The Social Health Authority replaced NHIF in October 2024. Here's a plain-language comparison of what changed and what you need to do.
From October 2024, the National Hospital Insurance Fund (NHIF) was replaced by the Social Health Authority (SHA) under Kenya's Social Health Insurance Act 2023. If you had NHIF cover, that cover is no longer active. You need to re-register under SHA.
| | NHIF | SHA | |---|---|---| | Monthly contribution (employed) | KSh 150–1,700 (flat bands) | 2.75% of gross salary | | Contribution for high earners | Capped | No cap — 2.75% of full salary | | Coverage structure | One fund | Three funds (SHIF, PHC, ECCIF) | | Primary care coverage | Limited | Included in Primary Healthcare Fund | | Chronic conditions | Limited | Covered via ECCIF | | Portability | Linked to specific hospitals | Portable across all accredited facilities |
Under NHIF, contribution bands meant that whether you earned KSh 50,000 or KSh 150,000, your monthly contribution was relatively similar — the highest NHIF band was KSh 1,700.
Under SHA, all employees contribute 2.75% of gross salary, with no ceiling. A KSh 200,000 salary now attracts a monthly SHA contribution of KSh 5,500 from the employee alone, plus an employer-matched contribution.
This is the most significant practical change for higher earners. The contribution for low earners is lower than under NHIF (KSh 50,000 × 2.75% = KSh 1,375 vs NHIF's KSh 1,700 at that band), but for high earners it's substantially higher.
Primary healthcare: SHA includes a Primary Healthcare Fund covering community health services and dispensary-level care — NHIF largely excluded this.
Chronic disease: The Emergency, Chronic and Critical Illness Fund (ECCIF) covers ongoing management of conditions like diabetes, hypertension, cancer, and renal failure — NHIF covered acute treatment but was limited for chronic management.
If you employ any staff, you must: 1. Register all employees with SHA (even if they were registered with NHIF — SHA registration is separate) 2. Update your payroll to deduct 2.75% of gross salary 3. Remit to SHA by the 9th of each month 4. File monthly returns via the SHA employer portal at sha.go.ke
Penalties for late remittance are 2% per month on the outstanding amount.
SHA has an appeals process for benefit disputes and treatment denials. Raise disputes through sha.go.ke or at SHA regional offices. The SHA ombudsman handles complaints that can't be resolved at branch level.
If you're building payroll or HR software and need to integrate SHA contributions and remittance, Mycrea builds these integrations for Kenyan businesses.
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