The Ministry of Health and the Council of Governors have signed an agreement to establish a new contracting cycle for county health facilities under the Social Health Authority (SHA) for 2026-2029. The deal was concluded on October 5, 2026, at Afya House in Nairobi. This agreement aims to clarify county authority, claims payments, and compliance requirements for county health facilities. The meeting included representatives from the Digital Health Agency and health regulators.
A letter from governors on September 28 raised concerns about the earlier draft contracts, prompting the need for a revised framework. Under the new agreement, facilities will first sign a Master General Terms and Conditions contract, followed by separate contracts for each fund that purchases their services. These funds include the Primary Healthcare Fund and the Social Health Insurance Fund. This new structure is expected to streamline the contracting process and improve relationships between county governments and health facilities.
County governments are now recognised as contracting parties, and each facility must obtain clearance from the County Executive Committee Member for Health before signing any contracts. This change aims to enhance county governments' involvement in the contracting process and ensure that facilities meet necessary requirements. The agreement also allows counties to submit proof of legal status, KRA PIN, tax compliance certificates, and NSSF compliance documents.
The Digital Health Agency will assist counties lacking registered domain names to obtain required email sub-domains by October 14, 2026. Payments will continue to be made into each facility's Facility Improvement Financing account. The new framework stipulates that clean claims will be paid within 90 days of receipt, and any shortfall will be notified within seven days. This payment structure aims to improve the financial stability of health facilities.
Unpaid clean claims will be recorded as certified liabilities, carried forward as the first charge on the next appropriation, and settled within the same financial year. This process is subject to parliamentary appropriations and will be conducted without interest, under the 2024 Social Health Insurance Regulations. Existing SHA contracts have been extended to October 14, 2026, to allow services and claims to continue while facilities transition to the new framework.
A 30-day compliance moratorium applies to certain statutory documents, after which facilities meeting other requirements will be conditionally contracted and given 30 days to submit outstanding paperwork. Implementation of the new framework will be overseen by a Joint Technical Committee comprising SHA, the Council of Governors, and County Health Departments. This committee will ensure a smooth transition and provide support to counties and health facilities as needed.
The SHA is scheduled to meet County Executive Committee Members for Health on October 6, 2026, and conduct contracting clinics in every county between October 5-14. Weekly county-by-county updates will be issued until all eligible facilities are contracted. The Cabinet Secretary for Health and the Council of Governors will review progress before October 14, ensuring that the new framework is implemented effectively and efficiently.
Key points
- The Ministry of Health and Council of Governors have agreed on a new contracting framework for county health facilities under the Social Health Authority (SHA) for 2026-2029.
- County governments are now recognised as contracting parties, and facilities must obtain clearance from the County Executive Committee Member for Health before signing contracts.
- The new framework stipulates that clean claims will be paid within 90 days of receipt, and unpaid claims will be recorded as certified liabilities and settled within the same financial year.
