHA/SHIF) whose implementation will kick off in July 2024. The assurance comes in the wake of heightened engagement between CHAK facilities and NHIF to address delayed claims payments.

Delegates at the CHAK Annual Health Conference 2024 were informed that every Kenyan would be required to register afresh for SHA/SHIF. Bio metric registration would be done for all beneficiaries while every child would be registered within 14 days of birth.

The SHA/SHIF is mandated by the law to:

• Register beneficiaries
• Manage funds received under the Social Health Insurance Act 2023
• Receive all contributions
• Empanel and contract healthcare providers and healthcare facilities
• Make payments to contracted healthcare providers and healthcare facilities out of the relevant fund as provided in the Act.

 

According to Julia Ouko who delivered a presentation on behalf of Dr Samson Kuhora, a law on empanelment and contracting would be formulated and a body put in place to run this function. A benefits panel would review benefits after every two years in consultation with CS-Health.

The delegates were further informed that although empanelment was not guaranteed, licensed health facilities in the country would be central to the implementation of the new policy direction.

Claims management would be done through claim settling agents and medical insurance providers. A tribunal would be set up to settle disputes although any decision could be appealed in law.

Speaking at the Annual Health Conference, Mr Chrisostim Wafula, Manager, Claims Management, NHIF/SHA told representatives of CHAK health facilities and other delegates that a multi-disciplinary team has been formed to support high volume hospitals in the claims reconciliation process as the transition process continued. The reconciliations were expected to be completed by June 30 with the process coordinated from NHIF/SHA head office.

Surgical claims flagged in 2023, some of which were way above the contract rates, had already been released to NHIF branches for processing and would follow the normal payment routes while old e-claims would be released at the end of April 2024 for processing.

Further, NHIF had received money from Government and would be processing Linda Mama claims. Capitation would be paid to the health facilities in the month of May.

Some CHAK member health units confirmed that they had received NHIF payments during the third week of April. However, the facilities continued to express reservations at the slow pace of claims payments, especially given the short time period left before the start of SHA implementation.

According to the delegates, some claims had been pending for over seven years and there were cases of capitation being paid using a wrong formula. The health facility representatives termed this unfair given that the capitation was already too low for the services offered.

The challenges had further been compounded by the on-going doctors’ strike that had pushed huge numbers of patients, especially those critically ill, to the CHAK facilities, given that county health services had ground to a halt.

Further, lower level health facilities were struggling with claims and there was no guarantee they would be empaneled for SHIF due to challenges with internet connectivity. Although the Government had embarked on installation of fibre optic cables, this was mainly serving county and sub county offices and adjacent areas. Lack of internet connectivity would greatly impact Level 3 health facilities which served a large number of clients.

The CHAK member health units also expressed concern that many clients were unaware of the NHIF benefits package and called on the Government to address this shortcoming during the SHA/SHIF implementation. The delegates were informed that there was a plan to communicate the SHA/SHIF package through the division of benefits.
Further, the delegates were briefed on the referral system in the new system. Patients would be referred to Level 4 and 5 health facilities from Level 2 and 3.

The Social Health Insurance Act 2023 establishes three new funds, namely, the Primary Healthcare Fund (PHF) which will be accessed in Level 2 and 3 health facilities upon registration to SHIF, the Social Health Insurance Fund (SHIF) which will be accessed in Level 4, 5 and 6 health facilities upon registration and up to date premiums, and the Emergency, Chronic and Critical Illness Fund (ECCIF) to be accessed upon depletion of SHIF cover.