On October 1, 2024, the Ministry of Health officially launched the Social Health Authority (SHA) to replace the National Health Insurance Fund (NHIF). The new entity aims to achieve universal health coverage by providing affordable, accessible, and quality healthcare services to all Kenyans. Established under the Social Health Authority Act, 2023, the scheme mandates all workers to contribute 2.75% of their gross salary to the fund.

Why SHA?

• Wider Coverage & Inclusivity – Unlike the NHIF, which primarily targeted the formal sector and employed individuals, SHA aims to provide health insurance for every citizen, including those in the informal sector and vulnerable groups who have been historically underserved.

• Revised Premiums & Contributions – SHA has a tiered contribution system that factors in the income levels of contributors. This system will replace the flat rate under the NHIF, making the insurance model more progressive and equitable.

• Comprehensive Benefits Package – SHA covers a broader spectrum of health services, including outpatient services, chronic disease management, and maternal and child health, which aligns with the Universal Health Coverage goals.

Under this new regime, the minimum monthly contribution has come down to Ksh. 300 from Ksh. 500 under the NHIF.

SHA is the overall manager that keeps track of the three separate accounts, namely:

• The Primary Health Care Fund

It is fully funded by the government. All Kenyans registered for SHA will be automatically registered for the Primary Healthcare Fund. It is used when visiting level 2 and level 3 facilities or upon referral by community health promoters, where patients are treated for free.One will be able to access promotive, preventive, curative, rehabilitation, palliative care and referral services from this fund.

• The Social Health Insurance Fund (SHIF)

This is funded by taxpayers using the 2.75% of gross salary contributions. It is primarily used in levels 4, 5 and 6 , and will only be accessed through a referral from a primary health facility.

• The Emergency Chronic and Critical Illness Care Fund (ECCIF) 

It is a special fund that caters for emergencies and chronic illnesses, after exhausting limits under the Social Health Insurance Fund.