In a statement, the ministry emphasized that updating these profiles is crucial to ensuring accurate SHA eligibility status, which facilitates seamless access to healthcare services when needed.
Through Director General Dr Patrick Amoth, the ministry expressed concern that while a total of 18.8 million Kenyans have enrolled in SHA, registration numbers remain significantly lower over weekends.
Dr Amoth noted that, over the past week, the average daily registration on weekends stood at 26,000 people compared to 75,000 during weekdays.
“This likely occurs because many registrations happen when individuals seek healthcare services, which should not be the case,” Dr Amoth said.
“Kenyans should be encouraged to register for SHA in the same way they subscribe to any other insurance service.”
Dr Amoth reported that the average means-tested contribution for SHA enrollees currently stands at Sh592.
So far, 3.1 million SHA-registered individuals have undergone means-testing to determine the appropriate premium they should pay for coverage under SHA.
Means testing is conducted for individuals who are not formally employed.
“Since the majority of Kenyans fall into this category, the number of those who have completed means-testing remains suboptimal,” Dr Amoth stated.
“This means that many registered individuals can only access primary healthcare and emergency services but will be unable to benefit from the Social Health Insurance Fund (SHIF) or the Chronic and Critical Care Fund.”
According to the ministry, SHA registration coverage is highest in Mombasa, Elgeyo Marakwet, and Bomet counties, where it exceeds 40%.
Conversely, the lowest registration rates have been recorded in Turkana, West Pokot, Garissa, and Samburu counties.
On the Health Provider Portal, 8,813 health facilities have enrolled, representing 56% of active health facilities in Kenya.
A total of 89% of these facilities have successfully logged into the system.
However, the success rate of system logins is lower in dispensaries and health centres (slightly above 80%) compared to higher-level health facilities, where logins are optimal.
“This is expected, given that many dispensaries and health centres have traditionally relied on manual documentation,” Dr Amoth explained.
To address this challenge, the ministry has deployed support teams to counties to provide on-site assistance at health facility levels.
Since October 1, 2024, a total of 1,064,222 people have accessed primary healthcare services under SHA, with the numbers steadily increasing over the past four months.
So far, 804,001 claims have been submitted, amounting to Sh18.0 billion with private and faith-based facilities having submitted claims totalling Sh12.2 billion.
Government-owned facilities have submitted claims totalling Sh5.8 billion.
Additionally, 427,959 pre-authorizations have been raised, with most coming from Level 4 and Level 5 hospitals.
Dr Amoth noted that the average turnaround time for pre-authorization processing has significantly improved, decreasing from 526 minutes in December 2024 to the current 76 minutes.
“The Social Health Authority is continuously reviewing this key performance indicator and implementing strategies to further streamline pre-authorization processing,” he added.
