SHA Maternity Benefits: What's Covered and What's Not

You're expecting a baby.

First thought: amazing. Second thought: how much is this going to cost?

Good news: SHA covers maternity.

But (there's always a but) — it doesn't cover everything, and there are rules you need to know before that due date.

Let me break it down.

Table of Contents

• What SHA Maternity Covers
• What SHA Doesn't Cover
• The Maternity Waiting Period
• Where to Deliver with SHA
  • Public Hospitals (Fully Covered)
  • Private Hospitals (Partial Coverage)
• Step-by-Step: Using SHA for Maternity
  • Before Pregnancy
  • During Pregnancy
  • During Delivery
  • After Delivery

What SHA Maternity Covers

Here's what's included under SHA maternity benefits:

Bottom line: SHA covers the essentials for a healthy pregnancy and delivery.

What SHA Doesn't Cover

Here's where you'll pay out of pocket:

Important: If you want a private room at Nairobi Hospital with your specific doctor, SHA alone won't cover that. You'll need private insurance or pay cash.

The Maternity Waiting Period

This is the part that catches people off guard.

SHA has no dedicated maternity waiting period.

Unlike private insurance (where maternity often has a 10–12 month waiting period), SHA covers maternity from the day your contributions are active.

However:

• Your general SHA registration must be complete
• You must have made at least one contribution
• The 30-day general waiting period for new members applies

In practice: If you've been contributing through your employer for months, you're good. If you just registered last week, wait 30 days.

Where to Deliver with SHA

SHA covers delivery at accredited facilities:

Public Hospitals (Fully Covered)

• Kenyatta National Hospital
• Pumwani Maternity Hospital
• Mama Lucy Kibaki Hospital
• Mbagathi Hospital
• County referral hospitals
• Sub-county hospitals
• Health centers with maternity

Pros: No additional cost, professional care Cons: May be crowded, general ward

Private Hospitals (Partial Coverage)

SHA also works at private facilities, but:

• Co-payments may apply
• Room upgrades cost extra
• You'll sign a cost-sharing agreement

Private facilities accepting SHA:

• Nairobi Hospital (with co-pay)
• Aga Khan Hospital (with co-pay)
• Karen Hospital (with co-pay)
• Nairobi Women's Hospital
• Avenue Healthcare branches
• Many mission hospitals

Call ahead to confirm SHA acceptance and expected costs.

Step-by-Step: Using SHA for Maternity

Before Pregnancy

1. Verify your SHA status is active (use the SHA Super App)
2. Check that your spouse is listed (if applicable)
3. Know your contribution history — no arrears

During Pregnancy

First trimester:

1. Visit any SHA-accredited clinic for antenatal
2. Present your ID for verification
3. Get your first tests done (blood type, HIV, etc.)
4. Receive your antenatal card

Second trimester:

1. Continue monthly antenatal visits
2. Get ultrasound(s) as recommended
3. Start planning your delivery location

Third trimester:

1. More frequent checkups
2. Confirm your delivery hospital accepts SHA
3. Pack your hospital bag
4. Know the SHA emergency number (0800 720 500)

During Delivery

1. Go to your chosen SHA facility
2. Present your ID for SHA verification
3. If emergency, any accredited facility will admit you
4. SHA covers delivery costs within limits

After Delivery

1. Postnatal checkups for mother (up to 6 weeks)
2. Newborn vaccinations (covered under SHA)
3. Any complications treated under SHA