President William Ruto has announced that up to 1,000 hospitals—mostly private facilities—have been closed or suspended due to fraudulent claims made under the Social Health Authority (SHA) scheme, which replaced the National Hospital Insurance Fund (NHIF). The crackdown aims to eliminate corruption and protect taxpayer contributions for universal health coverage.
What Is SHA & Why the Crackdown?
SHA is designed as a fee-for-service system to reduce claim abuse that plagued NHIF, where around 40% of funds were lost to false submissions President Ruto and Health CS Aden Duale have taken a hard stance to enforce integrity:
- Hospitals were submitting ghost patient admissions, double‑billing, inflating bed capacities, and using shared authorisation codes for false claims
- Health CS Duale confirmed closures/shutdown of 31–35 private hospitals across Nairobi, Kisumu, Bungoma, Mandera, Kilifi and more due to these malpractices
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Ruto’s Estimate: 1,000 Affected Facilities?
While CS Duale cited about 35 hospitals closed for fraud, Ruto suggested up to 1,000 private health facilities are implicated in SHA abuse. This discrepancy likely reflects ongoing investigations into wider fraud networks.
Impact on Patients & Healthcare Access
- The closures coincide with strikes and service boycotts by some faith-based and private hospitals, severely disrupting care
- Underpaid claims—especially for facilities owed over KSh 10 million—trigger service denials. One Reddit user detailed being told SHA wouldn’t cover a C-section, forcing out-of-pocket payment “SHA is down… hospital knows they’ll never get paid by SHA.”
Debt Settlement & SHA Reforms
President Ruto has intervened:
- He’s ordered payment of all NHIF-era claims below KSh 10 million, easing pressure on ~91% of health facilities
- Remaining large claims are undergoing verification, with payment plans to follow within 90 days
- These measures prompted RUPHA (Rural & Urban Private Hospitals Association) to call off its SHA boycott
Public Sentiment & Reddit Voices
Voices on Reddit express frustration over SHA’s shortcomings:
“We confirm SHA accounts updated… but receptionist: ‘SHA iko na issue… we will pay cash.’”
Others argue the SHA system enriches private tech and equipment consortia at the expense of hospitals:
“The consortium… gets 5% of all hospital claims… leaves public hospitals with approximately ~30% to run…”
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The Way Forward
- Transparent investigations: DCI files from closed hospitals are being pursued
- Reform implementation: Payment of small claims and verification of large ones under way.
- System integrity: Ruto pledges SHA will remain corruption-free and government will only pay for legitimate services
- Service restoration: Hospitals to resume SHA-based healthcare once claims are settled.
Bottom Line
President Ruto’s crackdown on fraudulent SHA claims targets deep-rooted corruption in Kenya’s health insurance. While closures—estimated in the hundreds—impact healthcare delivery, efforts to clear backlogs and restructure payments offer hope. But patient care remains strained as reforms and payouts proceed slowly.
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