NAIROBI, Kenya –The Social Health Authority (SHA) has collected Sh20.9 billion since its launch in October last year, the Ministry of Health has announced.
Of this, Sh18.2 billion has been disbursed to both public and private hospitals, ensuring timely reimbursements for healthcare providers under the Social Health Insurance Fund (SHIF).
According to the ministry, Sh16.97 billion of the paid claims were related to SHIF, while Sh1.33 billion went to Primary Health Care capitation.
The disbursement, it said, highlights the government’s commitment to sustaining healthcare services and achieving Universal Health Coverage (UHC) under the Taifa Care program.
The government has also accelerated claim processing through digital platforms, enabling real-time tracking and reducing settlement timelines.
While the law allows up to 90 days for processing claims, SHA has consistently completed payments in under 30 days, the ministry said.
“This reflects the government’s proactive approach to strengthening healthcare financing, reducing the financial strain on facilities, and improving system responsiveness,” the statement read.
However, some claims remain pending due to incomplete documentation, ongoing verification, or preauthorisation issues.
The ministry urged hospitals experiencing delays to liaise with SHA for assistance in resolving submission challenges.
To curb fraud and enhance financial integrity, all claims undergo clinical audits to ensure that preauthorised procedures were correctly approved and performed before payments are made.
The SHA has also introduced a new contribution model aimed at easing the financial burden on low-income households.
The minimum monthly contribution for vulnerable households has been reduced to Sh300, down from Sh500 under the defunct National Health Insurance Fund (NHIF).
Contributions vary based on household income, ensuring that those earning more contribute proportionally higher amounts.
This, the ministry said, promotes equity in healthcare funding while preventing low-income Kenyans from being locked out of medical services.
The ministry reaffirmed its commitment to transparency and accountability, stating that SHA will continue refining its systems to speed up claim approvals and eliminate inefficiencies.
With the government pushing for UHC under Taifa Care, SHA’s ability to maintain prompt disbursements and enhance service delivery will be critical in ensuring all Kenyans can access affordable, quality healthcare.
