The Kenyan Healthcare System: Social Health Authority, Hospitals, Emergencies, Medicines and Vaccinations

The Kenyan system is a mixed network. For each of the 47 counties, the Social Health Authority (SHA) publishes the list of its contracted facilities, ranked from level 2 to level 6 according to their size and technical facilities, and divided into four categories: government, private, faith-based and NGO facilities. Adding up the 47 counties in its table, it counts more than 10,000 facilities: 5,862 public, 3,828 private, 519 faith-based and 19 NGO, namely dispensaries, health centres, clinics and hospitals, with 18 level 6 facilities and 108 at level 5. Nairobi County alone has 738, of which 126 public, 555 private, 50 faith-based and 7 NGO. These facilities are regulated by the medical practitioners and dentists council (KMPDC) and by the clinical officers council (COC).

For a foreign resident, this organisation means a choice: a public, faith-based or private facility, contracted or not with the SHA, or a combination with an insurance policy. The guide to healthcare systems around the world compares these models, and the page on health insurance in Kenya presents the general framework.

The SHA is the body responsible for managing the funds collected under the social health insurance law: it pools contributions, contracts with approved providers and pays for care, including that of vulnerable people. The SHA’s pages describe the NHIF as a defunct scheme whose outstanding files it is handling. Three funds structure the benefits.

• Primary Healthcare Fund (primary care): consultations, diagnostics, tests, X-rays, ultrasounds, medicines, vaccinations, maternal and child health, screening for breast, cervical, prostate and colon cancer, optical health (eye tests, glasses) and end-of-life care.
• Social Health Insurance Fund (SHIF): specialist consultations and hospitalisation, minor, major and specialised surgery, maternity and neonatal care (normal delivery, assisted delivery and caesarean section), dialysis, mental health, oncology (chemotherapy, radiotherapy) and imaging (MRI, CT scan).
• Emergency, Chronic and Critical Illness Fund: ambulance evacuation, emergencies, intensive care (resuscitation, neonatal, paediatric, burns unit), palliative care and chronic diseases such as diabetes, cancer and mental disorders.

SHIF contributions are 2.75% of gross monthly income, with a minimum of 300 KES a month (about €2 at the 5 October 2026 rate: 146.20 KES to €1), with no cap. Employees have the contribution deducted by their employer, who pays it over to the SHA; the self-employed contribute 2.75% of their household income, determined by a means test completed online on the Afya Yangu portal (SHA).

According to the SHA, all residents of Kenya, whether citizens, refugees or other non-citizens, can register. The document required from a foreign resident is the Foreign Resident Certificate (Alien ID). Registration is done on the SHA website, by online self-registration, or by dialling the code *147# on a mobile phone. This certificate is requested from the Immigration Department, whose service charter provides for the registration of foreigners: see living in Kenya for the formalities.

Local registration gives access to the contracted Kenyan network, with capped benefits and rates set by the SHA; it replaces neither cover recognised in France nor medical repatriation. A visitor without resident status turns to travel or health insurance: France Diplomatie reminds readers that an assistance policy or insurance covering all medical costs (including surgery and hospitalisation) and repatriation is imperative, as hospitalisation costs can be very high and are never borne by the embassy. No bilateral social security agreement links France to Kenya, which does not appear on the list of CLEISS (the French liaison centre for international social security).

First-line care is at levels 2 and 3: dispensaries and health centres funded by the primary healthcare fund, which covers consultations, tests, vaccinations and prescribed medicines. To see a general practitioner or a specialist, a resident also turns to a private-sector practice or clinic, which are very numerous in Nairobi, chosen according to their insurance and the direct billing offered.

The SHA publishes an online eligibility checking tool and the list of facilities by county. Before a consultation, checking that the facility is contracted, that its professional approval is in order and that the insurance contract specifies the reimbursement conditions avoids unpleasant surprises; the notions of reimbursement basis and out-of-pocket costs help with comparisons.

The Kenyatta National Hospital, in Nairobi, is the national referral hospital, a public establishment under the supervision of the Ministry of Health. It offers surgery, medicine (paediatrics, cardiology, oncology, nephrology, infectious diseases), diagnostic (radiology, laboratory) and pharmacy services. Contracted public, faith-based or private facilities, ranked from level 2 to level 6, complete the provision in the other counties; a facility’s level indicates its technical facilities.

• Emergencies: police and emergency services on 999 or 112; Kenya Red Cross (ambulance) on +254 700 395 395, +254 738 395 395 or 1199; Nairobi fire brigade on 020 222 2181, 2182 or 2183 (France Diplomatie).
• Medical transport: the SHA emergency fund finances ambulance evacuation from the scene of the incident to the nearest facility; an international medical evacuation falls under an assistance policy; see the guide to how a medical repatriation works.
• Rainy season: France Diplomatie points out that flash floods and landslides from October to December disrupt travel; plan the journey to the chosen facility in advance.

The regulatory authority (Pharmacy and Poisons Board) urges patients to buy their medicines from a licensed pharmacy and to seek the advice of a health professional before any use, expressing concern about the high level of self-medication. It provides a portal for reporting adverse effects and poor-quality medicines, as well as a section for batch alerts and recalls. Medicines prescribed during a consultation at a primary healthcare fund facility are covered by that fund.

France Diplomatie advises taking only the strictly necessary medicines, in their original packaging, with a prescription giving the names of the molecules in international non-proprietary names, checking that they are authorised in the country and never taking medicines bought on the street, because of the risk of counterfeits. The guide to the medical questionnaire and medical history explains the effect of a pre-existing condition on insurance.

France Diplomatie first reminds readers to be up to date with the French vaccination schedule (diphtheria, tetanus, poliomyelitis, whooping cough, measles). Additional vaccinations are added depending on the conditions of the stay: yellow fever, endemic in the centre and west of the country, is strongly recommended and in principle required for people arriving from an endemic country or having transited for more than 12 hours through one; hepatitis A and typhoid fever depend on the conditions and length of the stay; hepatitis B concerns frequent or prolonged stays; ACWY meningitis the dry season or a reported epidemic; tuberculosis, children under 15 in the event of frequent or prolonged stays; rabies, particularly young children and rural areas; chikungunya, dengue and mpox are added depending on epidemics or exposure. A consultation at a vaccination centre before departure sets the programme.

• Malaria: endemic, with a low risk of transmission in Nairobi and a significantly higher one around Lake Victoria and on the coast; preventive treatment is recommended after medical advice.
• Cholera: the outbreak declared on 8 October 2022 is continuing; it has spread to 20 counties and remains active in 9, the worst affected being Nairobi, Garissa and Mandera, with cases reported in several neighbourhoods of the capital, including hotels; hand and food hygiene and bottled water are essential. Tuberculosis: Kenya is among the 30 high-burden countries, and the disease remains one of the leading causes of death. HIV: 1.4 million people are living with the virus (2022 figure), the third leading cause of death in the country.
• Other diseases: Rift Valley fever, mostly animal, is prevented by protection against mosquitoes and by cooking animal products thoroughly; HIV post-exposure prophylaxis is available in Kenya.
• Rains: from October to December, rainfall heightened by El Niño favours the resurgence of diseases; plan protection against mosquitoes.

Details of reimbursements, from the local employee to the retiree, are on the page on healthcare reimbursement in Kenya; the page on expat health insurance gives benchmarks for comparing policies, and Expavy helps you weigh these options against your situation.