Architects of SHA fraud: A stark pointer to weak systems and deep-seated internal graft- PART ONE
Tragically, the SHA fraud scandal is not just about stolen funds, it is about stolen health. Each ghost claim represents a real patient denied care, a doctor demoralised, and a system compromised robbing Kenyans their dear lives and rendering Kenya’s journey toward universal healthcare just a mirage due to internal rot
In our Three Part investigative series dubbed ‘Architects of SHA fraud: A stark pointer to weak systems and deep-seated internal graft’ The Informer Media Group delves inside Social Health Authority (SHA) and lays it bare the masterminds and facilitators of the morbid looting of the Primary Healthcare Fund (PHF), Social Health Insurance Fund (SHIF) and the Emergency, Chronic and Critical Illness Fund (ECCIF) involving insiders, rogue operators and phony companies used as special purpose vehicles in the looting spree that has gone unabated.
Tragically, the SHA fraud scandal is not just about stolen funds, it is about stolen health. Each ghost claim represents a real patient denied care, a doctor demoralised, and a system compromised robbing Kenyans their dear lives and rendering Kenya’s journey toward universal healthcare just a mirage due to internal rot.
Our investigations reveal that the web of cartels controlling the fraud racket is heavily involved in forgery, inflated billing, upcoding, phantom billing and registration of nonexistent patients.
The recent suspension of 45 private health facilities by the SHA were prompted by revelations of fraudulent claims and irregular payments.
These have proved to be not just isolated incidents, but rather a glaring indictment of systemic weaknesses and internal corruption within the country’s public health management apparatus.
This scandal paints a pattern of abuse.
In June and August 2025 alone, more than 70 health facilities were suspended or shut down for similar offenses, ranging from falsified records to billing for non-existent patients.
According to Health Cabinet Secretary Aden Duale, over 1,188 case files have now been submitted to the Directorate of Criminal Investigations (DCI), painting a damning picture of institutional rot and lax oversight.
At the heart of the issue lies the SHA’s failure to implement robust monitoring systems.
Investigations revealed widespread upcoding, ghost billing, patient duplication, and collusion between facility staff and unscrupulous medical officers.
These practices, undetected for months or even years, indicate not just criminal intent—but the failure of the SHA’s internal audit, claims verification, and regulatory arms.
The hospitals were drawn from several counties, with the North Eastern, Nyanza, and Western regions accounting for the largest numbers.
Nairobi county had just one facility, namely Novic Medical Centre, suspended.
In Mandera, 10 hospitals, namely, Aasif Medical and Health Service Limited, Ayale Medical and Nursing Home, Desertview Healthcare Services, Equity Afia Mandera, Kal Health Nursing Home, Mama Ebla Nursing Home, Sanaag Medical Centre, Tabsam Medical Centre, Wante Nursing Home and Zonal Annexe and Maternity were suspended.
In Garissa, Al-Baitul Tiiba Hospital, Garissa Doctors Clinic and Northgate Hospital Ltd were suspended, while in Wajir, Abakore Nursing Home and Artan Medical Centre were suspended.
Another county that registered a significant number of interdictions was Kisii, with seven facilities, including Filyne Chima Hospital Ltd, Gopima Medical Centre Ltd, Lenmek Healthcare Annex Magenche, Lenmek Hospital Limited, New Hope Nursing Home- Kisii, Nyanchwa Adventist Mission Hospital and Westlife Hospital Ltd suspended.
Homa Bay County had five suspended, including Chala Health Services Ltd, Equity Afia-Homa Bay, Lifenest Community Medical Centre, Nelepek Medical Care Centre and Okitta Nursing.
Neighbouring Kisumu had two, Abala Healthcare Limited and Nyabondo Centre For The Disabled – Kisumu (Fbo), and Migori County had Neocare Memorial Hospital suspended.
In Bungoma County, two facilities, including Chemwaa Health Centre and Grassroot Community Healthcare Ltd, were suspended, as in Kakamega, which had Aspro Medecol Solutions and The Tranquil Hospital suspended.
Narok, Kajiado, Meru, Kirinyaga and Uasin Gishu Counties each had one facility suspended, namely Akemo Valley Maternity and Nursing Home, Namanga Nursing Home, Guardian Hospital – Meru, Kimathi Medical Services Karaba and Palmcare Sinai Hospital, respectively.
Notably, the majority of the hospitals suspended were private healthcare facilities across the country.
However, facilities that have courted controversy since the list was released, including Nyandiwa Level 4 Hospital, which was being accused of being a ‘ghost’ hospital, and Ladnan Hospital, which had been suspected of belonging to the SHA chairperson Abdi Mohamed, were not mentioned in the list.
In our PART TWO and PART THREE of ‘Architects of SHA fraud: A stark pointer to weak systems and deep-seated internal graft’, we lay it bare the cartels involved and schemes used including actual amounts channeled to the facilities under probe, some whose accounts remained dormant until the questionable remittances from SHA started streaming in and withdrawn in quick succession.
