Kenya's Social Health Authority (SHA) risks collapse as monthly revenues barely cover expenses, MPs have warned. Dr James Nyikal, chair of the National Assembly's health committee, raised the concerns after an investigative visit to Mombasa.
Dr James Nyikal, chair of the National Assembly Departmental Committee on Health, stated on Thursday, March 19, 2026, that the Social Health Authority (SHA) is no longer sustainable. This comes just a week after the Auditor General flagged concerns over a potential Ksh50 billion loss during SHA's initial 2024 rollout. SHA collects about Ksh7.4 billion monthly, mainly from salaried workers, while spending Ksh7.2 billion on expenses. “The revenue that the Social Health Authority collects for the three funds in that Authority is really not enough to meet its expenses as things are now. They are barely getting what they can run on. So the revenue versus the expenses is a challenge,” Nyikal told journalists after an investigative visit in Mombasa. He added, “We are likely to face an issue of sustainability.” SHA replaced the National Health Insurance Fund (NHIF) on October 1, 2024. Over 29 million Kenyans are registered, with more than 1.8 million patients accessing comprehensive inpatient services. Yet only about 4.8 million are actively paying premiums: 3.5 to 4 million from the formal sector (2.75% salary deduction) and roughly 890,000 from the informal sector. SHA has collected Ksh142.78 billion and paid out about Ksh105 billion to healthcare providers. Providers accuse SHA of failing to honour some payments and delays, leading some hospitals to scale down operations. To address this, SHA is exploring partnerships with savings groups, SACCOs and microfinance institutions for informal workers. The government is considering raising self-employed contributions from an average Ksh560 to Ksh880 monthly for sustainability. President William Ruto has backed the scheme.