INTERVENTIONS PROPOSAL

The relevant stakeholders including the Authority, policy makers, the academia, members of the public, health professional associations, civil society organizations involved in matters of health, the Kenya Medical Supplies Authority and the county governments may propose interventions for inclusion in the benefits packages under regulation.

The proposals will be received by the HBTAP secretariat through various channels including direct requests by the Panel to key stakeholders; scheduled stakeholder meetings or forums; or digital platforms including hbtap@uonbi.ac.ke or by filling the form below.

REPUBLIC OF KENYA

SOCIAL HEALTH INSURANCE ACT, 2023

BENEFIT PACKAGE INTERVENTION PROPOSAL

FORM 4 (r. 45(2))

1. Name

2. Phone number

Email address

3. Profession

4. Organization

5. County

6. Name of intervention

7. Type of intervention

8. Proposed beneficiary for the proposed interventione.g., sickle cell patients

9. Reasons/justification for proposal of the intervention

10. Anticipated/Expected impact if the proposed intervention is included in the benefits package

11. Any additional information that you may want to provide about the intervention?*(You may attach a document in pdf format)*

Upload Supporting Document (Optional)*PDF format only, max 10MB

Upload a file

or drag and drop

PDF up to 10MB

Signature (Type your full name)

By typing your name above, you acknowledge that this constitutes your electronic signature.

Date

N.B. The form has to be duly filled for an intervention to be considered for selection