SHA vs NHIF: Key Differences Every Kenyan Should Know

Understanding Kenya's Two Health Schemes

If you worked in Kenya before October 2024, you probably knew NHIF. Now it's gone. SHA (Social Health Authority) replaced the National Hospital Insurance Fund (NHIF) on 1 October 2024, and it works completely differently. This post explains what changed, why it matters to your pay, and how to register so your healthcare access doesn't lapse.

What NHIF Was, What SHA Is Now

NHIF operated from 1966 until September 2024. It was established in 1966 as a department within the Ministry of Health and remained Kenya's primary authority for management of public health insurance until its abolishment in 2023. It charged employees through workplace deductions based on salary bands, or through voluntary monthly payments.

SHA is the replacement. The SHA replaced the previous National Hospital Insurance Fund through the Social Health Insurance Act on 22 November 2023 and began operations on 1 October 2024. It covers all Kenyans—employed, self-employed, and informal workers alike.

The shift is permanent. The NHIF officially ceased operations, with its final admission date being September 30, 2024, and SHA benefits commenced immediately thereafter.

Coverage Differences

NHIF coverage was limited. It included inpatient care at designated hospitals and some outpatient services, but only at the facility you chose during enrolment. Reimbursement rates were often below what private clinics charged.

SHA coverage is broader by design. It covers preventive care, outpatient services at public and accredited private facilities in your county, inpatient admission, emergency services, and dialysis. The key difference: SHA-registered private clinics in your county are part of your coverage, not out of pocket.

How Contributions Work Now

NHIF contributions used a graduated table. NHIF used a graduated rate based on salary bands peaking at KSh 1,700 per month. A worker earning KSh 50,000 paid KSh 1,000; someone earning KSh 200,000 paid the same KSh 1,700.

SHA contributions are percentage-based, with no cap. SHA is 2.75% of gross pay, minimum KSh 300/month, no upper cap, remitted monthly. For a KSh 50,000 earner, that's KSh 1,375. For a KSh 100,000 earner, it's KSh 2,750. High earners now pay considerably more than they did under NHIF.

Employed Kenyans have SHA deducted automatically from payroll by their employer and forwarded to SHA. All employers are required to deduct 2.75% from each employee's monthly gross salary and remit this amount to the SHA by the 9th of month following the payroll month.

Registration and Payment for Self-Employed and Informal Workers

Registration is now mandatory for everyone, not optional. Every Kenyan citizen, including their dependents, is now required to register as members of the SHA.

You can register via three methods. The easiest for those without stable internet is USSD: dial *147# on your mobile phone, then enter your ID number and answer means-testing questions about household income. Online registration uses sha.go.ke. In person, you can visit a Huduma Centre.

Registration itself is free. You then pay monthly premiums based on your income bracket. Self-employed traders, bodaboda riders, and informal sector workers pay based on a means test—the system assesses your annual household income and sets a monthly contribution. You pay through M-Pesa paybill number 200222, using your national ID as the account number.

Unlike NHIF, which required workplace proof or formal employment to join, SHA accepts all Kenyans with a valid ID and KRA PIN. There are no queues, no cards to collect, no special status required.

Why This Matters to You Now

If you held an NHIF card and have not registered with SHA, you have a problem. The NHIF officially ceased operations, with its final admission date being September 30, 2024. County hospitals and most public facilities now only recognize SHA members. Walking in with an old NHIF card will delay treatment or leave you to pay out of pocket.

Self-employed workers should register immediately. The longer you delay, the more months you accrue unpaid contributions, which attract a monthly penalty. Registration takes five minutes via *147#.

Employed staff: check your September 2024 payslip to confirm your employer switched to SHA deductions. If your payslip still shows NHIF, contact your HR or finance team. The transition should have been automatic, but some payroll systems lagged.

Getting Help

If registration feels overwhelming, especially for those unfamiliar with digital portals, SHA registration experts on Kaziiko can guide you through sha.go.ke step-by-step or help via phone. You can also find a verified Kenyan expert on Kaziiko who specializes in health insurance navigation. For self-employed workers wondering how much to pay, use the SHIF deduction calculator to estimate your monthly contribution based on household income.

SHA's toll-free helpline is 0800 720 601. The portal is sha.go.ke.

Frequently Asked Questions

Can I still use my old NHIF card?

No. NHIF ceased operations on 30 September 2024. Public hospitals and facilities no longer accept NHIF cards. You must register with SHA to access healthcare, even if your NHIF card looks valid. Registration is free; you pay only monthly contributions.

What happens if I don't register for SHA?

You cannot access government-subsidized healthcare. County hospitals, health centres, and referral hospitals now operate under SHA. If you arrive without SHA registration, you will be asked to either register on the spot (via *147#) or pay the full bill yourself. Registration takes minutes but is best done before you need care.

Is the 2.75% deduction the same for everyone?

For employed workers, yes—2.75% of gross salary, with a minimum of KSh 300 monthly and no upper cap. For self-employed and informal workers, the rate is also 2.75% of assessed annual household income, but the system means-tests your income first. You will receive an annual assessment letter showing your monthly contribution amount.

Where do I pay my SHA contributions if I'm self-employed?

Via M-Pesa paybill 200222. Use your national ID number as the account number. You can pay monthly or in full for the year. You can also pay through the USSD code *147# if you prefer not to use the M-Pesa app. Both methods are instant and give you a confirmation message.