Kenya's Social Health Authority (SHA) marks a watershed moment in the country's healthcare financing journey. As SHA replaces NHIF and becomes the default insurance framework for all licensed health facilities, the question every facility administrator must answer is: Is your EMR ready?
AfyaHub EMR is built for exactly this moment — a unified, end-to-end digital health platform that integrates SHA at every level of Kenya's health system.
🏥 Kenya's Health System Levels & SHA Integration
Kenya's health system operates across six levels. AfyaHub supports SHA claims and workflows at every tier:
Level 1 — Community Health Units (CHUs)
- Community Health Promoters (CHPs) register patients and link them to SHA numbers
- Preventive care visits documented and submitted for SHA capitation
- Referral letters generated digitally with SHA pre-authorization
Level 2 — Dispensaries
- SHA member verification at point of care
- Outpatient consultations, prescriptions, and diagnostics billed directly to SHA
- Offline-first capture ensures no claim is lost during connectivity outages
Level 3 — Health Centers
- Maternity, minor surgery, and inpatient SHA billing
- Integrated pharmacy management with SHA drug benefit lists
- Real-time SHA eligibility checks
Level 4 — Sub-County Hospitals
- Full inpatient SHA DRG (Diagnosis-Related Group) billing
- Theatre, lab, radiology, and ward billing integrated
- SHA pre-authorization workflows for elective procedures
Level 5 — County Referral Hospitals
- Complex case SHA billing with multi-department coordination
- Referral tracking from lower levels with SHA continuity of cover
- County-level SHA performance dashboards
Level 6 — National Referral Hospitals
- Specialized SHA benefit packages (oncology, cardiac, renal)
- National-level reporting to SHA and MoH
- AI-powered claims optimization to minimize rejections
🔄 End-to-End Architecture: How It All Connects
AfyaHub's architecture creates a seamless patient journey across all levels:
- Patient Registration — SHA number verified at first contact point (Level 1 or 2)
- Clinical Encounter — diagnosis, prescriptions, procedures documented in AfyaHub
- Automatic Billing — SHA-eligible services identified and claim generated in real time
- Claims Submission — electronic submission to SHA portal with supporting clinical documentation
- Referral Continuity — patient record and SHA cover follow the patient across levels
- Reconciliation — payment tracking, rejection management, and appeals workflow built in
✅ Why SHA + AfyaHub Is the Future
- 💰 Maximize SHA revenue — no missed billable encounters
- 🛡️ Reduce claim rejections — AI-powered claim scrubbing before submission
- 📊 Real-time dashboards — track SHA revenue vs. service delivery at every level
- 🔒 Audit-ready records — complete clinical and financial documentation for SHA audits
- 🌍 Works offline — SHA billing continues even without internet connectivity
🔗 Build Your SHA-Ready Facility Today
Whether you're a Level 2 dispensary or a Level 6 national referral hospital, AfyaHub EMR gives you the infrastructure to make SHA work for your facility — not against it.
Start the conversation: https://www.afyahubemr.com