SHA Leverages Digital Technology to Process Over One Million Health Claims Monthly
Social Health Authority now processes 26,000 claims daily with half the staff, using digital systems to boost efficiency and cut fraud.
By John Mtongoi Newsroom
August 18, 2026
2 min read
The Social Health Authority (SHA) has transformed its health claims processing through digital technology, now handling more than one million claims every month.
Speaking at the Kenya Health Summit in Nairobi, SHA CEO Mercy Mwangangi revealed that the organisation processes approximately 26,000 claims daily with just 35 employees directly managing the digital claims system. This is a significant improvement from the previous manual system that required nearly 1,737 employees; the current workforce stands at about 818, thanks to automation.
Technology Boosts Efficiency and Transparency
The digital infrastructure comprises 43 interconnected systems that support universal health coverage by streamlining claims management, verifying healthcare providers, and reducing fraudulent activities.
- A unique patient identification system uses national ID and biometrics to eliminate duplicate records and enhance portability of health data.
- Verification of healthcare facilities and professionals ensures that only licensed providers deliver services.
- Digital tracking of medicines from manufacturers to patients improves safety and reduces wastage.
- Telemedicine, logistics management, and data analytics enable better coordination and fraud detection.
Cost and Service Model
Contrary to claims of a multi-billion shilling expenditure, Digital Health Agency CEO Eng. Anthony Lenaiyara clarified that SHA has paid around Sh500 million over two years for technology services. The government did not purchase the infrastructure outright but contracted private firms to provide and maintain the system with a pay-per-active-member model.
Impact on Public Healthcare Facilities
The improved digital system has increased payments to public hospitals from 35% under the former NHIF system to about 62% under SHA, reflecting enhanced accountability and efficiency.
Guidance for Patients
Mwangangi urged Kenyans to ensure they are registered and eligible for SHA benefits before seeking inpatient care. Healthcare providers are expected to submit patient information through the digital platform to facilitate claim verification and reduce fraud.
President William Ruto supports the digitisation initiative, highlighting its role in promoting transparency and accountability in health financing.
