The Social Health Authority (SHA) has issued new guidelines to contracted healthcare providers aimed at streamlining the processing of healthcare claims for children living under alternative care arrangements.
In a notice dated July 16, 2026, SHA said it had observed inconsistencies in the documentation submitted in support of claims for children under alternative care, prompting the introduction of minimum documentary requirements for different categories of care.
“The Social Health Authority has observed inconsistencies in the documentation submitted in support of claims for children under alternative care arrangements,” the notice states.
SHA said the new requirements are intended to ensure consistency in claims processing while safeguarding uninterrupted access to healthcare services for eligible beneficiaries.
“To promote consistency in claims processing and ensure uninterrupted access to healthcare services for eligible beneficiaries, the Authority hereby guides the minimum documentary requirements applicable to the various categories of alternative care,” the notice adds.
Under the guidelines, healthcare providers must verify specific legal documents depending on the child’s care arrangement. These includel; certified adoption orders for adopted children, guardianship orders or deeds for children under legal guardianship, custody orders or letters from Children’s Officers for kinship care, and foster care placement approvals or relevant court orders for children in foster care.
The notice also outlines documentation required for children living in charitable institutions, those placed with relatives through court orders, children under parental responsibility arrangements, and those under Kafaalah, an Islamic child care arrangement recognised in law.
SHA said the move is expected to eliminate delays arising from incomplete or inconsistent documentation and improve the efficiency of claims processing across contracted health facilities.
Healthcare providers seeking clarification have been advised to contact the Authority through its toll-free number, 147.
The notice was signed by SHA Chief Executive Officer Dr. Mercy Mwangangi, reaffirming the Authority’s commitment to ensuring eligible children continue accessing healthcare services without unnecessary interruptions.
