Only 3.1 million Kenyans have completed the mandatory means test required to determine eligibility for the government-subsidized healthcare program under the Social Health Insurance Fund (SHIF), leaving millions in uncertainty about their medical coverage, according to the Ministry of Health.
The means test is designed to assess a household’s income, employment status, and socio-economic conditions to determine whether individuals should contribute to SHIF or receive financial support. The Ministry has urged Kenyans to complete the test to avoid exclusion from essential healthcare services such as hospital admissions, specialist treatment, and surgeries.
Health Director-General Patrick Amoth emphasized that failure to complete the means test will limit individuals to only primary healthcare and emergency services, significantly increasing out-of-pocket expenses for medical care.
“So far, we only have 3.1 million people who have done means testing, meaning [those who have not] cannot be eligible for the services offered under the Social Health Insurance Fund, which is contributory. They can only be able to access the primary healthcare services and emergency services,” said Amoth.
This means that millions who remain unregistered could struggle to afford hospitalization or specialized treatment, worsening Kenya’s healthcare access challenges.
Kenya has a population exceeding 50 million, yet an estimated 25 million people—particularly those in informal employment, low-income households, and vulnerable communities—are yet to undergo means testing. The Ministry of Health estimates that 19 million people need to be registered under SHIF, but the current enrolment stands at only 18,985,030.
The means test is conducted through various channels, including health facilities, online platforms, and Social Health Authority (SHA) branches. However, despite these options, uptake has been slow, raising concerns about widespread exclusion from critical medical services.
One of the challenges affecting registration is the complexity of the means-testing process, with some citizens reporting difficulties in completing the test. Amoth acknowledged this concern, noting that the Ministry is refining the tool to more accurately reflect people’s income levels.
“On average, our means test results in a premium of Sh592, and we are refining the tool to more accurately reflect income. However, a challenge we face is that many registrants do not complete the entire testing process,” he added.
The slow progress of SHIF registration comes amid broader scrutiny of the government’s healthcare reform efforts. President William Ruto’s administration has championed the transition from the National Health Insurance Fund (NHIF) to SHIF as a means of improving healthcare accessibility and financial sustainability. However, MPs and health sector stakeholders have raised concerns about system failures, implementation challenges, and lack of clarity regarding funding.
Recent reports indicate that 46% of health facilities have yet to join the SHA e-contracting platform, further complicating access to services under SHIF. Additionally, there have been complaints about technical issues, biometric verification delays, and confusion among citizens regarding how to navigate the new system.
With millions still untested, the Ministry of Health has called on Kenyans to urgently complete the process to avoid disruptions in their healthcare access. The government is expected to intensify public awareness campaigns to encourage registration, particularly targeting informal workers and vulnerable populations who are most at risk of being left out.
As SHIF implementation continues, it remains to be seen whether the government will address the concerns raised by stakeholders and citizens alike. For now, those who fail to complete the eligibility test risk being excluded from critical medical services, placing them at a financial disadvantage in accessing quality healthcare.
