SHA registration scandal: Critics chide CS Duale over cosmetic arrests

Harun Liluma, an employee of KMPDC is linked to the alleged Social Health Authority (SHA) registration scandal. [Gloria Milimu, Standard]

Health Cabinet Secretary Aden Duale has been accused of concealing theft at the Social Health Authority (SHA), with critics claiming no meaningful action has been taken against individuals allegedly involved in graft running into billions of shillings.

The critics argue that arrests and pronouncements made by the Office of the Director of Public Prosecutions (ODPP) are cosmetic and meant to create the impression of action, rather than address systemic loopholes at the public health insurer.

On Tuesday night, ODPP issued a statement approving charges against eight individuals over alleged fraudulent registration and payment of claims at SHA.

The statement was released just hours before Duale and the SHA Chief Executive Officer (CEO), Dr Mercy Mwangangi, were scheduled to appear before the National Assembly Departmental Committee on Health to respond to concerns over the alleged loss of Sh11 billion through suspected fraudulent claims by medical facilities.

Duale failed to attend the MPs' meeting, choosing to preside over the launch of the national rollout of Lenacapavir, a groundbreaking advancement in HIV prevention.

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Insiders argue that the ODPP statement was meant to forestall a barrage of questions from furious MPs over the fraud at SHA.

Deputy Secretary-General of the Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU), Dr Dennis Miskellah, poked holes in the announcement, saying merely naming individuals and hospitals implicated in fraud is not a solution.

“It is one thing to name individuals and have them take responsibility. In this country, corruption thrives because nobody is taken to court and jailed,” said Miskellah.

He added, “If there are people caught, it is not enough to stop their licenses; DCI, DPP and the judiciary must act quickly so that we stop this nonsense of crime, and them not being reimbursed.”

Miskellah regretted that fraud is affecting the discharge of healthcare services, with Kenyans not able to get care, while tens of hospitals continue to close due to a lack of funds, as SHA is not paying claims.

But in the statement, ODPP noted to have reviewed the files against the eight individuals that had been submitted to the DCI between January 28 and February 24, 2026.

At least eight hospitals are also listed as having been involved in fraudulent registration and conspiracy to defraud.

The hospitals include Danaba Care Hospital, Kamishawa Medical Centerm Kaafi Nursing Home, Mama Nerbeel Nursing Home, Alat Nursing Home, Julun Nursing Home, Adafaa Kids Care Medical Center and Dimtu Nursing Home Limited.

Danaba Care Hospital is accused of fraudulent registration and payments, with its directors, Mohammed Kulow Ali and Hassan Adan Ibrahim, accused of conspiracy to defraud and operating an unlicensed health facility.

Harun Liluma, an employee at the Kenya Medical Practitioners and Dentists Council (KMPDC), is facing charges of unauthorised access to a computer system, computer misuse and cybercrimes.

The former directors at Kamishiwa Medical Centre, Kamsia Hassan Kala and Hawa Alinoor Malo, are accused of conspiracy to defraud. Operating an unlicensed facility and obtaining money by false pretence.

Ibrahim Rashid and Ahmed Mohamud of Kaafi Nursing Home are accused of operating without being licensed, and operating without license.

Investigations of fraud were also conducted against Mama Neebeel Nursing Home, with Naima Sheikh Ali, Abdihakim Sheikh Ali, Adan Abdikhaliq Abdullah, the hospital proprietors, accused of obtaining money by false pretence and operating without a license.

Others accused include Ali Edin Ibrahim, owner of Alati Nursing Home, and Ismail Omar Mohammed of Julun Nursing Home.

Mohamed Mohamud Sheikhm Ali Ahmed Adan and Mohamednoor Ismael Omar Kulow Ali and Hassan Adan Ibrahim, directors of Adfaal Kids Care Medical Center are accused of conspiracy to defraud. The hospital is also alleged to be operating without a license and to be acquiring proceeds of crime.

Yussuf Siat Jelle, director of Dimtu Nursing Home Limited, is also accused of conspiracy to defraud, operating unlicensed, and acquisition of proceeds of crime.

Rural Urban and Private Hospitals Association (RUPHA) said some of the offences in question suggest collusion with SHA personnel or at the very least, dereliction of duty or failure of system guard rails within SHA to protect against the loss of funds.

RUPHA chairperson Dr Brian Lishenga said unauthorised access to a computer system, contrary to section 14(1) of the Computer Misuse and Cybercrimes Act raises questions regarding the robustness of the SHA Digital Infrastructure managed by the Digital Health Agency and procured at a price tag of Sh104 billion.

“It is worth noting that the Contract for Digital Systems between SHA and the Safaricom Consortium provides for Sh5.2 billion on Security Solutions to prevent ingress of SHA infrastructure by rogue actors,” said Lishenga.

In addition, he said the contract provides for Sh3 billion to be spent on various registries, including health facility registries.

“Given this steep investment by the people of Kenya, we demand that an independent audit of SHA security systems and Registries be conducted to identify gaps that facilitated these alleged breaches and hold individuals and companies accountable.

This audit will also establish "value for money", whether MoH and SHA can justify such heavy expenditure on security systems and registries given the ease with which they appear to have been breached,” he added.

Lishenga also took issue with offences regarding operating healthcare facilities without licenses.

According to him, it would be prudent for an independent audit to be conducted to establish the role of the KMPDC in protecting citizens from accessing unlicensed providers.

He questioned whether KMPDC has the capacity (personnel, vehicles, IT and resources) to properly carry out its functions, and if it was aware of the crime.

“How did unlicensed facilities access the SHA system if the same facilities must be first accredited by KMPDC prior to empanelment by SHA? Does the KMPDC registry actually communicate with the SHA registry, or do they function as soiled independent bodies? Posed Lishenga.

Further, RUPHA is seeking answers on how unlicensed facilities were contracted by SHA.

“We would like answers to these questions even as we prosecute the allegations of fraud,” maintained Lishenga.

At least the names of the facilities and individuals alleged to be behind the fraudulent registration happened barely six months after DCI listed at least 31 hospitals to be under investigation.

At least 1,188 files were handed over to the SHA in September last year for investigations. Of the files, fewer than 40 have been recommended by DPP for prosecution.

The Sh104 billion digital superhighway, he said, was meant to stop fraud that continues to be witnessed.

“We were told the multi-billion-shilling system was procured to prevent fraud, but right now, we are still reporting fraud. I am wondering if the system was to beat fraud, yet we it is not, can’t we cancel that contract?” posed Miskellah.

He regretted that even with the digital system that should ease work, doctors and hospitals delay getting reimbursement.

Turnaround for patients’ approval for services and care is also slow, notes the doctor.

“We are tired every time they are told that SHA is not working, and SHA reimbursement is not happening. Doctors and other health workers are not being paid, with some hospitals closing because of fraud,” said the union official.

Miskellah regretted that with the little collection, much is going to cracks, regardless of only 5 million Kenyans, more so, employed contributing their 2.75 per cent of their income to the social health scheme.

Data by SHA shows a total membership of 29 million, but only 2.9 million are in the formal sector and 1.4 million are active members.

“If we have a system that costs us Sh104 billion, we have not even seen a single person arrested, jailed and forced to return money,” said Miskellah.

Miskellah raised an issue with several doctors who have had their licenses suspended, and some of them are being investigated, while others have not been reinstated.

“We cannot have audit reports and not punish those who should be punished. We must find a way. We only have five million Kenyans contributing to SHA, and having it stolen, we cannot succeed if fraud continues to be reported. But fraud can only be stopped if people are being jailed, being fined,” emphasised Miskellah.

On its part, the Kenya Medical Association notes its support for lawful investigations and prosecution wherever evidence exists.

KMA President Dr Simon Kigondu said fraud exists in every sector where public resources are involved.

“The fraud solution is continuous vigilance, strong systems, and ethical leadership, not blanket condemnation of healthcare providers,” said Kigondu.

Kigondu said a strong SHA requires both accountability and financial stability.

“Fraud is not an institutional characteristic; it is an individual criminal act. Individuals who intend to defraud systems will always attempt to manipulate processes and may recruit others into such schemes,” said Kigondu.According to him, the correct approach to tackling fraud is not to label institutions or the healthcare sector as fraudulent, but rather to identify, investigate, and prosecute individuals where evidence exists.