Kenya replaced the National Health Insurance Fund with the Social Health Authority on 1 October 2024 under laws signed in October 2023, after a series of High Court and Court of Appeal rulings. The rollout has been marked by disputes over an IT system contract, unpaid hospital claims and a government crackdown on what the Health Ministry says is widespread claims fraud.
As of 31 October 2026 SHA has kept existing provider contracts in force until 31 December 2026 while facilities sign new ones, and Duale told senators in April 2026 that more than 1,200 facilities had been shut over suspected fraud. No report was found on the outcome of the 30 October HMIS deadline or of a decision on the government's appeal against the July 2024 High Court judgment.
President William Ruto signed the Social Health Insurance, Primary Health Care, Digital Health and Facility Improvement Financing bills at State House, Nairobi. The Star reported that the Social Health Insurance law abolishes the National Health Insurance Fund (NHIF) and creates three new funds.
Citizen Digital reported that formal-sector employees would contribute 2.75 percent of their monthly salary to the new Social Health Insurance Fund (SHIF), with a minimum contribution of Sh300 a month.
Justice Chacha Mwita issued conservatory orders barring implementation of the Social Health Insurance Act, the Primary Health Care Act and the Digital Health Act until 7 February 2024, pending a petition filed by an activist. The doctors' union KMPDU and the Kenya Medical Association were listed as interested parties.
A Court of Appeal bench of Justices Patrick Kiage, Pauline Nyamweya and Grace Ngenye suspended the High Court orders, allowing the laws to be implemented. Sections 26(5), 27(4) and 47(3) of the Social Health Insurance Act stayed suspended pending the appeal.
Registration for the Social Health Insurance Fund opened on 1 July 2024, according to Capital FM and The Star, ahead of the planned switch from NHIF.
A three-judge High Court bench of Justices Alfred Mabeya, Robert Limo and Fridah Mugambi found the laws unconstitutional, citing inadequate public participation and provisions that tied access to public services and emergency care to contributions. It gave Parliament 120 days to fix the defects.
The same bench suspended its decision for 45 days after the Attorney-General's office argued that quashing the laws would leave a void in the health sector, Business Daily reported. The Standard said the suspension ran to 27 August.
The Ministry of Health filed an appeal on 26 July against the High Court judgment, The Standard reported. The National Assembly, the Senate and the Attorney General backed its request for a stay.
A Court of Appeal bench of Justices Francis Tuiyott, Ali Aroni and Lydia Achode extended a stay keeping the three Acts in force until it ruled on 20 September, with sections 26(5) and 27 of the Social Health Insurance Act excluded, Capital FM reported.
Cabinet approved the transition from NHIF to the Social Health Authority (SHA) from 1 October 2024. Health Cabinet Secretary Deborah Barasa said more than 1.2 million people had voluntarily registered.
The Court of Appeal bench led by Justice Francis Tuiyott suspended the High Court judgment pending the appeal, saying reverting to the repealed NHIF would cause confusion. The Standard reported the ruling cleared the way for the rollout.
The Standard reported that a consortium of Safaricom, Apeiro and Konvergenz Network Solutions would supply the Integrated Healthcare Information Technology System, valued at about Sh104 billion. The firms were to recover their investment over ten years from February 2025, the paper said.
SHA began operating on 1 October 2024. Business Daily reported confusion as hospitals were cut off from NHIF before the new systems worked. The Daily Nation reported that acting SHA chief executive Elijah Wachira apologised and said claims processing had not worked as planned.
Senator Okiya Omtatah and two activists asked the High Court to suspend the rollout and the contract with the Safaricom consortium. Justice Bahati Mwamuye declined to stop the rollout but certified the application as urgent, according to The Standard and the Daily Nation.
The Rural and Urban Private Hospitals Association of Kenya (RUPHA) said its members would suspend SHA services from 24 February, citing Sh30 billion in unpaid arrears and an outpatient payment model it called unrealistic.
Auditor-General Nancy Gathungu reported that the government does not own or control the Sh104.8 billion system, that it was procured without competitive bidding and outside the budget, and that disputes go to the London Court of International Arbitration, according to Citizen Digital and Capital FM.
In a Cabinet reshuffle President Ruto moved Aden Duale from Environment to Health and Deborah Barasa from Health to Environment, according to a statement from the Head of Public Service.
Health Cabinet Secretary Aden Duale announced former Health Chief Administrative Secretary Mercy Mwangangi as SHA chief executive after a competitive recruitment. The Standard reported she replaced an acting CEO appointed after Elijah Wachira was suspended in November 2024.
Speaking at a town hall with Kenyans in London, President Ruto said 1,000 health facilities accused of defrauding SHA had been shut, according to The Standard and Citizen Digital. The Standard reported he also said SHA had served more than 4.9 million people. Both outlets noted that Duale had recently announced 35 closures.
Health Cabinet Secretary Aden Duale said during a visit to King Fahad Hospital in Lamu that 24.4 million people had registered with SHA and described it as better than NHIF, according to The Star and The Standard.
Duale said SHA had received claims worth Sh82.7 billion, paid Sh53 billion and rejected Sh10.6 billion for fraud or non-compliance. He said 728 facilities had been closed and 301 downgraded. He also rejected social media claims that SHA had paid ghost hospitals.
Duale handed files on health facilities to the Directorate of Criminal Investigations. People Daily reported 190 files from SHA and 998 from the medical regulator KMPDC, with 24 facilities described by Duale as having conclusive evidence of fraud.
RUPHA, which says it represents more than 700 private and faith-based hospitals, began serving SHA patients on a cash basis except for emergencies. Its chairman Brian Lishenga cited unpaid claims and the 27 August rejection of Sh10.6 billion in claims.
After a consultative meeting with private providers, Duale said the government would begin settling Sh5.3 billion in pending NHIF bills, The Star and The Standard reported. The Star said hospitals owed Sh1 million to Sh10 million would be paid first and an independent committee would verify claims above Sh10 million.
A Ministry of Health audit found about Sh11 billion was lost through fraudulent SHA claims between October 2024 and April 2025, mostly from private hospitals, Capital FM reported. The Standard reported that 1,118 facilities had been closed.
Capital FM (via allAfrica)#Duale told the National Assembly's legislative retreat in Naivasha that more than 29 million Kenyans were registered with SHA and that Sh93.4 billion had been disbursed since the rollout, according to a Ministry of Health statement and The Star. The Star also reported that Sh130.4 billion had been collected.
Justice Bahati Mwamuye found the 1 October 2024 rollout premature and in breach of the rights to health and dignity, but upheld the IT system procurement, finding no proof of fraud. He ordered a compliance plan within 90 days and quarterly reports for a year.
Former Deputy President Rigathi Gachagua said SHA would collapse within six months. Duale called the claim unfounded and said more than 30.1 million people were registered and Sh121 billion had been paid to facilities over 19 months.
Duale told senators that more than 1,200 facilities had been shut in the crackdown on suspected SHA and NHIF fraud, that the DCI held about 81 files and that at least 18 cases were in court, including cases involving two former chief executives of SHA and NHIF. None of the cases was reported as concluded.
SHA announced free deliveries at Level 2 and 3 facilities and raised the annual cancer benefit from Sh550,000 to Sh800,000, under Legal Notice No. 78 of 2026 published by the Health Cabinet Secretary.
SHA suspended MP Shah Hospital in Nairobi from its provider panel pending investigations, according to a notice from chief executive Mercy Mwangangi. The reports did not state the allegations and carried no comment from the hospital.
SHA said existing provider contracts would expire on 30 September 2026 and that facilities without a contract for the new cycle running to June 2029 could not serve SHA patients, under a contracting framework the Ministry calls HAKIKA. On 1 October SHA extended the signing deadline to 14 October and said the expired contracts would stay valid in the meantime, Business Daily reported, and CIO Africa also reported the 14 October date.
CIO Africa reported that Duale had warned that facilities not yet moved to the new Health Management Information System (HMIS) could not serve patients. On 1 October the Ministry gave facilities yet to complete the move until 30 October and said no patient would be denied care, according to The Star and CIO Africa.
The Health Ministry and the Council of Governors agreed to extend county facility contracts to 14 October, give facilities 30 days to supply five missing documents and have SHA pay clean claims within 90 days. The Standard reported that Duale and Mombasa Governor Abdulswamad Shariff Nassir, who chairs the governors' health committee, signed the communique.
In a notice dated 15 October, SHA chief executive Mercy Mwangangi said existing provider contracts, due to lapse on 14 October, would stay in force until 31 December 2026, and that new contracts must be signed by then, with the new cycle starting on 1 January 2027, The Star and Nairobi Wire reported.
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Nairobi Wire · nairobiwire.comLast updated 31 October 2026. Spotted an error? See corrections. Every event links to the record it comes from. Allegations are attributed to whoever made them.