Every month, 2.75% of a civil servant’s salary is automatically deducted and sent to the Social Health Authority (SHA), a fund meant to guarantee access to essential health services. Yet for thousands of public workers across Kenya, that promise rings hollow.
On the 10th of each month, many find themselves locked out of the very healthcare system they’ve been funding, denied treatment because their employers failed to remit the deductions on time.
This crisis has reached a breaking point, exposing systemic failures that have made healthcare access a gamble for dedicated public servants. Even Ministry of Health employees, who work directly under the same system, are not spared. They too are often forced to pay out-of-pocket for treatment, already deducted from their pay slips.
“It’s a betrayal,” says Dr. Ndegwa, a civil servant who requested anonymity. “We’re turned away at hospitals for services we’ve already paid for. This isn’t about technical glitches. it’s about human lives.”
The fallout is tied to over 44,000 non-compliant employers, with Nairobi County alone accounting for 12,900 defaulting institutions that owe Ksh. 4.7 billion. This backlog hampers SHA’s ability to reimburse hospitals, creating a domino effect that ultimately harms the very people the system was built to protect.
In response, SHA CEO Dr. Mercy Mwangangi has launched a six-week door-to-door campaign to enforce employer compliance. The initiative, dubbed the SHA Rapid Results Employer Compliance Drive, aims to identify whether the failure is due to confusion or deliberate evasion.
PS Oluga stressed the urgency: “Patients are fully registered with SHA, yet locked out due to employers’ negligence. This conflict erodes public trust and weakens healthcare delivery.”
While SHA officials maintain that nearly all public sector employers are now compliant, with only four counties lagging, the larger problem of enforcement in the private sector remains.
Unless the compliance blitz yields tangible results, civil servants will continue living a cruel paradox: faithfully contributing to a system that abandons them when they need it most.
