SHA defends AI means testing system after exposé
By Cynthia Lodite, May 6, 2026The Social Health Authority (SHA) has strongly defended its Means Testing Instrument (MTI) following an expose’ by Africa Uncensored.
In a statement on Wednesday, May 6, 2026, SHA insisted that the new system is fairer, data-driven, and designed to protect low-income households under the reformed health insurance framework.
In the statement, SHA, while welcoming public debate, maintained that the transition from the defunct National Health Insurance Fund (NHIF) was necessary to correct long-standing structural and equity failures.
“We welcome rigorous public discourse on health financing and are committed to addressing these concerns with transparency and strict adherence to our statutory mandate. The transition to the SHA was necessitated by the structural and equitable failures of the defunct National Health Insurance Fund (NHIF),” SHA said.
According to SHA, the MTI system was not just developed in isolation; instead, with extensive collaboration led by the Ministry of Health and in consultation with various stakeholders.
Why SHA and not NHIF?
While defending the new model, SHA explained that historically, NHIF relied heavily on the 20% of Kenyans in formal payroll employment to finance healthcare for the entire country, an unsustainable model that promoted inequality and left the vulnerable behind.
At the same time, SHA noted that NHIF effectively punished low-income households by charging them a disproportionately higher percentage of their earnings; those with the lowest incomes were charged up to 5%, while high-income earners paid as little as 1.12%.
In this case, if, for example, an individual whose income is Ksh1,000,000 per month was charged Ksh1,700, which translates to 0.17% while an individual whose informal income is Ksh10,000 was required to pay Ksh500, which translates to 5% of their income.
“The determination of member contributions under the Social Health Insurance Act, 2023, addresses this historical injustice. The new statutory flat rate of 2.75% of household income, subject to a minimum of Kes. 300 per month, serves as an equalizer,” SHA said.
Why use proxy means testing?
While still defending the Proxy means testing, SHA maintained that the approach was not unique to Kenya and that it has been a globally recognised best practice for directing healthcare.
“To implement this 2.75% equitable mandate for the non-salaried and informal sectors, the Authority utilises Proxy Means Testing (PMT). This approach is not unique to Kenya; it is a globally recognised best practice for directing healthcare,” SHA explained.
In addition, the Authority has maintained that implementation of the AI model involved consultation with various stakeholders during its design, including universities, research institutions, government entities, and development partners.
Further adding that reports and technical input from external experts were incorporated into the tool improvement, and that the MTI process uses official data and continually evolves as household information improves.
“The Authority MTI process uses official data and continually evolves as household information improves. Technical parameters were developed using nationally representative household data, with the objective of minimising both exclusion errors (failing to identify households that genuinely cannot afford contributions) and inclusion errors (assigning subsidies to households that do not require them). Some questions highlighted were for future modelling and do not impact current premiums,” SHA stated