The Ministry of Health, the Council of Governors, the Social Health Authority (SHA), the Digital Health Agency and health regulators signed a deal on Monday, 5 October 2026 at Afya House in Nairobi, establishing how county health facilities will be contracted under SHA’s 2026‑2029 cycle and allowing services and claims to continue during the transition.

Under the new framework, facilities will first sign a single Master General Terms and Conditions contract, then enter separate contracts for each fund that purchases their services, including the Primary Healthcare Fund, Social Health Insurance Fund, Emergency, Chronic and Critical Illness Fund, and the Public Officers Medical Scheme Fund.

County governments are now recognised as contracting parties; each facility must obtain clearance from the County Executive Committee Member for Health before signing, and the County Attorney must review the contracts.

Facilities with their own tax registration must provide individual documents, while an undertaking on KRA compliance will apply where relevant; NSSF compliance certificates are accepted for staff employed by the county.

Data protection compliance can be demonstrated with a registration certificate from the Office of the Data Protection Commissioner listing all covered facilities, and Level 4 and 5 facilities must also submit recent audited financial statements; Level 2‑3 facilities use the latest audited county statements.

Each facility must operate an official email address using a sub‑domain of the county’s domain; the Digital Health Agency will help counties without registered domains obtain the required sub‑domains by 14 October 2026.

Fee schedules from the County Finance Act will serve as price lists, and any changes must be reported to SHA with the effective date; payments will follow SHA tariffs or negotiated rates.

SHA will pay clean claims within 90 days of receipt, in order of receipt, and will notify facilities if payment cannot be made by the 14th of the month; unpaid clean claims become certified liabilities carried forward as the first charge on the next appropriation and must be settled within the same financial year.

Existing SHA contracts have been extended to 14 October 2026 to allow services and claims to continue while facilities complete the new contracting process, but no further extensions will be granted.

A Joint Technical Committee of SHA, the Council of Governors and County Health Departments will oversee implementation, with SHA meeting County Executive Committee Members for Health on 6 October and conducting HAKIKA contracting clinics in every county between 5 October and 14 October, followed by weekly county‑by‑county updates until all eligible facilities are contracted.

The Council of Governors will also assist Level 5 hospitals in completing their HMIS transition by 30 October 2026, and the Cabinet Secretary for Health and the Council of Governors will review progress before 14 October, continuing consultation on outstanding issues.