The Social Health Authority (SHA) has introduced strict enforcement measures requiring employers to remit employee health contributions on time, including a 2% monthly penalty for delays. However, this crackdown exposes a critical flaw that could leave many Kenyan workers unable to access healthcare despite their contributions being deducted.

Biometric Verification Challenges

In August 2025, Health Cabinet Secretary Aden Duale reinstated mandatory biometric fingerprint verification for all SHA beneficiaries at Level 4, 5, and 6 hospitals. This move replaced the previously used One-Time Password (OTP) system, aiming to curb fraud and fake claims that had threatened the health sector. Over 25 million Kenyans have been registered in this biometric system, a transition strongly supported by President William Ruto.

However, shortly after the system's rollout, a nationwide downtime forced hospitals to revert temporarily to the OTP system, causing confusion and service disruptions. Patients attending clinics experienced difficulties when their biometric data failed or when hospitals insisted on OTPs despite the policy reversal.

The Employer Registration Gap

Beyond technical glitches, the most significant risk lies with employers failing to correctly register employees on the SHA portal. Medical Services Principal Secretary Harry Kimtai warned that employees not declared by their employers cannot access services, even if they self-register.

This means an employer might deduct the required 2.75% contribution from a worker’s salary but fail to upload the employee’s details or those of their dependents onto the Employer Portal. Without this declaration, the SHA system has no record of the beneficiary.

PS Kimtai has urged the public to ensure dependents are properly registered, requiring documentation such as national IDs, birth certificates, and OTP consent from dependents’ phones. Failure to update these details can block access to healthcare services.

Impact on Workers

The International Commission of Jurists (ICJ) Kenya highlights that many fully paid-up members face barriers to accessing entitled medical services due to systemic and bureaucratic failures. While biometric verification improves fraud prevention by confirming physical presence, it also creates challenges for patients whose fingerprints fail or whose dependents are not registered.

Brian Lishenga, National Chairman of the Rural-Urban Private Hospitals Association, noted that biometrics are superior to OTPs in preventing fraud but acknowledged the difficulties patients face when the system does not recognize them.

Steps for Workers

  • Verify your registration status on the SHA portal or by dialing *147#.
  • Ensure all dependents are declared with the required documents.
  • Hold your employer accountable for declaring you and your dependents correctly.
  • If denied service, confirm with your employer’s HR department whether you have been properly registered on the Employer Portal.

While SHA intensifies efforts to penalize non-compliant employers, the pressing issue for many Kenyans is the disconnect between payment of contributions and official registration. Until this gap is resolved, workers risk being denied care due to system recognition failures despite having paid their dues.