A wave of outrage is sweeping across the country after shocking reports emerged that the Social Health Authority (SHA) has silently scrapped monthly payments and is now demanding full-year contributions before Kenyans can access health services. This sudden change, which appears to have taken effect in June 2025, has caught thousands off guard. Patients across the country are being turned away from hospitals, told they must pay Ksh12,460 in a lump sum—the equivalent of an entire year’s payment—before they can be treated. For a system that was meant to provide universal, affordable healthcare, this has come as a brutal betrayal. Many feel abandoned by a government that promised better services through the new SHA structure, only to leave them scrambling for loans, facing humiliating rejection at health facilities, or going untreated. SHA CEO Dr Mercy Mwangangi addresses growing concerns from Kenyans after reports emerged that monthly SHA payments were scrapped in favor of full-year contributions, leaving many locked out of essential health services. [Photo: Courtesy] SHA Scraps Monthly Payments Without Warning Kenyans from all walks of life are venting their anger over what they see as an abrupt and unfair policy shift. John Nalugala, who has been paying his Ksh1,030 monthly since the scheme was introduced, voiced his frustration online. “What is the problem with this SHA? I tried paying for my third month, only to be told I must now pay for the whole year — Ksh12,460. I can’t afford that in one go. Is this scheme only for the rich?” Linda George, another Kenyan, shared her story of being denied treatment at a Level 4 hospital despite showing proof of two months of payment. “We were shocked when the hospital told us SHA services now require yearly payment upfront. Many of us couldn’t get help. We went home in pain.” A spot check by Nyakundi Report confirmed these disturbing reports. Patients were told they could either pay the full annual fee or apply for a Hustler Fund loan to cover the cost — then repay it in instalments. The option for paying monthly, which was the only manageable way for many in the informal sector, seems to have vanished.
This development has blindsided many who believed President William Ruto’s announcement of the lipa pole pole system was designed to reduce the burden on ordinary citizens. Instead, Kenyans feel that the system is being used to push them into debt just to access basic healthcare. Mixed Signals from SHA and Government Officials Even government officials appear to be struggling to explain the confusion. Medical Services Principal Secretary Ouma Oluga acknowledged the problem and asked Kenyans to keep records of all such incidents for documentation.
SHA CEO Dr Mercy Mwangangi, while responding to concerns raised by the Nation , admitted that she was still investigating the issue. “I’m following up on this and on the system, after which I will give an update. But for now, kindly collect all these issues and share them with me.” But these responses have done little to calm the outrage. Kenyans are asking why such a major shift was made without public notice. The idea of paying upfront for healthcare in a country where most people live hand to mouth feels like cruelty disguised as reform.
Meanwhile, some hospitals are reportedly pressuring patients to take Hustler Fund loans, linking them directly to their SHA registration process. This means that for someone seeking treatment, the path forward now includes borrowing money from the state, adding to their financial strain. Kenyans Feel Betrayed by Healthcare Promises The SHA was rolled out with great promise—a new model to replace NHIF and make healthcare more accessible. But what’s unfolding now is far from what was pledged.
The sudden move to lump-sum payments is a nightmare for self-employed Kenyans, boda boda riders, mama mbogas, and casual workers—all of whom were meant to benefit most from the new system.
Many who have already paid part of the required amount are not receiving services. Others are locked out completely for not having the full sum. The trust built around SHA’s rollout is collapsing fast.
Worse still, the silence from top officials and lack of clear communication are only deepening the mistrust. Kenyans are asking whether this was the plan all along—to trap them into loans while pretending to offer flexible payment options.
SHA’s current model now seems to contradict its founding principles. The promise of equity, affordability, and access has turned into a reality of exclusion, debt, and despair.
Unless urgent changes are made and a clear directive is issued to restore monthly payments, the Social Health Authority risks becoming just another failed project—one that punishes the poor while serving the interests of profit and control.