President William Ruto praised Mombasa County on Thursday for registering more than one million residents under the Social Health Authority (SHA), describing it as the leading county nationally in SHA enrolment and a model other counties should replicate.

Speaking during an event in Mombasa, Ruto said the government has paid out Sh7.8 billion to cover medical costs for residents enrolled under the scheme in the county. "At least 1 million Mombasa residents have been registered at SHA in Mombasa. Today Mombasa County is number one on matters of SHA registration," he said, adding: "We have paid Ksh.7.8 billion for SHA in Mombasa, and that is tremendous." He commended Mombasa Governor Abdulswamad Sherrif Nassir for what he described as significant progress in the county's health sector, and urged other counties to adopt similar measures to boost enrolment and expand healthcare access.

Ruto has praised Mombasa's SHA performance on several occasions over the past year as its enrolment figures climbed, from roughly 695,000 residents (58 percent of its target population) in mid-2025, to more than 600,000 reported again in early 2026, and now past the one-million mark. Health Cabinet Secretary Aden Duale separately credited the county with an 80 percent registration rate out of 32.2 million Kenyans enrolled nationally as of earlier this year.

That national enrolment figure, however, has drawn scrutiny: SHA data has shown that while 32.2 million Kenyans are formally registered, only an estimated 5 million are actively remitting premiums, with much of the broader registered total including children and other dependants who do not pay contributions themselves. Mombasa's own registration success has also previously been overshadowed by a separate dispute: in 2025, the Mombasa County Assembly raised concerns over roughly Sh1.2 billion in arrears owed to county-run health facilities and support funds, with the Assembly Speaker publicly questioning how the county could lead nationally in registration while facing substantial unpaid claims that left patients struggling to access services. It is not clear from current reporting whether that specific arrears issue has since been resolved.