Sh11bn lost to SHA fraud as government closes 1,118 health facilities

Health CS Aden Duale address MPs during their retreat in Naivasha. [Antony Gitonga, Standard]

The Ministry of Health has so far closed 1,118 healthcare facilities across the country that have defrauded public funds through the Social Health Authority (SHA) system.

This comes after announcements that Sh11 billion was siphoned through the SHA systems between October, 2024 and April, last year through fake claims, un-procedural surgeries, ghost patients, and collusion.

According to Aden Duale, the CS for Health, the government had instituted measures that will see prosecution of all those involved in the fraud while ensuring the lost funds were recouped in the long run.

Addressing MPs in Naivasha during the ongoing 2026 Legislative Retreat, CS Aden Duale said the government would not relent to close more facilities that will be involved in fraud. 

Duale said so far, 29 million Kenyans had registered under SHA, where over Sh130 billion had been collected and Sh93.3 billion disbursed to healthcare facilities for services offered.

Duale raised concerns over fraud by a section of facilities who have lodged more claims of deliveries through the Caesarean Section programs as opposed to normal deliveries.

'We have taken note of a section of facilities that spiked their claims up to 97 percent of C-section deliveries due to more monetary benefits as opposed to normal deliveries,” he said.

To drive more contributions by low income members, the CS said the government had introduced SHA lipa polepole which has enrolled 412,011 active contributing more than sh1.4 billion.

Further, Duale said more than 558,000 vulnerable households have been supported by the National government in addition to 63,461 households being supported by NG-CDF.

Duale indicated that the government had established 36 facilities overseas to cater for medical evacuation with a funding capped at sh500, 000.

"We are also seeking Sh5.9B budgetary support for Primary Health Care facilities that will be used to offset unpaid dues owed to facilities for the last three months", said Duale.

Gilgil MP Martha Wangari noted that some health facilities had taken advantage of Caesarean deliveries with the deliveries projected to hit 30 percent by the year 2030.

Wangari called on the health ministry to only consider claims in instances of complicated deliveries while welcoming introduction of a code of conduct that will make health officials liable in cases of neglect that lead to death of patients.

On his part, Nyeri MP Duncan Mathenge called for more allocations to cater for cancer, mental health, rehabilitation care noting that the current pay is not adequate.

Silvanus Osoro, MP for South Mugirango called for speedy prosecution of personnel involved in defrauding SHA funds through fictitious claims.