What Are SHA and SHIF?
SHA (Social Health Authority) and SHIF (Social Health Insurance Fund) are Kenya’s new universal health coverage system that replaced NHIF in 2024.
Simple explanation:
- SHA: The organization that runs health insurance
- SHIF: The main insurance fund that covers most Kenyans
Goal: Ensure all Kenyans can access quality healthcare without financial hardship.
What Changed from NHIF?
Old System (NHIF)
- Fixed monthly contributions (KES 150-1,700)
- Limited coverage
- Many services not covered
- Long waiting periods
- Co-payments for many services
New System (SHA/SHIF)
- Income-based contributions (2.75% of gross salary)
- Comprehensive coverage
- More services covered
- Immediate coverage for emergencies
- Reduced co-payments
Main change: You now pay based on what you earn, not a fixed amount.
Who Needs to Register for SHA/SHIF?
Everyone in Kenya should register, including:
-
Employed people (formal sector)
- Contributions deducted from salary automatically
-
Self-employed (jua kali, small businesses, freelancers)
- Register and pay based on estimated income
-
Unemployed or very low income
- Contributions covered by government
-
Informal sector workers
- Register and contribute based on income
-
Dependents (children, spouses, elderly parents)
- Covered under principal member’s account
How Much Do You Pay?
For Employed People (Formal Sector)
Contribution: 2.75% of your gross monthly salary
Examples:
- Salary KES 20,000 → Pay KES 550/month
- Salary KES 50,000 → Pay KES 1,375/month
- Salary KES 100,000 → Pay KES 2,750/month
Deducted automatically from your payslip by your employer.
For Self-Employed and Informal Sector
Contribution: 2.75% of declared monthly income
Minimum: KES 300/month You declare your income and pay accordingly
Payment: Via M-Pesa, bank, or online portal
For Unemployed and Vulnerable Groups
Government pays for:
- People with no income
- Elderly with no pension
- People with severe disabilities
- Orphans and vulnerable children
You still need to register even if government pays for you.
What Does SHA/SHIF Cover?
Inpatient Services (Hospital Admission)
- Medical ward admission
- Surgical ward admission
- Maternity services (normal and C-section)
- Newborn care
- ICU (Intensive Care Unit)
- All necessary medications and supplies
Coverage: Up to 180 days per year
Outpatient Services (Clinic Visits)
- Consultations with doctors
- Basic medications
- Lab tests (blood tests, X-rays, etc.)
- Minor procedures
Coverage: Unlimited visits
Surgical Services
- All necessary surgeries
- Anesthesia
- Post-operative care
- Surgical supplies
Coverage: Most surgeries covered
Maternity Services
- Antenatal care (all pregnancy check-ups)
- Normal delivery
- Cesarean section
- Postnatal care
- Newborn care
- Complications during pregnancy/delivery
Fully covered (no co-payments)
Emergency Care
- Ambulance services
- Emergency room treatment
- Life-saving procedures
- Stabilization and transfer
Fully covered, even if you just registered
Chronic Disease Management
- Diabetes care and medication
- Hypertension medication
- Asthma treatment
- Epilepsy medication
- HIV/AIDS treatment (ARVs)
- TB treatment
- Mental health services
Ongoing coverage with regular refills
Specialized Services
- Cancer treatment (chemotherapy, radiotherapy)
- Kidney dialysis
- Heart surgery
- Organ transplants (kidney, liver)
- Advanced imaging (CT, MRI)
- Specialist consultations
Coverage varies: Some require pre-authorization
Preventive Services
- Immunizations
- Health screenings
- Family planning
- Health education
Fully covered
What’s NOT Covered?
- Cosmetic surgery (unless medically necessary)
- Experimental treatments
- Treatment outside Kenya (unless pre-approved)
- Services before registration (except emergencies)
- Alternative medicine (traditional healers)
- Over-the-counter medications
- Private wing/VIP rooms (only standard wards)
How to Use SHA/SHIF
Step 1: Register
- See “How to Register” article for detailed steps
- Get your SHIF number
Step 2: Visit a Contracted Facility
- Go to any SHA/SHIF contracted hospital, health center, or dispensary
- Most public facilities and many private facilities are contracted
Step 3: Show Your ID
- Bring your national ID or passport
- Facility will verify your SHIF membership
Step 4: Receive Services
- Get the care you need
- Most services have no co-payment
- Some specialized services may have small co-payments
Step 5: No Big Bills
- You don’t pay the full cost
- SHA/SHIF pays the facility directly
- You only pay any required co-payment (usually small)
Dependents and Family Coverage
Who Can Be Your Dependent?
- Spouse (legally married)
- Children (biological or legally adopted)
- Up to age 18
- Up to age 25 if in school
- Any age if disabled
- Parents (if they have no other coverage)
- Legally adopted children
Adding Dependents
- Register them when you register
- Or add them later through the portal/USSD
- Provide their ID numbers or birth certificates
No Extra Cost
Good news: You pay 2.75% of your income regardless of how many dependents you have.
Example: Whether you have 1 child or 5 children, you still pay the same 2.75%.
Benefits Compared to Old NHIF
More Comprehensive Coverage
NHIF: Limited services, many exclusions SHIF: Nearly all services covered
Income-Based Contributions
NHIF: Fixed amount (poor people paid same as middle class) SHIF: Pay based on what you earn (fairer)
Immediate Emergency Coverage
NHIF: Waiting periods for some services SHIF: Emergencies covered immediately
Better Outpatient Coverage
NHIF: Limited outpatient SHIF: Comprehensive outpatient
Chronic Disease Coverage
NHIF: Limited chronic disease benefits SHIF: Full chronic disease management
Challenges and Solutions
Challenge 1: Higher Contributions for Some
Issue: People who earned well under NHIF’s maximum now pay more
Example: Under NHIF, max was KES 1,700/month. Now someone earning KES 100,000 pays KES 2,750.
Why: To fund comprehensive coverage for everyone, including vulnerable populations
Challenge 2: Self-Employed Income Declaration
Issue: Hard to verify income for self-employed
Solution: Declare honestly. Under-declaring hurts the system and may affect your benefits.
Challenge 3: System Transition
Issue: Shift from NHIF to SHA/SHIF had teething problems
Status: System improving as it stabilizes
Challenge 4: Not All Facilities Contracted
Issue: Some private facilities not yet contracted with SHA
Solution: Check SHA website or call helpline to find contracted facilities near you
Common Questions
Q: I was registered with NHIF. Am I automatically in SHIF?
A: Yes, NHIF members were transitioned automatically. But verify your details and update if needed.
Q: What if I can’t afford 2.75% of my income?
A: If genuinely unable to pay, apply for government subsidy. Very low income earners pay minimum KES 300 or get full subsidy.
Q: Can I use SHA/SHIF and private insurance together?
A: Yes. SHIF covers basics, private insurance can cover extras (private rooms, international treatment, etc.).
Q: What if my employer doesn’t deduct contributions?
A: Report them. It’s illegal. You can also pay directly and claim reimbursement from employer.
Q: Do I need a referral to use SHIF?
A: For most services, start at nearest facility. They’ll refer you if needed. For emergencies, go directly to hospital.
Q: What if I lose my job?
A: You must continue paying to maintain coverage. Pay minimum KES 300/month until you find new employment.
Q: Can I get services outside my county?
A: Yes. SHA/SHIF works nationwide. Go to any contracted facility anywhere in Kenya.
Where to Get Help
SHA Customer Service
- Call Center: 0800 720 721 (toll-free)
- Website: sha.go.ke
- Email: info@sha.go.ke
USSD Code
- Dial *147# for quick access to services
SHA Offices
- Main office in Nairobi
- County offices (ask at your county health headquarters)
Online Portal
- Register at sha.go.ke
- Check your status
- Update details
- View claims history
Take Action Today
If You Haven’t Registered
- See “How to Register for SHA/SHIF” article
- Register this week
- Add your dependents
- Keep paying contributions
If You’re Already Registered
- Verify your details are correct
- Ensure contributions are being paid
- Add any missing dependents
- Know which facilities near you accept SHIF
Learn More
- Visit sha.go.ke
- Call 0800 720 721 with questions
- Ask at your local health facility
- Read SHA/SHIF brochures
SHA/SHIF aims to make healthcare accessible and affordable for all Kenyans. Despite early challenges, it’s a significant step toward universal health coverage. Register, pay your contributions, and use the services when you need them. Your health matters, and SHA/SHIF is here to help protect it.