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Health CS Duale lists 36 healthcare services not available in Kenya under SHA

Brian Kimani
By Brian Kimani September 20, 2025 01:02 (EAT)
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Health CS Duale lists 36 healthcare services not available in Kenya under SHA
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The Ministry of Health has gazetted a list of 36 healthcare services that are currently not available in Kenya, citing gaps in expertise, equipment, and medical supplies. 

In a Gazette Notice signed by Health Cabinet Secretary Aden Duale, the decision followed recommendations by the Social Health Authority (SHA) and the Benefits Package and Tariffs Advisory Panel (BPTAP). 

The services listed include advanced joint replacement surgeries, highly specialized cancer therapies, and complex transplant procedures.

Among the services declared unavailable are wrist joint arthroplasty, metacarpal joint arthroplasty, and ankle joint arthroplasty. The ministry explained that the procedures could not be offered due to lack of surgical expertise, advanced implants, and limited access to prostheses.

Also included in the list are allogeneic bone marrow or peripheral blood stem cell transplants, which the government said cannot be performed because only autologous transplants are currently available in a few centres, with allogeneic capacity remaining inadequate. 

Other unavailable services include transjugular intrahepatic portosystemic shunts, Yttrium-90 (Y-90) radio-embolisation for cancer treatment, and proton therapy, which is widely used in advanced oncology care abroad but has not been introduced locally.

The gazette also highlighted gaps in handling neurophysiology-related procedures such as surgical management of birth-related brachial plexus injuries, nerve ablation therapy, and neural regenerative therapy, attributing the absence of these services to a lack of specialised equipment and trained personnel.

By making the list public, the Ministry of Health said it aimed to provide clarity on services not accessible under the Social Health Insurance Fund (SHIF) and to guide investments in the health sector.

Here's the full list: 

  • Wrist joint arthroplasty – Lack of dedicated joint replacement and implant availability

  • Metacarpal joint arthroplasty – Limited prosthesis access and expertise
  • Ankle joint arthroplasty – Lack of surgical expertise and advanced implants
  • Whole femoral replacement – No access to mega-prostheses
  • Proximal femoral replacement – Inadequate oncology infrastructure
  • Distal femoral replacement – Lack of implants and training
  • Proximal tibial replacement – Not routinely performed due to resource limitations
  • Allograft use – No national bone bank
  • Complex congenital heart surgery requiring ECMO in paediatrics – Lack of ECMO capacity and ICU support
  • Liver transplant – No paediatric liver transplant program
  • Bone marrow transplant – No dedicated bone marrow transplant (BMT) units
  • Kidney transplant (paediatric) – Underdeveloped paediatric nephrology services
  • Intrathecal chemotherapy for retinoblastoma – Limited access to specialist paediatric oncology
  • Laryngeal transplant – No national legal framework for larynx transplantation
  • Intrauterine blood transfusion – Lack of foetal therapy centres and trained maternal-foetal specialists
  • Intrauterine shunt placement (bladder outlet obstruction, hydrothorax, cysts) – No capacity for intrauterine surgical procedures
  • Intrauterine vesicocentesis, thoracentesis, paracentesis – Lack of interventional radiology in maternal-foetal settings
  • Fetoscopy, amniotic band ligation, laser ablation – Absence of fetoscopic instruments and trained personnel
  • Amnioreduction, amnioinfusion – Rarely performed due to risk and limited technical skills
  • Foetal reduction, cord occlusion, cordocentesis – Lack of access to selective foetal reduction tools and protocols
  • Advanced endometriosis excision – Limited advanced laparoscopic skills among gynaecologists
  • Sacral neuromodulation for urinary/faecal incontinence – No neuromodulation equipment or trained urogynecologists
  • Peptide receptor radionuclide therapy (PRRT), specifically Lutetium-177 – Lack of licensed radiopharmaceutical handling units and specialist nuclear medicine infrastructure
  • DOTA-Tyr3-OctreotateTATE PET/CT scan (DOTA-TATE scan) – Diagnostic unavailability for neuroendocrine tumour staging
  • Fibroblast activation protein inhibitor PET/CT imaging – FAPI-based imaging unavailable nationally despite its value in detecting fibrotic and neoplastic lesions
  • Microwave ablation of metastatic tumours – No national capacity for percutaneous microwave tumour ablation
  • Chimeric antigen receptor T-cell therapy (CAR T-cell therapy) – Highly specialized cell therapy not yet authorized or available in Kenya
  • Bispecific T-cell engagers – No production or regulatory pathway for bispecific antibody-based immunotherapies
  • Allogeneic bone marrow/peripheral blood stem cell transplant – Only autologous transplants performed with limited centres; allogeneic capacity inadequate
  • Transjugular intrahepatic portosystemic shunt – Limited by unavailability of essential tools and consumables
  • Yttrium-90 (Y-90) radio-embolization – Lack of access to Yttrium-90 isotopes and delivery systems
  • Surgical management of birth-related brachial plexus injuries – Lack of neurophysiology equipment and trained personnel
  • Photopheresis (ECP – Extracorporeal Photopheresis) – Not available
  • Nerve ablation therapy – Lack of neurophysiology equipment and trained personnel
  • Neural regenerative therapy – Lack of neurophysiology equipment and trained personnel

  • Proton therapy – Not available

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