Kenya’s health sector is now facing a serious crisis after fresh claims of fraud within the Social Health Authority (SHA) were exposed. In a report shared by Cyprian Is Nyakundi, disturbing details have come to light showing how some doctors and hospitals have been stealing money meant for medical services by misusing SHA pre-authorization codes.
These codes, which are supposed to ensure patients get approved treatment, are now being used to create fake surgeries and exaggerated claims for profit. Health Cabinet Secretary Aden Duale recently raised the alarm, warning that the SHA system is under attack from within. One case involved a doctor accused of doing ten surgeries a day at a hospital 600 kilometers away from his station, something that is not only impossible but also proves the level of fraud happening.
This doctor later confessed that he didn’t even know his code was being used, which means either his details were stolen or someone inside the system was leaking information. According to Duale, some doctors are now sharing their pre-authorization codes in exchange for kickbacks.
This means that clinics can submit fake surgery claims and still get paid, using the name of a trusted doctor. In many cases, the hospitals report that a patient underwent an expensive procedure, like a C-section or orthopedic surgery, when in reality nothing happened. These fake claims are hard to detect, especially since the SHA system was built on trust.
With no strong monitoring in place, it’s easy for this fraud to go unnoticed for months. One case even revealed that a doctor was listed as performing surgeries in two different hospitals hundreds of kilometers apart on the same day. He later admitted to giving his code to a friend who runs a clinic.
The damage caused by this fraud is huge. Every time money is stolen through these fake claims, real patients suffer. Hospitals run out of drugs, equipment breaks down, and staff shortages increase. Worse still, the public starts losing trust in a system that was supposed to help them.
Even the very health workers who are being forced to pay into SHA through salary deductions are not safe. As Duale put it, “You cannot block your own workers from the scheme and still expect it to succeed.”
The situation calls for immediate action. The Ministry of Health has already launched investigations and promised to bring the culprits to justice.
Failure to act fast will only lead to more losses and greater suffering for innocent Kenyans who depend on public healthcare. It is now clear that SHA fraud is not just about money, it’s about life and death.
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