The Social Health Insurance Fund (SHIF), operational since October 1, 2024, has quickly become a critical pillar in Kenya’s healthcare financing system.
As of August 25, 2025, hospitals had submitted claims worth Sh82.7 billion to the Social Health Authority (SHA), while primary healthcare facilities added another Sh9 billion, reflecting the huge demand for reimbursement under the new scheme.
So far, the fund has paid out Sh53 billion to hospitals, alongside Sh7.7 billion to primary healthcare facilities, with a balance pending settlement in the next payment cycle.
However, not all claims have been honoured outright. Claims worth Sh10.6 billion have been rejected, while others remain in the pipeline: Sh6.4 billion approved and awaiting disbursement, Sh7.6 billion still under review, and Sh3 billion undergoing reevaluation.
Additionally, Sh2.1 billion worth of claims are currently under surveillance, pending further verification.
The numbers highlight both the progress and challenges of SHIF’s implementation.
