Revealed: How Kenyans lost Ksh.11 billion in fraudulent SHA claims

Even after the installation of what was termed as tight procedures and a waterproof IT system to secure hard-earned deductions from Kenyan employees, the billions were still siphoned through fictitious surgeries and fraudulent claims by health facilities, with the help of SHA workers.

Appearing before National Assembly legislators in Naivasha, Health Cabinet Secretary Aden Duale disclosed a new trend where expectant women were forced to undergo surgeries during childbirth, some of which were unnecessary, to inflate claims.

As part of a crackdown on those involved, 50 medics have been struck off from the list of those with SHA authorisation rights.

His presentation before the National Assembly retreat in Naivasha, Nakuru County, laid bare how the taxpayer lost Ksh.11 billion in just six months, between October 2024 and April 2025.

Duale lifted the lid on how many privately owned health facilities forced mothers to the theatre for delivery.

"Somebody wants to force a mother to a C-section when she can deliver normally just because they want to get a difference of Ksh.20,000," said the Health CS.

"We used to see doctors tell mothers to sukuma (push) during birth... Nowadays it is just go to theatre. We want to go back to sukuma," said National Assembly Speaker Moses Wetang’ula.

Duale revealed that many of the forced C-section surgeries were fake.

"We have one facility that told us they are doing C-sections, and when I visited it had no theatre, which had 35 claims of CS," Duale noted. 

CS Duale enumerated other cases of fraudulent documentation, mostly filled by one individual, which were used to siphon billions from SHA coffers.

"There is a patient in Kwale County whose dependent children are 381. We are handing over that patient to DCI," the CS added. 

Members of the National Assembly pushed the CS to reveal details of individuals caught in the scandal and measures taken so far.

"How many people have been arrested so far in connection to those cases you have mentioned?" asked Charles Nguna, MP Mwingi West.

"We have deregistered 22 doctors and 36 clinical officers from the SHA platform. We have also closed down 1,118 health facilities. DCI has also promised to go after those who stole," Duale remarked. 

CS Duale said he presented over 1,000 files to the DCI for investigation in September last year, but the pace of settling the cases is yet to hit 100 per cent.

Despite the gloomy picture, the ministry presented a case of a fairly successful SHA rollout, revealing that over 29 million Kenyans had already registered on the platform.