Five counties in SHA fraud web as 12 hospitals shut amid probe

The counties of Bungoma, Homa Bay, Mandera, Wajir and Kisii have been flagged for widespread fraud in Social Health Authority (SHA) claims, with 12 hospitals shut down in a sweeping government crackdown.

The five counties have been cited as having long-standing fraud networks similar to those reported under the now-defunct National Health Insurance Fund (NHIF).

Private hospitals have been identified as the main offenders, according to Health Cabinet Secretary Aden Duale.

“The system and SHA forensic auditors have flagged these facilities as being involved in serious fraud,” Duale said.

Among the affected institutions is Bungoma West Hospital. Other implicated facilities are located in Homa Bay, Mombasa, Kerugoya and Nairobi, while Mandera and Wajir each have at least five hospitals accused of submitting fraudulent claims.

SHA Chief Executive Officer Mercy Mwangangi confirmed that Bungoma West Hospital has been suspended for 90 days over suspected fraudulent activities.

The facility is barred from serving SHA beneficiaries or transacting with the authority during the suspension period, with management directed to transfer patients to nearby contracted hospitals.

Duale said the Ministry of Health remains committed to protecting public funds meant for healthcare. “We shall take action against anyone stealing taxpayers’ money,” he said.

According to the CS, at least 24 facilities are currently undergoing forensic audits, while about 1,000 facilities nationwide have been closed over fraudulent SHA claims. Thirty investigation files have already been submitted to the Office of the Director of Public Prosecutions (DPP) for prosecution, with 18 cases already before the courts.

The Directorate of Criminal Investigations (DCI) is also probing more than 200 facilities suspected of fraud. “We have a duty under the law to protect public resources,” Duale said, noting that officers have firm instructions to ensure accountability.

He added that 12 hospitals linked to SHA fraud have been shut since March 30, 2026.

Speaking during a graduation ceremony at the Hawa Kosar Islamic Centre in Garissa County, Duale emphasised the government’s commitment to safeguarding Universal Health Coverage (UHC). “Anyone stealing money meant for SHA will be arrested. All fraudulent claims will be investigated and action taken,” he said.

Interior and National Administration Cabinet Secretary Kipchumba Murkomen last week warned that officers involved in fraudulent SHA claims would face arrest, prosecution and recovery of stolen funds.

“We have zero tolerance for corruption. Any rogue officers involved will be arrested, prosecuted and their facilities permanently closed,” Murkomen said during the onboarding of police and prison officers into SHA.

The Ministry of Health attributed the detection of fraudulent claims to the Sh104 billion digital health system, which has strengthened oversight and transparency. “The days of physical paperwork are over. Digital systems provide strong oversight,” Duale said, noting that the Digital Health Agency (DHA) plays a key role in detecting irregular claims.

DHA Chief Executive Anthony Lenayaira said SHA operates as a fully digital system requiring only biometric verification and a national ID.

He noted that biometric identification and one-time passwords help flag suspicious transactions automatically.

Meanwhile, the ministry plans to establish ambulance dispatch centres by June to improve emergency response nationwide.

Duale said emergency ambulance services will be accessible to all Kenyans and funded by the SHA. “Ambulances will transport patients to hospitals without any upfront payment. Emergency services will be provided free of charge for the first 24 hours to stabilise and save lives,” he said.

Under the Emergency, Chronic and Critical Illness Fund (ECCIF), Kenyans will access emergency ambulance services through a national toll-free number. The fund, financed by the Exchequer, eliminates upfront hospital deposits and covers emergency treatment, intensive care, high dependency services and management of chronic illnesses such as cancer and dialysis.

Apart from ECCIF, SHA operates the Primary Health Care Fund (PHCF), financed by the Exchequer, and the Social Health Insurance Fund (SHIF), funded through individual contributions of 2.75 per cent of income.

So far, at least 30,269,902 Kenyans have registered with SHA.