Last Monday, Nairobi County cleaner Miriam Ochieng queued outside a public hospital in Eastlands, clutching her new Social Health Authority (SHA) card.
By mid-morning, she was told the facility no longer honoured it.
The consultation fee alone costs what she earns in two days. She walked away untreated, one of a growing number of county employees quietly abandoning the county government’s flagship health scheme.
Previously, the Nairobi County government had enrolled its employees under Jubilee Health Insurance until 2025, when it transitioned them to the Social Health Authority (SHA).
Despite mandatory deductions from their payslips, hospitals are rejecting SHA cards, services are limited and approvals are delayed, raising fresh questions about the efficiency of the new health financing model.
The Kenya County Government Workers Union (KCGWU), Nairobi Branch, has issued a one-week ultimatum to SHA to fix what it describes as a chaotic system that has left workers and their families struggling to access medical care.
Branch secretary Calvin Okello on Monday said employees have been forced to dig deep into their pockets to pay for treatment whenever they visit health facilities.
“Some hospitals have completely refused to treat our employees under SHA. We have given a seven-day notice to the county government to procure a new medical cover,” Mr Okello said.
He explained that workers were enrolled in SHA after the expiry of the county’s previous medical insurance contract.
“It is a right for an employee to have proper and comprehensive health insurance. SHA has been on and off. Sometimes they offer treatment, and other times, when you visit facilities, you are told they are no longer working with SHA. We don’t want those inconsistencies because they are really affecting us,” he said.
According to the union, about 19,000 Nairobi County workers could pull out of SHA if the issues raised are not addressed.
“We have categorically said that we don’t want SHA because it is not working,” Mr Okello added.
The union is also demanding timely remittance of statutory deductions and the settlement of delayed payments owed to retired workers, some of whom have been camping at City Hall seeking compensation.
Mr Okello said the scheme’s unpredictability had left workers dangerously exposed, warning that nearly 100,000 people, including employees and their dependants now risk being locked out of healthcare.
With about 19,000 county workers enrolled and each allowed up to five dependents, he said the consequences of SHA’s failures extend far beyond individual employees.
“You cannot know what lies tomorrow. It is too inconsistent,” he said, adding that contributions deducted from workers’ salaries were effectively being withheld without service.
“It is our money, yet when you go to the hospital, you are denied treatment. It is like putting your money in a bank and being told you cannot withdraw it.”
