Duale says 20,000 Kenyans joining SHIF daily as new health scheme gains ground

Health Cabinet Secretary Aden Duale has revealed that an average of 20,000 Kenyans are enrolling daily into the Social Health Insurance Fund (SHIF), administered under the newly established Social Health Authority (SHA), with over 4.3 million citizens having completed the required means testing by April 15, 2025.

Appearing before Parliament on Wednesday, Duale stated that the new health financing model was gaining momentum, with 5,616,119 members actively contributing to SHIF — 4,192,744 from the formal sector and 1,423,375 from the informal sector.

“As of April 15, 2025, a total of 4,386,921 Kenyans had completed the means testing. The average number of Kenyans completing means testing and making contributions stands at 20,000 per day. The current average contribution is Sh590,” Duale said.

He affirmed that these contributions were sustainable and would cover all benefits as stipulated by law, noting that the government funds primary healthcare (PHC) services, easing the burden on contributors.

“These members do not shoulder the burden of the 21,304,688 registered members, as PHC services are paid for by the government, not through member contributions,” he explained.

Duale criticised the now-defunct National Health Insurance Fund (NHIF), calling it outdated and unjust to low-income earners.

“The defunct NHIF system was colonial, anti-poor, and largely geared towards formal white-collar employment. It penalised the poor by charging the highest premiums to those with the lowest income,” he said.

He also pointed out how NHIF disadvantaged the middle class: “The NHIF penalised middle-income earners, as it was only a secondary option — the primary charge was usually private insurance. NHIF merely paid for the hospital bed.”

Health CS Aden Duale: Six months since its launch, SHA has already enabled 40% of Kenyans to access universal health coverage. Every day, between 40-50,000 Kenyans register for SHA. pic.twitter.com/QTMDMCRXmk

— The Eastleigh Voice (@Eastleighvoice) April 16, 2025

Under the new Social Health Insurance Act, the SHA now serves as the first charge. Key milestones since its establishment include free primary healthcare for 21.39 million Kenyans across all public Level 2–4 facilities, contracted private and faith-based institutions, and a 40 per cent universal health coverage rate within the first six months. The benefits package has also expanded to include ICU care, cancer treatment, all surgeries, and maternity services.

Emergency care is available free of charge in all facilities, as required by Article 43(2) of the Constitution.

Duale highlighted that claim payments are made on the 14th of each month, unlike NHIF, which lacked a consistent payment timeline.

However, he acknowledged several ongoing challenges, such as employers failing to remit contributions, limited public awareness of SHA, manipulation of the means-testing tool, legacy NHIF debts, and resistance to reform.

He noted that although operational gaps have emerged during implementation, there is currently no need for immediate legislative changes.

“If and when the Ministry identifies the need for legal reforms, we will bring proposals before Parliament,” he said.

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• 000 Kenyans joining SHIF daily as new health scheme gains ground

Addressing the inclusion of teenage mothers and other vulnerable groups, Duale affirmed that the system ensures no one is left behind.

“Teenage mothers without national ID cards are registered in all public health facilities and issued temporary IDs,” he said, adding that the government covers their SHA premiums.

He called for a national dialogue on rising teenage pregnancy rates. “I urge this House and other leaders, including religious leaders, to engage in a national conversation on the increasing number of teenage mothers.”

For the needy, Duale said the Ministry of Social Protection will work alongside the Ministry of Health and local authorities to identify and support beneficiaries.

“The national and county governments, as well as the National Government Constituencies Development Fund (NGCDF), will pay SHA premiums for these vulnerable groups,” he stated.

Sponsors may also register and contribute via the Afyayangu app.

Unlike the old system, SHA members now access benefits instantly, with no waiting period. “Access to SHA benefits is immediate — there are no waiting times,” Duale emphasised.

Regarding service coverage, the Ministry outlined SHA provisions: free PHC at public and contracted Level 2–4 facilities; inpatient and additional services for contributors at Level 4–6 hospitals; emergency services for all Kenyans; and chronic and critical care for paid-up members at Level 5–6 facilities.

Duale said all benefits have been gazetted under Legal Notice No. 47 of 2024, including enhanced ICU cover from Sh4,000 to Sh28,000 per day, and an additional Sh150,000 for cancer treatment.

The referral system under SHA comprises three levels: Levels 2–4 for outpatient care, Levels 4–6 for inpatient services, and Levels 5–6 for chronic and emergency care.

“This referral model aims to decongest specialised facilities, allowing them to concentrate on delivering specialised services,” he added.

On facility empanelment, the CS clarified that all facilities licensed by the Kenya Medical Practitioners and Dentists Council (KMPDC) and the Clinical Officers Council are automatically empanelled — a departure from the NHIF’s model, which required additional payments.

Duale confirmed that SHA has approved a staffing establishment of 815, with former NHIF staff being prioritised for recruitment.