The Social Health Authority (SHA) has clarified how it determines health insurance contributions following an investigative report by Africa Uncensored that questioned possible disparities in household charges.
SHA stated that it uses a Means Testing Instrument, an artificial intelligence-based system applying Proxy Means Testing to estimate household income, especially for those in the informal sector.
The authority explained that the system is designed to promote fairness and ensure that contributions to the Social Health Insurance Fund reflect a household’s ability to pay.
Comparing the current framework with the former National Health Insurance Fund (NHIF), SHA argued that the previous system placed a heavier burden on low-income earners.
It noted that under NHIF, poorer households often contributed a higher proportion of their income than wealthier individuals, leading to inequality in payment structures.
Under the current model, households are required to contribute 2.75 percent of their income, with a minimum monthly payment of Sh300.
SHA further indicated that more than half of formally employed members are now paying less than they did under the previous scheme, suggesting improved affordability for many contributors.
However, Africa Uncensored raised concerns over the system, alleging that the AI-based tool may contain algorithmic bias.
The report suggested that it could overcharge poorer households while underestimating wealthier ones and also questioned the accuracy of its poverty classification methods.
In response, SHA dismissed the allegations, insisting that the instrument was developed with input from multiple institutions and underwent thorough validation.
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The authority maintained that most informal sector households currently pay Sh850 or less per month and rejected claims of widespread fraudulent activity, terming them unsubstantiated.
By Philip Koech
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