SHIF Explained: How New Health Financing Affects Prevention & Primary Care
For years, most Kenyans associated medical cover with NHIF. But in 2024, the government phased it out and introduced a new system called the Social Health Insurance Fund (SHIF). SHIF helps people pay for healthcare through pooled contributions, making medical services more affordable.
Unlike NHIF, which was widely seen as curative and limited in reach, SHIF is designed to bring health cover closer to families, reduce out-of-pocket costs, and put more emphasis on prevention and primary healthcare.
As part of the Universal Health Coverage (UHC) roadmap and Vision 2030, SHIF is not just a rebrand - it is a structural reform meant to give every Kenyan access to affordable, quality health services.
According to government data, less than 20% of Kenyans had active NHIF cover before SHIF was launched, which left millions vulnerable. SHIF aims to change that by creating a mandatory, inclusive system.
What is Social Health Insurance Fund (SHIF)?
The Social Health Insurance Fund (SHIF) is a government-managed health insurance scheme designed to provide financial protection for healthcare services to members, reducing out-of-pocket medical expenses.
Key Points:
- Provides access to hospitalization, outpatient care, and preventive services
- Usually funded through contributions from members, employers, and government subsidies
- Aims to ensure universal health coverage and improve public health outcomes
- Often linked to national health systems and regulated by a health ministry or social security authority
Why SHIF Was Introduced?
NHIF had important achievements, but it struggled with:
- Low coverage: Large sections of informal workers were left out.
- Inefficiencies: Claims and payments were often delayed.
- Unequal benefits: Some people received wide cover while others barely benefited.
To fix this, SHIF was introduced with a sharper focus on equity, sustainability, and Universal Health Coverage (UHC). It is now the financial backbone of Kenya’s UHC roadmap and Vision 2030 agenda, ensuring that everyone, regardless of income, can access healthcare services when they need them.
How Social Health Insurance Fund (SHIF) Works?
SHIF is structured around three main principles:
1. Mandatory Contributions
- Formal employees contribute a set percentage of their income.
- Informal sector and self-employed contribute through structured community payment models.
2. Pooling of Resources
- All contributions are collected into one national fund, spreading the risk across the population.
- This ensures the sick are supported by the healthy, and the poor are supported by the wealthier.
3. Benefits Package
- Coverage goes beyond hospital bills.
- Preventive services, community health programs, screenings, and primary health visits are included.
- Digital systems are being rolled out to track claims and ensure accountability.
SHIF and Prevention
One of the biggest shifts is the pivot toward preventive healthcare. Instead of waiting for people to fall seriously ill and then funding expensive hospital stays, SHIF invests in catching problems early.
- Screenings: Regular checks for diabetes, hypertension, cancers, and other NCDs
- Vaccination programs: Funding immunisation drives for children and high-risk adults.
- Maternal and child health: Covering antenatal visits, safe delivery, and child growth monitoring.
- Nutrition and awareness programs: Encouraging healthier lifestyles to reduce long-term disease.
Example: Under SHIF, a patient with early-stage diabetes can get free or subsidised screening and nutrition counselling at a local health centre, rather than waiting until complications force a costly hospital admission.
This preventive model reduces costs for both families and the healthcare system.
SHIF and Primary Care
Primary healthcare is the first line of defense against illness. SHIF makes Tier 1 facilities - dispensaries, health centres, and community clinics - the default entry point for patients.
- Closer access: Families can get care at local units rather than traveling to referral hospitals.
- Stronger counties: County health facilities receive funds to staff, stock, and run outreach programs.
- Early treatment: Conditions are managed before they become severe.
Example: Instead of overcrowding Kenyatta National Hospital with mild cases, SHIF ensures someone with a fever or early chest infection is treated at a neighbourhood health centre, saving costs and reducing hospital congestion.
Opportunities and Challenges in 2025
Opportunities
- Community focus: More roles for community health workers, nutritionists, and health educators.
- Digitalisation: Electronic claims and patient records improve efficiency and transparency.
- Cost savings: Families spend less out of pocket, improving trust in the system.
Challenges
- Informal sector contributions: Ensuring compliance remains tough.
- Facility readiness: Not all counties have equally equipped Tier 1 centres.
- Governance: Strong oversight is needed to avoid fund mismanagement.
Career Impact and Training Routes
SHIF’s prevention-first approach is already changing the job market. New roles are opening in community health, nutrition, surveillance, and health data management.
Where ICMHS Fits In?
ICMHS (Imperial College of Medical & Health Sciences) offers programs that align directly with SHIF priorities:
- Certificate in Community Health: Prepares students for frontline health promotion and disease prevention roles.
- Certificate in Social Work and Community Development: Builds skills for planning and running health programs at county and community levels.
- Certificate in Health Care Support Assistant: Trains field-ready staff for household outreach, immunisation follow-ups, and local health support.
- Certificate in Health Records & Information Technology (HRIT): Equips students with the data management skills needed as SHIF digitises health systems.
- Diploma in Nutrition and Dietetics: Matches the growing focus on NCD prevention and dietary counselling under SHIF.
For students, this means that enrolling in ICMHS today is a direct step into roles that SHIF is funding and expanding across the country.
Why Choose ICMHS Under SHIF?
SHIF is creating demand for a new kind of health workforce - practical, prevention-focused, and community-based. ICMHS is uniquely placed to deliver that training.
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Programs directly aligned with SHIF: Community Health, Health Records & IT, and Nutrition courses match SHIF’s prevention and data priorities.
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Accredited and industry-recognised: All courses are registered with national bodies (KNEC, TVETA, KNDI, NCK, COCK).
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Hands-on, job-ready training: Students gain practical exposure in clinics, communities, and hospitals, preparing them for SHIF-funded roles immediately.
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Pathways for growth: Start with a Certificate, advance to a Diploma, and progress toward degree-level training while building work experience.
ICMHS is not just a college - it’s the launchpad for careers that SHIF is funding and expanding.
Salary Snapshot for SHIF-Aligned Careers
| Career Path | Entry Level (KES/month) | Mid-Career (KES/month) | Senior Level (KES/month) |
|---|---|---|---|
| Community Health Assistant | 35,000 - 50,000 | 55,000 - 75,000 | 90,000+ |
| Nutritionist / Dietician | 40,000 - 60,000 | 70,000 - 120,000 | 150,000+ (NGOs/clinics) |
| Health Records Officer (HRIT) | 30,000 - 50,000 | 60,000 - 100,000 | 120,000+ |
| Public Health Educator / Promoter | 40,000 - 60,000 | 70,000 - 90,000 | 100,000+ |
| Program Officer / Manager | 90,000 - 120,000 | 150,000 - 200,000 | 250,000+ (donor projects) |
(Ranges are based on county job adverts, NGO salary surveys, and HRIT salary data. Actual pay varies by employer and county.)
Conclusion
SHIF is more than just a new name for NHIF. It represents a major reform in how healthcare is financed, with prevention and primary care at the heart of the system. Families benefit through easier access, lower costs, and healthier outcomes.
For aspiring health professionals, this is the right moment to prepare. Institutions like ICMHS provide the programs that directly match SHIF’s needs - from community health to nutrition and health data.
Your career in public health and prevention can start today with ICMHS.
FAQs Related to SHIF
1. What is SHIF?
The Social Health Insurance Fund is the new national health cover that replaced NHIF in 2024.
2. How is SHIF different from NHIF?
NHIF was more curative and had low coverage, while SHIF focuses on prevention, equity, and universal access.
3. Does SHIF cover preventive services?
Yes. It funds screenings, vaccinations, antenatal care, and other early-stage health services.
4. How will SHIF change primary care?
Tier 1 health centres and dispensaries will become the first point of contact, improving access and reducing congestion in referral hospitals.
5. What careers are most in demand under SHIF?
Community health assistants, nutritionists, health records officers, and health educators are already seeing increased demand.
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