Respiratory Illnesses Dominate Kenya’s Health Claims as New SHA Report Reveals Rising Disease Burden

Respiratory diseases such as coughs, flu, throat infections, and pneumonia are the leading causes of medical claims submitted to Kenya’s Social Health Authority (SHA), according to a new Social Health Insurance Fund (SHIF) payment report.

The 166-page report shows that more than 21.4% of all claims handled by SHA between July 2025 and April 2026 were related to respiratory illnesses. However, despite affecting the largest number of patients, their treatment costs are relatively low compared to other chronic diseases.

SHA, led by Director-General Dr. Mercy Mwangangi, replaced NHIF as Kenya’s new public health insurance system.

According to the report, upper respiratory tract infections such as flu and cough accounted for more than 10% of all claims. Pneumonia and bronchitis contributed a further 5.7%.

A SHA official said these conditions are generally treated at low cost through doctor consultations, standard medication, and basic diagnostic tests.

“Diseases that bring in the highest number of patients are often the cheapest to treat from an insurance perspective,” the official said.

A separate Economic Survey by the Kenya National Bureau of Statistics (KNBS) also showed that respiratory diseases were the most reported illnesses in 2025, with 15.4 million cases recorded.

The Ministry of Health has warned that respiratory conditions are now a major public health threat, especially as diseases such as tuberculosis, asthma, and lung cancer continue to rise.

The report also found that stomach-related illnesses, including peptic ulcers, accounted for 17.8% of all SHA claims.

Malaria has also emerged as a major concern, with cases rising sharply from 3.8 million in 2024 to 14.3 million in 2025. It accounted for 9.8% of claims and 6.7% of SHA spending.

However, the most expensive diseases to treat are cancer, kidney disease, heart conditions, and maternity services.

Cancer accounted for only 2.8% of claims but consumed 16.5% of total SHA funds due to the high cost of treatment and specialized diagnostics.

Kidney disease accounted for 13.6% of total expenditure, largely due to regular dialysis treatments required weekly for patients.

Maternity services took up nearly 19% of total SHA spending, driven by an increase in Caesarean deliveries across the country.

Road traffic accidents also continue to consume significant resources due to costly surgeries, intensive care unit (ICU) admissions, and long-term treatment needs.