Kenya's move from NHIF to the Social Health Authority (SHA) — the system most people call Taifa Care — is the biggest change to how facilities get paid in a generation. It also generates a lot of noise. Here's the short, practical version for a Level 2–3 clinic or a pharmacy.
What actually changed
NHIF became SHA, and claiming moved onto a digital rail. In practice that means three things for you:
- Claims are electronic. A paid visit becomes a structured FHIR claim bundle submitted through the Digital Health Agency's API — not a paper form.
- Diagnoses must be coded. Claims carry ICD-11 codes, so "malaria" on a scrap of paper isn't enough; it needs the code behind it.
- Certification is the gate. To be SHA-contracted, your software has to be DHA HMIS-certified. No certification, no SHA billing.
Why you don't have to wait
Here's the part that gets lost: most small private facilities are cash-only today. They run on cash and M-Pesa, and they will for a while.
So the smart sequence isn't "wait for SHA, then digitise." It's the reverse:
Go digital now for the value you get today — one patient record, stock that doesn't expire, M-Pesa that reconciles, an eTIMS invoice on every sale — and switch on SHA claims the moment your certification lands.
That way you're not paying for paper's inefficiency while you wait on a regulatory process you don't control.
What to look for in software
If SHA is on your horizon, make sure whatever you adopt is built to certify, not bolted-on afterwards:
- Coded from day one — ICD-11 on diagnoses, so the data's ready.
- Claims built from the visit — not retyped at day's end.
- eTIMS on every transaction — a separate, income-tax rule that already applies, SHA or not.
- A clean integration seam — so live SHA, M-Pesa and eTIMS credentials drop in without re-doing your workflow.
Salus is built exactly this way: cash-first today, SHA-ready underneath. When your contracting lands, you flip a switch — you don't start over.