Ministry of Health Lists Top 5 Counties Leading in SHA Fraud in Kenya

The Ministry of Health has named five counties in Kenya that are leading in suspected fraud within the Social Health Authority (SHA) system. This comes as the government continues a nationwide crackdown on fake medical claims.

Health Cabinet Secretary Aden Duale spoke on Saturday, April 4 in Garissa, where he revealed that Homa Bay County, Bungoma County, Mandera County, Wajir County, and Kisii County have recorded the highest number of suspicious claims.

According to Duale, most of these questionable claims are coming from private health facilities. He explained that some hospitals may be submitting false bills or charging for services that were never provided.

The government has already taken action by shutting down several health facilities linked to the fraud. Since March 30, at least 12 facilities have been closed as investigations continue. In addition, 24 facilities are currently undergoing detailed audits, while about 250 others are being investigated by the Directorate of Criminal Investigations.

Duale further revealed that 30 case files have already been submitted to the Office of the Director of Public Prosecutions, with 18 health facilities already facing court cases. Overall, more than 1,000 facilities have been shut down across the country due to fraud-related issues.

Investigations have shown that some hospitals inflated their claims to receive more money from the SHA system. In some cases, health facilities are suspected of working together with insiders within the system to approve fake claims.

The five counties that have been flagged are now under close monitoring. Auditors are focusing on unusual billing patterns and repeated claims that raise suspicion.

Several health facilities have also been mentioned in the ongoing crackdown. These include Bungoma West Hospital, which was suspended for 90 days over suspected fraud. Other facilities under investigation include Baypharm Medical Centre in Homa Bay, Dawida Annex Hospital in Taita Taveta, Kerugoya Medical Centre in Kirinyaga, Raycos Health Centre in Mombasa, Calvary Hope Medical Centre in Bungoma, Shamberere Dispensary in Kakamega, Kurafa Medical Centre in Kiambu, Umoja Three Medical Centre in Nairobi, and Pro Elite Westlands General and Specialist Hospital in Nairobi.

The Ministry of Health has assured Kenyans that it will continue to fight fraud in the health sector to protect public funds and ensure that services are delivered honestly.