In the first ten months since the Social Health Insurance Fund (SHIF) began operating, the government has paid out Sh65.4 billion to 4,718 hospitals, clinics, and health centres across Kenya.
The money, released between July 2025 and April 2026, helped cover essential medical services, including dialysis, cancer treatment, maternity care, surgeries after road accidents, outpatient treatment, and intensive care admissions.
According to the report titled Social Health Insurance Fund (SHIF) Facility Payment Report, the payments were made in two phases. Between July 2025 and February 2026, SHIF disbursed 40 billion shillings. Another Sh25.4 billion was released in March and April 2026 alone.
However, the distribution of funds was not equal across the country. Counties with large referral hospitals and specialised private or faith-based facilities received the highest amounts, while remote and marginalised counties received much less.
Nairobi Received the Largest Share
Hospitals in Nairobi received the highest amount at Sh14.9 billion, far ahead of every other county. The county hosts major referral hospitals such as Kenyatta National Hospital, Kenyatta University Teaching, Referral and Research Hospital, Aga Khan University Hospital, and The Nairobi Hospital.
Uasin Gishu County followed with Sh4.6 billion, while Kiambu County received Sh4.1 billion, supported mainly by large faith-based hospitals such as AIC Kijabe Hospital and PCEA Kikuyu Hospital.
Other counties among the top recipients included:
- Kisumu County — Sh2.8 billion
- Kisii County — Sh2.77 billion
- Meru County — Sh2.74 billion
- Mombasa County — Sh2.68 billion
- Nakuru County — Sh2.28 billion
- Nyeri County — Sh2 billion
- Machakos County — Sh1.47 billion
Marginalised Counties Received the Least
Counties in arid and semi-arid regions received the smallest allocations, largely because they have fewer hospitals, lower SHIF registration rates and limited specialised healthcare services.
Samburu County received the lowest amount at Sh61.4 million. Other low-funded counties included:
- Lamu County — Sh126 million
- Tana River County — Sh138.8 million
- Isiolo County — Sh160.9 million
- Marsabit County — Sh177.6 million
- Turkana County — Sh212.2 million
- Narok County — Sh243.5 million
- West Pokot County — Sh258 million
The report says factors such as road networks, hospital availability, population size, contribution rates and access to specialised treatment heavily influenced how money was distributed.
Hospitals That Received the Most Money
Among individual hospitals, Moi Teaching and Referral Hospital received the highest payment in the country at 1.696 billion shillings. The hospital serves patients from across western Kenya and handles many complex medical cases.
Kenyatta National Hospital received Sh1.5 billion, while Kenyatta University Teaching, Referral and Research Hospital received Sh1.24 billion.
Faith-based hospitals also received large payouts. Tenwek Hospital received Sh1.08 billion, while AIC Kijabe Hospital received Sh878.6 million.
Other top-paid facilities included:
- Rift Valley Provincial General Hospital — Sh646.1 million
- Aga Khan University Hospital — Sh644.6 million
- Coptic Hospital — Sh580.4 million
- The Nairobi Hospital — Sh566.7 million
- Coast General Teaching and Referral Hospital — Sh565.1 million
Private Hospitals Took the Biggest Share
Private hospitals received the largest portion of SHIF money despite public hospitals serving a larger population.
Out of all payments made by SHIF, 49.1%, or Sh32.1 billion, was paid to 2,143 private hospitals.
Meanwhile, Sh20.2 billion, or 30.8% of the total money, was sent to 2,230 public hospitals.
Faith-based hospitals got Sh13 billion in 336 facilities, accounting for close to 20% of the total disbursement.
The report says private hospitals received more because many of them offer specialised and expensive treatment, leading to larger insurance claims.
Level 4 and Level 5 Hospitals Received Most Funds
County referral and sub-county hospitals classified as Level 4 facilities received the largest share of funding at Sh28.3 billion across 873 hospitals.
Level 5 hospitals received Sh18.8 billion.
Together, Level 4 and Level 5 hospitals accounted for almost three-quarters of all SHIF payments, showing that most spending is concentrated in hospitals providing advanced treatment and specialised care.
At the lower end, Level 2 facilities such as dispensaries and health posts received only Sh233.5 million, just 0.36% of total payments.
Sh30.5 Billion Claims Still Unresolved
Despite the large payouts, many hospitals are still waiting for payment.
The report shows that Sh30.5 billion worth of claims remain under review and have not yet been paid to hospitals.
In addition, 489 health facilities had their payments rejected because of bank-related errors such as incorrect account details, wrong branch codes, dormant accounts and mismatched account names.
SHA said the system automatically rejects claims with incomplete information.
The report also revealed that:
- 285,523 claims were rejected because of missing documents
- 62,656 claims lacked itemised invoices
- 38,211 claims were rejected after facilities failed to resubmit them within 14 days
Dr Brian Lishenga, chairperson of the Rural Private Hospitals Association (RUPHA), said delayed payments continue to strain hospitals financially.
He said hospitals are struggling with the growing backlog and called on the government to continue making regular payments to avoid affecting patient care.
SHA has advised affected facilities to verify and update their banking details before resubmitting claims.
