NAIROBI, Kenya – The national and county governments have officially launched a joint initiative to identify poor and vulnerable Kenyans eligible for free medical coverage under the new Social Health Insurance Fund (SHA), marking a major milestone in the country’s healthcare reforms.
Health Cabinet Secretary Aden Duale and Council of Governors vice chairperson Mutahi Kahiga announced the development on Thursday following a daylong consultative meeting.
The exercise aims to ensure that indigent Kenyans are fully covered, with premiums jointly funded by both levels of government.
“The indigents will be identified by the Ministry of Health, the Council of Governors, and the State Department of Social Protection, and their premiums will be paid jointly by the two levels of government,” Duale and Kahiga said in a joint statement.
The Ministry of Health is expected to publish standardized guidelines for the registration and payment of premiums for the vulnerable population by Monday next week.
Counties will use the guidelines to integrate support for indigent Kenyans into their annual work plans and budgets for the upcoming fiscal year.
The move operationalizes President William Ruto’s pledge that no Kenyan would be denied healthcare due to poverty.
In past pronouncements, the President vowed that the government would foot the medical insurance premiums for citizens unable to pay.
“We will also know if you are able to pay, and if you are not, the government will cater for your expenses,” Ruto said in November, criticizing the former National Health Insurance Fund (NHIF) for favoring the wealthy and sidelining the poor.
The President also highlighted that NHIF left behind a Sh30 billion debt after services provided exceeded the financial inflows, contributing to its collapse and the establishment of the SHA.
Currently, approximately 22 million Kenyans are registered with SHA.
However, concerns persist about the scheme’s sustainability, with only about six million contributors actively paying premiums so far.
Unlike the NHIF, where contributors paid a flat rate between Sh500 and Sh1,700 monthly, SHA requires a 2.75% deduction from salaries, a model designed to create a more progressive and equitable funding pool.
Duale emphasized that wide consultations and partnerships are essential for delivering the government’s goal of universal healthcare.
“We have an immense responsibility on our shoulders, requiring collaboration for us to meet the common objective of delivering quality, affordable, and accessible healthcare to every Kenyan,” he said.
In a parallel effort to modernize healthcare delivery, the government and county administrations also agreed to fast-track the rollout of a Digital Health System.
Governors, through the coordination of the Council of Governors Secretariat, have committed to signing finalized intergovernmental agreements to facilitate the implementation of digital health services across the country.
Duale told MPs earlier this week that the digital system would eliminate the need for patients to carry physical files or insurance cards.
“Once you are registered, you can walk into any facility — public, private, or faith-based — and be treated. No paper files, no physical cards,” said Duale.
The digital system is expected to improve efficiency, reduce fraud, and ensure seamless service delivery, with patient records accessible securely across healthcare institutions.
