NAIROBI, Kenya – The government has stepped up efforts to ensure self-employed Kenyans contribute fairly to the Social Health Authority (SHA) by linking the agency to multiple government databases, allowing it to scrutinize financial transactions and identify those underpaying health premiums.
The SHA has been granted access to mobile money transactions, Kenya Power payment records, and Kenya Revenue Authority (KRA) tax filings, among other data sources, to verify individuals’ declared incomes.
This initiative targets self-employed Kenyans whose premiums are determined through the Means Testing Tool—an online form where users report their assets and sources of income.
Health Cabinet Secretary Dr. Deborah Mlongo said the move is aimed at curbing widespread misrepresentation of financial status.
“Many people declare themselves landless or claim to live in mud houses to qualify for lower premiums,” she said during a health summit hosted by Deputy President Kithure Kindiki.
New Algorithm to Detect False Declarations
The Ministry of Health has also linked SHA systems to the National Transport and Safety Authority (NTSA) and the Immigration Department to flag vehicle owners and frequent travelers who underreport their earnings.
Additionally, the agency now has access to the Kenya Agricultural Management and Information System (KIAMIS), which details farmers’ land ownership and income from agricultural activities.
“We have a new algorithm under development that will rely on data triangulation across multiple government databases to improve the accuracy of means testing,” Mlongo said.
SHA can now tap into other data sources, including the Kenya National Bureau of Statistics (KNBS), Hustlers Fund, the Insurance Regulatory Authority, the Registrar of Companies, and the Communications Authority for mobile phone records.
The government aims to increase the average monthly premium paid by self-employed Kenyans to KSh880—nearly triple the KSh300 minimum promised in the 2022 election campaigns.
Currently, self-employed Kenyans contribute an average of KSh560 per month.
Despite efforts to expand coverage, SHA faces significant challenges in premium collection.
Out of the 19.5 million registered members, only 3.5 million actively pay their premiums—mainly those in formal employment, whose contributions are deducted directly from their salaries.
The rest, about 14.5 million, rely on free primary healthcare at dispensaries and health centers but must pay to access higher-level services.
Deputy President Kindiki has instructed SHA to deploy the new algorithm by February 28, with a nationwide campaign set to launch on March 1 to encourage more Kenyans to enroll and pay.
“We need to make premiums predictable,” Kindiki said, acknowledging that many low-income earners struggle with fluctuating charges.
However, those who feel overcharged can appeal their assigned premium, though reductions below KSh1,000 are rarely considered.
The new measures mirror past challenges faced by the defunct National Health Insurance Fund (NHIF), where 80% of voluntary members defaulted on their KSh500 monthly contributions.
In the 2021/2022 financial year, NHIF membership grew from 13.94 million to 15.4 million, but only 6.7 million—primarily salaried employees—consistently paid their premiums.
This led to NHIF failing to meet its KSh90.57 billion revenue target.
The Kenya Kwanza administration initially set the lowest SHA premium at KSh300, hoping more informal workers would enroll.
However, with the KNBS estimating that 39.8% of Kenyans—about 20 million people—live in poverty, enforcing higher contributions could prove challenging.
The risk of mass defaults remains a key concern as the government moves to tighten enforcement.
