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Kenya’s SHIF rollout marks a bold leap toward equitable, universal healthcare—replacing NHIF with a fair income-based scheme and vastly expanding benefits. Despite legal hurdles and operational hurdles—especially integrating informal workers and ensuring full public participation
Following passage of the Social Health Insurance Act in late 2023, the Social Health Authority (SHA) was established and the Social Health Insurance Fund (SHIF) officially launched on 1 October 2024, replacing the legacy NHIF .
Contributions: salaried workers contribute 2.75% of gross wages (min KSh 300, no cap), while informal sector members pay a flat rate .
Registration began earlier, in July 2024, and by January 2025, over 17.8 million Kenyans had signed up .
The SHIF rollout faced legal challenges:
A High Court ruling in July 2024 found parts of the Act unconstitutional—specifically sections barring emergency care for non-contributors and inadequate public deliberation .
However, the Court of Appeal in September 2024 issued a stay of that judgement, allowing SHIF implementation to continue while the appeal is heard ().
SHIF offers far broader coverage and fairness compared to NHIF:
Includes inpatient, outpatient, mental health, chronic disease, maternal care, and emergency services .
Replaces NHIF’s flat band premiums with income-relative contributions, easing the cost burden on lower earners .
Targets universal coverage—all residents, including informal sector workers, students, refugees, and persons with disabilities, are now required to register .
Registration and management are digital-first: via SHA portals, biometric verification, and USSD/SMS services .
Employers must enroll employees and dependents by 1 October 2024 .
Contributors can check their SHIF status using USSD (*155#), SMS (21101), or the online portal .
By January 2025, uptake was strong—17.8M enrollees, including 13.2M new registrations ().
Key challenges remain: integrating informal sector contributors, stakeholder education, digital system robustness, and finalizing constitutional compliance as per appeal .
|
Area |
Status as of Mid-2025 |
|---|---|
|
SHIF Live Since |
October 1, 2024 |
|
Mandatory Contributors |
All salaried, informal workers, dependents |
|
Contribution Rate |
2.75% gross income; min KSh 300/month |
|
Coverage Expanded To |
Inpatient, outpatient, chronic illness, mental health, maternity, emergencies |
|
Coverage Registrations |
17.8 million registered by January 2025 |
|
Judicial Review |
High Court ruling paused by Court of Appeal stay |
|
Key Risks |
Informal sector enrolment, digital capacity, full constitutional compliance |
Kenya’s SHIF rollout marks a bold leap toward equitable, universal healthcare—replacing NHIF with a fair income-based scheme and vastly expanding benefits. Despite legal hurdles and operational hurdles—especially integrating informal workers and ensuring full public participation—the system is now active, widely adopted, and charting a new path toward truly Universal Health Coverage.
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