SHA Breaks Silence on MTI Concerns, Points to Global Best Practices

The Social Health Authority (SHA) has defended its Means Testing Instrument (MTI) after concerns were raised by Africa Uncensored. It said the system forms part of wider reforms meant to fix inequalities in Kenya’s health financing structure.

In a statement dated May 6, 2026, SHA said the transition to the Social Health Authority system became necessary due to deep structural failures in the defunct National Health Insurance Fund (NHIF). It added that the old system no longer served Kenyans fairly or sustainably.

SHA explained that the NHIF relied heavily on a small group of formal workers. As a result, it failed to distribute health financing equitably across the population.

“Historically, the NHIF relied heavily on the 20% of Kenyans in formal payroll employment to finance healthcare for the entire country, an unsustainable model that promoted inequality and left the vulnerable behind,” the statement read.

The Authority also criticized the previous contribution structure. It said the system placed a heavier burden on low-income households than on high-income earners.

“It effectively punished low-income households by charging them a disproportionately higher percentage of their earnings; those with the lowest incomes were charged up to 5%, while high-income earners paid as little as 1.12%,” SHA stated.

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SHA Sets 2.75%, Contribution Model

SHA said it now uses a flat 2.75% contribution rate under the Social Health Insurance Act, 2023. It also set a minimum payment of KES 300 per month. The Authority said this approach ensures fairness because it links payments to the ability to pay.

For informal sector households, SHA uses Proxy Means Testing (PMT). It relies on national data to estimate income levels and assign contribution bands. The Authority said it continues to refine the tool to improve accuracy and reduce errors in targeting.

SHA said most informal sector households fall within lower contribution bands. It added that the system includes safeguards that fully subsidize indigent households through government support. It also introduced “Lipa SHA Pole Pole” to help households pay in flexible instalments.

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Appeals and Review Process

The Authority said members can challenge their assessments through an appeals process. It noted that it continues to improve the system to ensure faster reviews, clearer outcomes and correction of genuine errors.

SHA reaffirmed its commitment to refine the MTI system. It also pledged to strengthen data partnerships and improve engagement with stakeholders to build a more equitable health financing model.

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The Social Health Authority (SHA) issued a press statement on May 6, 2026, responding to concerns over its Means Testing Instrument and defending its fairness, design and global alignment. PHOTO/ SHA X