In a concerning development for Kenya’s healthcare system, the Social Health Authority (SHA) is grappling with a severe funding crisis, as only 3.3 million out of 19.4 million registered Kenyans are actively contributing to the scheme. This shortfall is putting essential healthcare services at significant risk, raising alarm bells nationwide.
The Ministry of Health has revealed that despite 19.4 million Kenyans being officially registered under the SHA, a staggering 16.1 million are not making their required contributions.
According to Dr Patrick Amoth, the Director General of Health, “Health services are expensive, and we cannot only have those in formal employment bearing the burden of the rest of the Kenyan population.”
He emphasized the need for all registered individuals to complete the means testing process and commit to paying their premiums to sustain the system.
This funding gap has already led to disruptions in healthcare services, with patients, particularly those requiring chronic and critical care, facing challenges such as out-of-pocket payments or being turned away from facilities.
The issue is compounded by the fact that the SHA inherited a Ksh 30.9 billion debt from the now-defunct National Health Insurance Fund (NHIF), further straining its financial resources.
The low contribution rate, particularly among informal sector workers who constitute a significant portion of Kenya’s workforce, has been identified as a critical challenge.
Principal Secretary Harry Kimtai noted, “The challenge lies in the informal sector, which faces income instability,” highlighting the difficulty of ensuring consistent contributions from this group.
Additionally, over 30% of Kenyans are classified as indigent and rely on government subsidies, adding further pressure to the already stretched system.
Despite these challenges, the Ministry of Health is actively working to boost registration and contributions, with over 350,000 new registrations in the past five days alone, bringing the total to 19.3 million as of February 12, 2025.
However, the crisis has sparked widespread concern and criticism. Members of Parliament, including National Assembly Health Committee Chairperson Robert Pukose, have demanded transparency on how allocated funds are being utilized, pointing out that only a fraction of the budgeted Ksh 4 billion and Ksh 2 billion has been spent.
Meanwhile, patients seeking emergency, chronic, and critical care services are bearing the brunt of the funding shortfall, with many facilities unable to provide comprehensive care due to financial constraints.
The government has appealed to counties, especially in arid and semi-arid regions with low registration rates, to intensify efforts to enrol more Kenyans into the SHA.
As Kenya strives to achieve Universal Health Coverage (UHC), the SHA funding crisis underscores the urgent need for innovative solutions to ensure equitable and sustainable healthcare financing.
While the government remains optimistic about resolving these challenges, the immediate priority is to bridge the contribution gap and restore public trust in the system.
