The government's decisive action to shut down 35 private health facilities over alleged fraudulent activities within the Social Health Authority (SHA) has ignited widespread debate among Kenyans. Health Cabinet Secretary (CS) Aden Duale has been at the forefront, raising a significant red flag over these illicit practices that are reportedly defrauding billions of shillings from the newly established SHA fund. The SHA, which transitioned from the defunct National Health Insurance Fund (NHIF) in October 2024, was intended to curb such malpractices, making the current revelations a point of major public concern.

CS Duale has explicitly outlined several types of fraudulent activities being perpetrated by a collusion of healthcare facilities, healthcare workers, and even patients. These include the misrepresentation of claims, where outpatient services are deceptively converted into inpatient claims to inflate values. Another concerning practice is forced admissions, where health workers coerce patients into unnecessary hospital stays solely to increase claim values. The misuse of patient codes is also rampant, with patients reportedly sharing their access codes with hospitals to fraudulently claim services that were never rendered. Furthermore, the abuse of pre-authorization codes by doctors, the admission of 'ghost' patients (individuals who do not exist or exceed the facility's physical capacity), and double charging, where facilities bill both the SHA Fund and demand cash payments from patients for the same services, have all been identified as methods of defrauding the authority.

In response to these alarming findings, CS Duale emphasized that such actions are illegal, unethical, and a direct betrayal of the trust placed in Kenya's health system. He asserted that these activities severely undermine universal healthcare efforts and vowed that the government would not hesitate to take strong and swift action against any culpable individual or institution. The closure of the 35 private health facilities spans across several counties, including Kisumu, Bungoma, Busia, Nairobi, Kilifi, Mandera, Wajir, and Kajiado. Additionally, suspected facilities, medical workers, and patient files will be submitted to the Directorate of Criminal Investigations (DCI) for thorough investigation.

The announcement has triggered a wave of reactions across social media, with many Kenyans expressing mixed feelings and deep skepticism. A common sentiment revolves around the irony of SHA, a system procured at a reported cost of KSh 106 billion (or KSh 104 billion as some sources cited) to eliminate fraud, facing the same issues as its predecessor, NHIF, in less than a year. Users questioned the effectiveness of the new system, with one noting, "If the SHA technology didn’t limit the discretion of doctors and hospitals- on admissions and misuse of ghost and real patient codes — then we are back to square one." Others pondered whether merely changing the name from NHIF to SHA could address underlying issues of immorality and fraud within the nation's healthcare sector, suggesting that perhaps NHIF should have been improved instead of replaced. The public debate highlights concerns that the 'scandal that will brew from SHA' could make history, underscoring the demand for accountability and transparency in the management of public health funds.