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Only 3.1m Kenyans have taken means test for subsidised SHIF scheme
Clients walk towards the newly rebranded Social Health Authority(SHA) building on October 1, 2024, as the government officially rolled out the healthcare service provider.
Photo credit: Wilfred Nyangaresi | Nation Media Group
Only 3.1 million Kenyans have undergone means testing, a crucial step in determining eligibility for government-subsidised healthcare under the Social Health Insurance Fund (Shif), according to the Ministry of Health, leaving millions at risk of limited access to healthcare.
Means testing is a financial assessment that evaluates a household's income, employment status, and socio-economic conditions. It ensures that those who can afford to contribute to the Shif do so, while vulnerable groups receive financial support. This process takes place at designated registration points, including health facilities, online platforms, and Social Health Authority branches.
According to the Ministry of Health, those who fail the means test will be automatically excluded from comprehensive health services such as hospital admissions, specialist treatment, and surgery.
Instead, they will only have access to primary healthcare and emergency services, significantly limiting their medical coverage and increasing the financial burden of seeking care.
“So far, we only have 3.1 million people who have done means testing, meaning they cannot be eligible for the services offered under the Social Health Insurance Fund, which is contributory. They can only be able to access the primary health care services and the emergency services. On average, our means test results in a premium of Sh592, and we are refining the tool to more accurately reflect income. However, a challenge we face is that many registrants do not complete the entire testing process," Director General for Health, Patrick Amoth said.
With a population of over 50 million, an estimated 25 million people, including those in informal employment, low-income households, and vulnerable groups still need to be means-tested to understand if they qualify for full or subsidised health coverage.
This estimate is based on the total population and the proportion of people who require a financial assessment to determine their eligibility for government-subsidised health care.
The Ministry has indicated that Kenya is making steady progress towards the 19 million SHIF registrations mark, with 18,985,030 people already registered.
According to the Kenya National Bureau of Statistics (KNBS), approximately 83.5 percent of Kenyans worked in the informal sector in 2023, where incomes are often unpredictable. Many rural and peri-urban households rely on subsistence agriculture or low-paying jobs, making financial assessment critical to determining their ability to contribute to SHIF.
In addition, historical data from the National Health Insurance Fund (NHIF) suggests that many enrollees benefited from subsidised coverage under public health programmes.
However, a major concern is that 4.3 million Kenyans who transferred from the now-defunct NHIF have yet to update their profiles.
"Without this update, they will remain ineligible for services when they visit health facilities. We urge them to check and update their profiles to avoid being locked out of essential health services," added Dr Amoth.
Registration is ongoing, with an average of 75,000 new registrations recorded on weekdays.
Mombasa is leading the way, with more than 40 percent of the eligible population already enrolled. However, registration rates have been lower in the arid northern counties, particularly Turkana, West Pokot, Garissa, and Samburu.
In terms of the health provider portal, over 56 percent of health facilities, around 16,000 have registered with the SHA and successfully logged in.
However, level 2 and level 3 facilities have the lowest login rates, mainly because many of them were not digitised prior to the implementation of the new system.
