Kenya Health Survey Shows Only 40% Have Insurance Coverage

A Kenya Mini Demographic and Health Survey released by the Kenya National Bureau of Statistics indicates that roughly 40 per cent of the population holds some form of health insurance, leaving about 60 per cent without cover.

The survey records 40.3 per cent overall coverage, with the Social Health Authority (SHA) accounting for 39.4 per cent, private insurers 1.1 per cent and employer-managed schemes 1.7 per cent; 59.7 per cent of respondents have no insurance or are unsure.

Coverage varies sharply by income, with the richest fifth of households at 52 per cent insured compared with 24 per cent among the poorest fifth; urban residents are slightly better off at 43.9 per cent versus 38 per cent in rural areas.

County disparities are pronounced, Nyeri recording the highest share at 66.9 per cent (around 67 per cent) and Tana River the lowest at 13.7 per cent (about 14 per cent); Isiolo, Garissa and Mandera also rank among the bottom counties.

Among women aged 15 to 49, 42 per cent reported being registered with SHA, with registration rates rising from 22 per cent for those aged 15-19 to 52 per cent for ages 30-34; education level shows a similar pattern, 24 per cent of women with no schooling are registered versus 60 per cent of those with education beyond secondary school.

County registration for women ranges from 14 per cent in Isiolo to 68 per cent in Taita Taveta, reflecting the broader regional gaps identified in the survey.

Of the women who are registered, 53 per cent used SHA services in the previous twelve months, mainly for outpatient consultations (62 per cent) and antenatal care (9 per cent); 91 per cent said the cover reduced out-of-pocket spending, 92 per cent were satisfied and 91 per cent would recommend it.

SHA chief executive Mercy Mwangangi told the National Assembly Health Committee that 32,180,494 people were registered as of July 31, 2026, representing 67.7 per cent of the population, while about 5 million (roughly 15.5 per cent) were actively contributing.

Committee chair James Nyikal remarked that “Registration is not enough,” noting that many registrants do not make regular payments.

The authority reports that only 43.9 per cent of contributing members had paid their premiums for the current month, 52 per cent had not and 4.1 per cent were unsure.

SHA was established by the Social Health Insurance Act 2023, replacing the National Hospital Insurance Fund, and now operates three funds – the Primary Health Care Fund, the Social Health Insurance Fund and the Emergency, Chronic and Critical Illness Fund – with mandatory registration and income-linked contributions.