Understanding the Social Health Insurance Fund (SHIF) in Kenya

Table of Contents

1. Introduction to SHIF
2. How SHIF Differ from NHIF
3. SHIF Costs and Contributions
4. Issues Arising from SHIF Implementation
5. How to Register for SHIF
   o Via USSD Code
   o Online Registration
   o In-Person Registration
6. How to Check if You Are Registered on SHIF
7. Conclusion

1.Introduction to SHIF

The Social Health Insurance Fund (SHIF) is Kenya’s new national healthcare financing system, replacing the long-standing National Health Insurance Fund (NHIF) on October 1. The transition to SHIF is part of Kenya's broader efforts to ensure universal health coverage by increasing access to affordable and
efficient healthcare services. Unlike its predecessor, SHIF aims to offer more extensive benefits, reach a larger population, and operate under a streamlined system to address the growing healthcare needs of Kenyans. However,
despite its promising objectives, SHIF’s rollout has faced significant challenges, leaving both patients and healthcare providers grappling with confusion.

2.How SHIF Differ from NHIF

While NHIF operated on a flat-rate contribution model, SHIF uses a progressive deduction system. Employees in the formal sector now contribute 2.75% of their gross pay rather than the NHIF’s maximum contribution cap of Ksh 1,700.

The government introduced this model to create a larger pool of funds, ensuring adequate financing for chronic illnesses, expensive procedures, and other long-term healthcare needs. However, the shift has come with implementation issues, including system glitches, unprocessed claims, and the exclusion of patient records during the transition.

3.SHIF Costs and Contributions

Under SHIF:

• Formal sector employees contribute 2.75% of their monthly salary through payroll deductions.
• This structure replaces the NHIF's flat rate, making the contribution rate proportional to earnings.

The change intends to provide equitable financing by ensuring that higher-income earners contribute more to support the system. However, questions remain about whether these contributions will adequately fund Kenya’s healthcare system without overwhelming citizens.

4.Issues Arising from SHIF Implementation

The launch of SHIF has been marred by several challenges, including:

Unprepared Healthcare Providers: Many healthcare providers were unclear on how payments would be processed under the new system, creating delays in offering services to patients.

System Glitches: Patients have reported missing names and incomplete records in the SHIF system, causing denial of services.

Legal and Administrative Hurdles: The system faced legal challenges, with court orders highlighting gaps in its rollout. Additionally, the Ministry of Health failed to adequately consult key stakeholders, including healthcare providers and patient advocacy groups.

Impact on Patients with Chronic Illnesses: Patients relying on treatments like dialysis or chemotherapy were particularly affected. Some were denied treatment due to system issues, forcing them to miss vital appointments. One patient lamented, “I’ve been registered for years, but now they say I have to
register again. My condition can’t wait for such bureaucracy.”

Incomplete Contracts with Medical Facilities: The late signing of agreements with hospitals meant that some facilities could not offer SHIF-covered services, leaving patients stranded.

Poor Communication: Many Kenyans have found the transition confusing due to inadequate public education about SHIF registration and usage.

5.How to Register for SHIF

There are three convenient ways to register for SHIF:
Option 1: Via USSD Code

1. Dial *147# on your mobile phone.
2. Enter your ID number.
3. Follow the prompts to provide your personal information, including your name and date of
   birth.

Option 2: Online Registration

1. Visit the SHIF website and click on “Register.”
2. Enter your personal details, such as your ID type, ID number, and phone number.
3. Verify your account using a one-time password (OTP) sent to your phone.

4.Complete your profile by providing additional details (employment information, dependents, etc.) and uploading a passport photo.

5.Finish the process by setting up a PIN for future login.
Note: You will need to visit a SHIF agent for biometric verification after completing the online registration.

Option 3: In-Person Registration

1. Visit a SHIF registration center or agent near you.
2. Fill out a registration form and submit it alongside the required documents, such as your ID card.
3. Confirm your details with the agent and complete the process.

6.How to Check if You Are Registered on SHIF

Once registered, you can confirm your status in two ways:
Option 1: Using USSD Service

1. Dial *155# on your phone.
2. Select your preferred language.
3. Choose option 1 - National Health Scheme.
4. Enter your ID number.
5. Confirm via an OTP sent to your registered phone number.
6. Choose option 6 - My Status.

You’ll receive a message displaying your membership details, including your member number, ID number, year of birth, contribution status, and dependent details.

Option 2: Manual Verification
Visit a SHIF headquarters or branch office (formerly NHIF) with your ID card and previous NHIF membership number. Staff members will assist you in verifying your status.

7.Conclusion

The Social Health Insurance Fund (SHIF) represents a significant step toward improving healthcare access and affordability in Kenya. However, its chaotic rollout and unresolved implementation issues have left patients and providers facing challenges. To make the most of SHIF, Kenyans should proactively register, confirm their membership status, and stay informed about changes. By addressing the gaps in communication, system readiness, and stakeholder engagement, SHIF has the potential to revolutionize healthcare delivery in Kenya.
For now, patience and vigilance are key as the new system stabilizes.

Remember, Kifedha is your go-to solution for fast and reliable financing.
If you’re looking for a quick and reliable financial solution, contact us through our contact form, call us on +254791573231 or visit one of our branches  across Nairobi, Kiambu, Machakos, and Kajiado counties to explore your financial opportunities.