NAIROBI, Kenya, Mar 30 — The government has moved to reassure Kenyans over the performance of the Social Health Authority (SHA), announcing that KSh 18.18 billion—about 78 percent of all submitted health claims—has been processed and paid.
Health Cabinet Secretary Aden Duale said the payments were made over a 19-month period across multiple schemes, including the Social Health Insurance Fund (SHIF), Primary Healthcare Fund (PHC), and others.
He emphasized that the remaining claims are at various stages of processing, dismissing concerns about missing funds.
Duale revealed that at least KSh1.43 billion worth of health insurance claims have been rejected due to suspected fraud.
The CS said the flagged claims are part of broader reforms aimed at enhancing accountability in Kenya’s health financing system.
“The remainder is neither hidden nor lost. KSh1.43 billion was rejected due to fraud-related issues. KSh2.36 billion was returned to facilities for correction due to incomplete or inaccurate submissions. These are not with SHA, but with the facilities themselves,” he said.
Duale stated that faith-based health facilities have received KSh 1.15 billion under the Primary Health Care (PHC) program, benefiting 448 institutions nationwide.
“A further KSh 5.58 billion is currently under clinical review, well within the contractual 90-day processing window. On Primary Health Care, KSh1.15 billion has already been disbursed to 448 faith-based facilities, with all PHC claims cleared up to January,” he said.
His remarks come after DCP leader Rigathi Gachagua alleged that faith-based organizations running medical facilities are owed KSh90 billion.
“The former impeached Deputy President must move beyond reckless allegations and submit himself to facts, transparency, and accountability. First, you loudly claimed to hold a dossier alleging that faith-based organizations running medical facilities are owed KSh 90 billion,” CS Duale said.