Prime Cabinet Secretary Musalia Mudavadi's defence of the Social Health Authority has opened a fresh political battle over President William Ruto's healthcare record, with the government pointing to millions of beneficiaries while critics insist the real test is whether patients can actually get treatment when they need it.
Mudavadi, speaking at the Kenya Health Summit 2026 in Nairobi, argued that the government had made substantial progress since replacing the National Hospital Insurance Fund with SHA.
“Every Kenyan deserves a health system that works, not just on paper, but when they walk into a hospital, visit a clinic or need care at home,” Mudavadi said.
His remarks came as the administration sought to showcase its health reforms ahead of the 2027 General Election, with Ruto's allies increasingly using statistics to defend a programme that has become one of the government's most politically contested policies.
Mudavadi cited the registration of 32.3 million Kenyans under SHA, compared with eight million beneficiaries under NHIF. He said SHA had received more than Sh209 billion since October 2024 and paid Sh178 billion to health facilities in all 47 counties.
The government says eight million people have received treatment through the scheme.
It also points to more than 500,000 surgeries, treatment for over 50,000 cancer patients, 850 modern medical equipment units delivered to hospitals and more than 20 million outpatient visits supported through the Primary Health Care Fund.
But those numbers have failed to silence critics.
Instead, SHA has become a political dividing line between the government and an opposition preparing to make healthcare one of the issues on which it will challenge Ruto in 2027.
Nairobi Senator Edwin Sifuna has argued that the government is putting too much emphasis on registration figures while failing to address the experience of patients and hospitals.
Sifuna's argument is straightforward: having millions of people registered does not necessarily mean millions of Kenyans can access affordable treatment.
The criticism has been reinforced by recent public opinion research. An Afrobarometer survey published this year found that health was the most important problem Kenyans wanted the government to address, while 89 per cent of respondents said they worried about being unable to obtain or afford medical care. Among those who had visited a public health facility, 62 per cent said it was difficult to obtain the services they needed.
The findings give the opposition a powerful political argument — that the government's impressive SHA statistics are not necessarily translating into confidence among citizens.
Despite record SHA registration, experts continue to point to gaps in contributions, funding challenges and medicine shortages as obstacles to achieving Universal Health Coverage.
There is another problem for the administration: the scheme's financing and claims system has repeatedly come under scrutiny.
SHA has faced complaints from health facilities over delayed reimbursements, while the government has responded by tightening verification of claims to prevent fraud.
Critics say the delays can leave hospitals struggling to provide services, while the government maintains that stronger scrutiny is necessary to protect public funds.
The controversy has given Ruto's political opponents an opening to attack not only SHA but the broader record of his administration.
Former Deputy President Rigathi Gachagua has repeatedly criticised the scheme and used it as part of his wider argument that the Kenya Kwanza government has failed to deliver on its 2022 promises.
Ruto, however, has shown no intention of retreating.
In July, he warned against proposals to scrap SHA and revive NHIF, saying such a move would reverse the reforms his administration had undertaken.
“Those people telling us to go back to a system that was not working are a very risky lot for our nation,” Ruto said.
The President has also challenged his critics to look beyond political claims and assess the services being delivered under the new system.
“If they want to know whether SHA is working, they should ask the Community Health Promoters,” Ruto said.
The administration is increasingly presenting the Community Health Promoters as proof of its shift towards preventive healthcare. More than 107,000 CHPs have been deployed, with the government saying they have reached millions of households.
