From Promise to Practice: Is SHA Working for Ordinary Kenyans?

One year after SHA replaced NHIF, patients and healthcare providers are still weighing the benefits and challenges of Kenya's ambitious healthcare reform.

Article by: Babz Abdul-Raheem.
Date: June 20,2026.

When the Social Health Authority (SHA) was launched, it was presented as one of the most ambitious healthcare reforms in Kenya's history. The promise was simple but powerful: affordable, accessible, and universal healthcare for every Kenyan.

One year later, however, the verdict from the public remains mixed. For some Kenyans, SHA represents a step toward a more inclusive healthcare system. For others, it has become a source of frustration marked by confusion, delays, and uncertainty.

The transition from the National Health Insurance Fund (NHIF) to SHA was never expected to be easy. Government officials argued that the old system was plagued by inefficiencies, fraud, and unequal access to healthcare services. SHA was designed to address these challenges by expanding coverage and ensuring that more Kenyans could access quality medical care.

Yet the experiences of many citizens suggest that the transition has not been seamless.

Across the country, patients have reported difficulties accessing services, delays in verification, and uncertainty over which treatments are covered under the new system. Some hospitals have also complained of delayed reimbursements, creating tension between healthcare providers and the government.

For ordinary Kenyans, the biggest concern remains reliability.

A healthcare system is only as effective as its ability to deliver services when people need them most. For a mother seeking treatment for her child, a worker injured on the job, or an elderly citizen managing a chronic illness, bureaucratic explanations matter little if healthcare cannot be accessed promptly.

The challenges facing SHA have become particularly visible in public hospitals, many of which continue to struggle with shortages of medicine, equipment, and personnel. Critics argue that healthcare reform cannot succeed if hospitals themselves remain underfunded and overwhelmed.

Supporters of the new system maintain that major reforms take time. They point out that millions of Kenyans have successfully registered and that the long-term benefits of SHA may only become fully visible after several years of implementation. They also argue that many of the current challenges are transitional and will be resolved as systems improve.

Still, public patience is being tested.

Healthcare is one of the most sensitive areas of governance because it directly affects people's lives. Every delayed treatment, every rejected claim, and every patient turned away from a facility becomes a powerful measure of whether the reform is working.

The debate over SHA is therefore about more than healthcare financing. It is about trust. Citizens want assurance that the contributions they make will guarantee quality healthcare when they need it. Hospitals want certainty that they will be paid on time. Healthcare workers want systems that enable them to serve patients effectively.

One year after its launch, SHA stands at a crossroads. It has the potential to transform healthcare in Kenya, but its success will depend on how effectively government addresses the concerns being raised by patients, healthcare providers, and county governments.

The question facing policymakers is no longer whether SHA was a good idea. The question is whether the system can deliver on the promises that inspired it.

For millions of Kenyans, the answer will not be found in policy documents or government briefings. It will be found in hospital wards, clinic waiting rooms, and the everyday experiences of citizens seeking healthcare.

One year on, SHA remains a reform filled with promise but also one facing growing pressure to prove that it works.