Hospitals get Sh3.4 billion boost as SHA settles insurance claims
SHA also moved to clarify concerns raised on social media about funds directed to some hospitals. It revealed that Nyandiwa Level 4 Hospital received Sh19 million between January and June 2025.
The Social Health Authority (SHA) says it has disbursed Sh3.4 billion to hospitals nationwide to settle Social Health Insurance Fund (SHIF) claims.
The allocation will clear expenses for inpatient care, drugs, mental wellness services, substance abuse treatment, critical care, and surgeries.
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SHA said the funds are part of its effort to support facilities to deliver services without interruptions.
In addition, the Authority confirmed that Sh1.09 billion has already been paid out from the Primary Health Care Fund, while another Sh1.7 billion is being processed to cover dialysis, oncology, and surgical claims. It added that a comprehensive list of all disbursements will be published on its website in due course.
SHA also moved to clarify concerns raised on social media about funds directed to some hospitals. It revealed that Nyandiwa Level 4 Hospital received Sh19 million between January and June 2025.
The funds were used for inpatient long stays and maternity services, with the hospital confirming receipt.
Chief Executive Officer Dr. Mercy Mwangangi reassured that the Authority remains committed to timely payments and will continue to uphold accountability and transparency in all its operations.
Kenya transitioned from NHIF to the Social Health Insurance Fund (SHIF) to establish a more inclusive UHC structure.
SHIF is a comprehensive public health insurance service established by the Social Health Insurance Act of 2023.
The programme, launched in October 2024 under SHA transitioned almost all Kenyans from the defunct NHIF to SHIF.
Unlike the NHIF, which primarily targeted the formal sector and employed individuals, SHIF aims to provide health insurance for every citizen, including those in the informal sector and vulnerable groups who have been historically underserved.
SHIF introduced a tiered contribution system that factors in the income levels of contributors.
SHIF is centred on extending coverage to the uninsured, with the minimum contribution to the scheme being determined by the means testing instruments.
Salaried NHIF members used to make contributions as per a graduated salary scale ranging from a minimum of Sh150 to a maximum of Sh1,700, but SHIF has a standard rate which will be capped at 2.75 per cent of their salary plus other side deductions that their employers are going to make to the Primary Healthcare Fund.
Those who earn Sh20,000 are now required to pay Sh550 while those whose salary is Sh50,000 contribute Sh1,375.
On the other hand, earners of Sh100,000 are deducted Sh2,750 while those who take home Sh200,000 pay Sh5,500.
Top earners; those who take home Sh500,000 pay Sh13,750 while those getting Sh1 million and above pay Sh27,500.
The SHIF expanded its benefits to cover a broader spectrum of health services, including outpatient services, chronic disease management, and maternal and child health which aligns with UHC goals.
Every Kenyan is required to register as a member of SHIF and also any person who is not a Kenyan but ordinarily resides in Kenya for more than 12 months and any child born after the commencement of the Social Health Insurance Act, No. 16 of 2023.
To access public services from the national and county government or related entities, a registered person must demonstrate that they have complied with registration and contribution requirements.
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