Francis Atwoli, Secretary General of the Central Organisation of Trade Unions (COTU), has accused the Ministry of Health (MoH) and the Digital Health Authority (DHA) of being responsible for fraudulent claims at the Social Health Authority (SHA). He claims the SHA lacks autonomy due to its reliance on an IT platform controlled by the MoH and DHA.

• Atwoli, a member of the SHA board, has been attempting to meet with Health Cabinet Secretary Aden Duale for one month regarding these issues.
• The core problem, according to Atwoli, is that SHA's operations are "entirely dependent on an IT platform" managed by the DHA and MoH, instead of being independently controlled by SHA.
• Atwoli warned that if SHA is not given 100 percent control of its IT platform, workers will lose faith in the institution, affecting compliance and service provision.

The Social Health Authority (SHA) has refuted claims that a list of payments to hospitals went missing and that it disabled the Kenya Master Facility Registry. This comes after the payment records and the registry became inaccessible on Monday, August 25, amidst allegations of massive fraud within the authority.

• Health Cabinet Secretary Aden Duale exposed widespread fraud at SHA, with Ksh10.6 billion in claims rejected due to fraudulent activities or non-compliance.
• Total claims submitted under the Social Health Insurance Fund (SHIF) reached Ksh82.7 billion, with Ksh53 billion already paid out.
• The Kenya Master Health Facility Registry (KMHFR), crucial for verifying hospital details and tracking payments, was reportedly down, coinciding with the fraud allegations.

Kenya's new Social Health Authority (SHA), launched in October 2024 to replace the corrupt National Hospital Insurance Fund (NHIF), is already embroiled in significant fraud scandals, with billions of shillings being lost to cartels. This corruption threatens to undermine universal healthcare efforts, leaving patients without critical medical services.

• The SHA has rejected Sh10.6 billion worth of fraudulent claims in less than a year, following the NHIF's estimated loss of over Sh50 billion to fraud before its dissolution.
• Health CS Aden Duale stated in August 2025 that his ministry had suspended 40 hospitals and blacklisted 12 doctors in an effort to combat the fraud.
• Investigators uncovered "ghost facilities," fake patient files, and "upcoding," where hospitals billed for expensive treatments that never occurred, including a "hospital in a phone" receiving Sh10 million.