Kenya’s new health cover system recognises polygamous households. Here is how to make sure everyone is covered.
The Social Health Authority (SHA) has transformed healthcare coverage in Kenya by introducing a more inclusive system that recognises the diverse family structures in the country.
Unlike the previous NHIF system, which only recognised one wife and one husband, SHA now allows the registration of up to four wives, one husband, and an unlimited number of children, provided you can prove the relationships.
Speaking at a public forum on 23 November 2025, Health Cabinet Secretary Aden Duale said: “NHIF was only recognising one wife and one husband, but SHA allows up to four wives, one husband and an unlimited number of children, as long as you can prove that these are your children.”
Multiple spouse coverage under the SHI Act
The Social Health Insurance Act provides the legal foundation for this. Subregulation (4) states: “A contributor with more than one spouse shall pay a premium for each spouse as determined by the means testing instrument and the spouse shall be eligible to access benefits fourteen days from the date of declaration under subregulation (1) and payment of the premium.”
Contributors in polygamous marriages must pay a separate premium for each additional spouse, with the amount determined by a means-testing instrument that assesses the household’s total income. A 14-day waiting period applies before the newly added spouse can access benefits, shorter than the standard 30-day period for other dependants. SHA also extends coverage through the Linda Jamii programme, which covers mothers from conception through prenatal care, delivery, and vaccination.
Pre-registration requirements
Before adding additional spouses to your SHA account, ensure you have the following:
For each spouse:
- Valid National ID card
- Active phone number for OTP verification
- Individual SHA registration, which must be completed first
Proof of marriage, one of the following:
- Marriage certificate
- Affidavit of marriage
- Letter from your local chief confirming the marriage
Step-by-step registration process
Step 1: Individual registration
Each spouse must first register individually with SHA through the Afya Yangu portal at afyayangu.go.ke or via USSD code *147# using their National ID and phone number.
Step 2: Adding the spouse as a dependant
- Log in to your SHA account at sha.go.ke or through the Afya Yangu portal.
- Go to “My Profile,” then “Dependants,” then “Add Dependant.”
- Select “Spouse” from the options
- Enter the spouse’s National ID details
- Submit your proof of marriage.
- Provide the spouse’s phone number, as they will receive a One-Time Password via SMS to confirm the addition.
- Complete and submit the application.
Step 3: Await processing
Your application will be reviewed, and the spouse will be added to your household registration upon approval.
Who pays the premiums?
For salaried members, premiums are deducted from each employed spouse’s salary. For non-salaried households, the family decides who contributes. The total income of all household members is assessed to determine the appropriate premium level. A standard 30-day waiting period applies before newly added spouses can access benefits, though this is waived when replacing a deceased spouse.
For polygamous marriages, you may need to register additional wives under different households while linking them to you as the primary contributor, particularly if you are in formal employment or enrolled in the Public Officers Medical Scheme Fund (POMSF).
As CS Duale described, Linda Jamii: “We are not protecting the mother only or the child only. We cover the mothers from conception to prenatal, all the way to delivery and vaccination, that’s what’s called Linda Jamii.”
If a dependant passes away, notify SHA immediately with the relevant death notification documents. For assistance, visit any SHA branch, a Huduma Centre, a public hospital with an SHA help desk, or dial *147#.
