The Social Health Authority (SHA) has collected Sh203.7 billion since its launch, with more than 32 million Kenyans now registered under the new health insurance system.
SHA Chief Executive Officer Dr Mercy Mwangangi said the authority has so far paid Sh178.4 billion to healthcare providers through its four funds.
She made the remarks during a media town hall on Kenya’s health sector on Wednesday, August 12.
The Social Health Insurance Fund (SHIF), which receives monthly contributions from Kenyans, has collected Sh151 billion since its introduction in October 2024.
Of this amount, Sh134.7 billion has been paid to healthcare providers.
Mwangangi said more than 10 million Kenyans have already accessed healthcare services without making payments at Level Two and Level Three facilities.
She said the free primary healthcare programme has been rolled out across all 47 counties.
“A country that invests in primary healthcare is investing in 70 per cent of the disease burden,” Mwangangi said.
The SHA boss said the fund has also supported 1.2 million safe deliveries at primary healthcare facilities.
More than one million inpatient admissions have been funded, including 19,444 critical care cases and 7,000 mental health admissions.
SHA has also funded 469,000 surgical procedures and treatment for more than 48,000 cancer patients.
The government recently increased the oncology cover from Sh550,000 to Sh800,000.
About 16,800 patients have also accessed dialysis through the fund, with most chronic patients receiving two sessions every week.
Mwangangi said the authority has contracted nine international facilities for overseas treatment, with the benefit capped at Sh500,000 per eligible patient.
However, she acknowledged that SHA still has outstanding claims.
The authority has Sh29 billion worth of claims under manual review, while county governments are owed about Sh4 billion.
Mwangangi said SHA has rejected Sh17 billion in claims and returned another Sh13 billion to healthcare providers because of missing documentation.
Providers have 14 days to correct and resubmit returned claims.
The CEO also defended the authority’s payment record, saying SHA settles claims within 90 days.
She said the increase in membership has been accompanied by a rise in contributions from both formal and informal sector workers.
The formal sector contributes about Sh8 billion every month, while informal sector contributions range between Sh500 million and Sh700 million.
Mwangangi said more than 600,000 Kenyans are actively making contributions through the “Lipa SHA Pole Pole” initiative, which allows members to pay in smaller instalments.
She urged Kenyans to continue contributing to SHIF, saying the success of the programme depends on collective contributions.
“SHIF will succeed in this country if we all contribute and put money into it. If you are not contributing, then you do not benefit,” she said.
The latest figures show the rapid expansion of SHA since it replaced the National Health Insurance Fund (NHIF), with the government seeking to make primary healthcare more accessible to millions of Kenyans.
