Health Cabinet Secretary Aden Duale has announced sweeping reforms to overhaul Kenya’s healthcare system through the Social Health Authority (SHA), marking a decisive departure from the defunct National Health Insurance Fund (NHIF).

Partnerships with hospitals

SHA has processed Ksh5.4 billion in primary healthcare claims, with 53 per cent allocated to public facilities, 38 per cent to private institutions, and nine per cent to faith-based organisations. Duale said Ksh1.2 billion for May 2025 will be disbursed.

The ministry has secured partnerships with leading private hospitals to expand specialised care access.

Aga Khan University Hospital and Nairobi Hospital will provide oncology and renal services, including kidney transplants, at gazetted SHA tariff rates with no out-of-pocket expenses.

Efficiency and equity

A breakthrough partnership with pharmaceutical company Roche has reduced the cost of Herceptin, a breast cancer drug, from Ksh120,000 to Ksh40,000.

Duale stressed that SHA’s efficiency was superior compared with services under NHIF: “We have capped administrative costs at just five per cent, meaning 95 per cent of every shilling goes directly to healthcare”.

The new system employs means testing, ensuring contributions match income levels.

“A mama mboga will no longer pay the same as a CEO,” Duale explained.

For Kenyans whose earnings vary from day to day, SHA introduced “Lipa SHA Pole Pole,” an interest-free, flexible payment plan allowing daily, weekly, or monthly contributions.

Some 1.8 million informal sector contributors have registered in eight months, surpassing NHIF’s best annual performance of one million.

Quality assurance

In a fraud crackdown, 728 ghost facilities have been closed.

“If you are a SHA-contracted health facility, you must meet the highest standards,” Duale declared.

The health budget allocates Ksh6.2 billion for Universal Health Care contract workers, Ksh1.75 billion for medical arrears, and Ksh4.2 billion for new medical interns.

Some Ksh3.2 billion will support training for community health promoters.

Future reforms

Upcoming initiatives include expanding SHA enrolment in underserved regions, digitising health systems in seven counties under phase two, and intensifying surveillance to eliminate fraudulent facilities.

These reforms, Duale said, represent “promises in action”.