NHIF vs SHIF

Kenya’s Social Health Insurance Fund (SHIF), replacing the National Hospital Insurance Fund
(NHIF), is transforming healthcare access with a structured, income-based contribution model
under the Social Health Authority (SHA). SHA administers three key funds. One of the funds is
Primary Healthcare Fund that provides preventive services. The other is the Emergency, Chronic,
and Critical Illness Fund which supports urgent and costly treatments. Lastly, the Social Health
Insurance Fund (SHIF) that covers routine healthcare, outpatient services, chronic care, maternal
health, and vaccinations.
SHIF offers a broad range of healthcare services, including preventive, curative, and
rehabilitative care, with a focus on outpatient services, chronic disease management, maternal
and child health, and vaccinations. Contributions are set at 2.75% of monthly income. Employers
match this amount for salaried employees, while self-employed individuals pay 2.75% with a
minimum of KES 300. Contributions are due by the 9th of each month, with late penalties.
Registration requires a National ID for adults, a birth certificate for children, or an Alien ID for
foreign residents. Upon the implementation of SHIF regulations, every resident in Kenya must
apply for membership within 90 days by filling out Form 1 and submitting the necessary
identification documents. Dependents—spouses, children, and financial dependents—are
covered, extending healthcare to entire families.
Before SHIF, the NHIF system followed a tiered contribution model where members contributed
based on their income, starting from KES 150 for low-income earners and increasing in steps up
to KES 1,700 for individuals earning higher wages.
SHA ensures provider accreditation, quality through audits, and accountability. Though it’s a
major stride toward universal healthcare, some challenges remain, such as managing costs for
diverse income levels.