health insurance enrollment Kenya

Kenya’s healthcare landscape is undergoing a remarkable transformation with the rollout of the Social Health Authority’s (SHA) flagship program, Taifa Care. Since its launch in October 2024, the program has made significant strides toward achieving Universal Health Coverage (UHC), a key goal of the Kenya Kwanza government. Health Cabinet Secretary Aden Duale recently announced that 24 million Kenyans have enrolled in Taifa Care, with 5.4 million having accessed healthcare services through the Primary Health Care Fund. 

Notably, 1.8 million informal sector workers have joined the program in just eight months, surpassing the informal sector enrollment under the old National Hospital Insurance Fund (NHIF) by over 800,000 beneficiaries.

This blog post explores the impressive enrollment milestones, the importance of informal sector inclusion, the factors driving this success, challenges faced, and the future outlook for Kenya’s health insurance landscape.

I. Understanding Taifa Care: Kenya’s Social Health Authority and Its Vision

The Social Health Authority (SHA) was established under the Social Health Insurance Act of 2023 as the regulatory and implementing body for Kenya’s new health insurance scheme. Taifa Care, the flagship program under SHA, replaces the defunct NHIF and aims to provide equitable, affordable, and quality healthcare to all Kenyans regardless of socioeconomic status.

At the heart of Taifa Care is the Primary Health Care Fund, a government-backed initiative that allows beneficiaries to access services at dispensaries, health centers, and Level 2 to 4 facilities without out-of-pocket payments. This fund is fully appropriated by Parliament and managed by the Ministry of Health, ensuring that ordinary Kenyans receive vital healthcare services without financial hardship.

II. Enrollment Milestones: A New Era of Health Coverage

The enrollment figures speak volumes about the program’s rapid acceptance and reach:

This surge is not just a number; it represents millions of Kenyans who now have access to essential healthcare services that were previously out of reach or unaffordable. The increase from approximately 9 million NHIF members to 24 million Taifa Care enrollees marks a dramatic expansion in coverage, signaling a new chapter in Kenya’s healthcare journey.

III. Why Informal Sector Enrollment Matters

Informal sector workers constitute about 80% of Kenya’s workforce. These include small-scale traders, artisans, boda boda operators, farmers, and others who often work without formal contracts or stable incomes. Historically, this group has been underserved by health insurance schemes due to:

• Irregular and unpredictable income flows
• Lack of employer contributions or formal payroll deductions
• Limited awareness and complicated enrollment procedures

The fact that 1.8 million informal sector workers have enrolled in just eight months is a testament to the program’s inclusivity and adaptability. This enrollment surpasses NHIF’s informal sector coverage by a significant margin, reflecting improved outreach, simplified registration processes, and payment options tailored to the realities of informal work.

In practical terms, this means that many Kenyans who previously had to pay out-of-pocket for healthcare can now access services without financial strain, reducing the risk of catastrophic health expenditures that push families into poverty.

IV. What’s Driving This Enrollment Success?

Several factors have contributed to the rapid uptake of Taifa Care:

Notably, premier hospitals like Aga Khan University Hospital and Nairobi Hospital now offer specialized services at SHA-approved rates, making quality care accessible to ordinary Kenyans.

V. Utilization of Healthcare Services: Beyond Enrollment

Enrollment is only one part of the equation; actual utilization of services is critical to improving health outcomes. The Primary Health Care Fund has enabled 5.4 million Kenyans to access a range of services, including:

• Preventive care: Immunizations, screenings, and health education
• Maternal and child health: Antenatal care, safe deliveries, postnatal services
• Chronic disease management: Treatment and monitoring of diabetes, hypertension, and other non-communicable diseases
• Emergency care: Immediate treatment for accidents, injuries, and acute illnesses

These services are delivered across public, private, and faith-based facilities, ensuring broad geographic and socioeconomic reach. The government’s disbursement of over KES 551 billion to 7,446 accredited facilities has been instrumental in supporting these life-saving interventions.

VI. Challenges and Areas for Improvement

Despite the impressive progress, challenges remain:

• Reaching Remote Communities: Low enrollment in rural areas due to infrastructure limitations and cultural barriers
• Sustaining Premium Payments: Ensuring consistent contributions from informal workers with fluctuating incomes
• System Capacity: Healthcare facilities facing staff shortages and resource constraints
• Data Management: Complexities in integrating data across counties and ministries
• Fraud Prevention: Ongoing efforts to combat fraud and ensure fund integrity

VII. Looking Ahead: The Road to Full Universal Health Coverage

The government has set ambitious targets to further expand enrollment and deepen coverage. Plans include:

• Intensified outreach campaigns targeting informal workers, youth, and vulnerable populations
• Integration with other social protection programs to create a holistic safety net
• Continued investment in healthcare infrastructure and human resources
• Enhanced digital systems for enrollment, claims processing, and member services
• Strengthened partnerships with counties, private sector, and civil society

The government’s commitment to zero tolerance for fraud, financial sustainability, and universal access to quality care remains central to these efforts.

VIII. Conclusion: A People-Centered Health Revolution

The enrollment of 24 million Kenyans into the SHA’s Taifa Care program, including 1.8 million informal sector workers, marks a historic milestone in Kenya’s health sector. This rapid expansion reflects a people-centered revolution that is making healthcare more affordable, accessible, and accountable.

For ordinary Kenyans—from the mama mboga to the boda boda operator—this means access to essential health services without the fear of financial ruin. It means a future where medical bills no longer force families to sell property or go into debt. It means a stronger, healthier nation.

As Kenya continues on this transformative path, the success of Taifa Care will depend on sustained commitment, innovation, and inclusive policies that leave no one behind.