The SHA transition was designed to replace the “regressive” NHIF system, where low-income earners often paid a higher percentage of their earnings than the ultra-rich.
However, the new tool used to calculate contributions for the 83% of Kenyans in the informal sector has become the new lightning rod for controversy. The Africa Uncensored AllegationsThe 49-minute documentary, a collaboration with Lighthouse Reports and The Guardian, made several startling claims: Algorithmic Bias:
The system allegedly has an error rate of 80–90% in determining poverty levels, leading to massive overcharging of the poorest households. Proxy Flaws: The tool uses 43 variables—such as the type of roof (iron vs. tiles) or household size—to “guess” income.
Critics argue these are poor predictors of actual wealth in a volatile economy. Prior Warning: The report suggests that government consultants flagged these inequities before the launch, but the system was deployed anyway.
The SHA Response: “Data Continually Evolves”In its official rebuttal, SHA maintained that the Proxy Means Testing (PMT) model is a “globally recognized best practice” used to direct healthcare subsidies in several developing nations. Key Defense Points:Correcting Historical Injustice: SHA noted that under the old NHIF, someone earning Ksh 10,000 paid 5% of their income (Ksh 500), while a millionaire paid only 0.17% (Ksh 1,4700).
The new flat rate of 2.75% is meant to be the “great equalizer.” Reality Check on Payments: SHA released data showing that 92% of informal sector households are currently assessed at Ksh 850 or less per month. Collaborative Design:
The authority insisted the tool was developed alongside universities, research institutions, and the Ministry of Health to minimize both “exclusion errors” (missing those who need help) and “inclusion errors” (subsidizing those who don’t). The Premium Breakdown: What Kenyans are PayingAccording to SHA’s May 2026 update, here is how the informal sector currently shakes out:
