Ksh11 Billion SHA Fraud Crackdown Intensifies as DPP Sanctions Charges Against Hospital Bosses

The Office of the Director of Public Prosecutions moves to prosecute key suspects following a DCI investigation into widespread irregularities within the Social Health Authority

The Director of Public Prosecutions, Nelson Ingonga, has given the green light to prosecute hospital directors and government officials implicated in an alleged multibillion-shilling fraud involving the Social Health Authority (SHA).

In a statement issued on Wednesday, February 25, the Office of the Director of Public Prosecutions (ODPP) confirmed that Ingonga had received and reviewed investigation files forwarded by the Directorate of Criminal Investigations (DCI), covering the period between January 28 and February 24, relating to suspected fraudulent activities within the SHA.

Who Is Being Charged

The DPP has sanctioned charges against directors of various healthcare facilities across Kenya, as well as employees of the Kenya Medical Practitioners and Dentists Council, over alleged fraudulent registration and payment irregularities involving the SHA. The specific names of the individuals and facilities have not been disclosed at this stage due to ongoing legal processes.

Among the charges approved are operating unlicensed healthcare facilities, conspiracy to defraud, unauthorised access to computer systems, and abuse of office.

ODPP and DCI Pledge Firm Action

The ODPP reaffirmed its constitutional mandate in the wake of the approvals, stating that it remains committed to upholding the rule of law in the matter.

The DCI, for its part, signalled that investigations are far from over. The agency indicated it would intensify its probe into fraudulent activities within Kenya’s healthcare system, deploying forensic tracing, intelligence gathering, and multi-agency collaboration to ensure all perpetrators are held accountable — regardless of their standing or influence.

“We are leaving nothing to chance,” the DCI stated, adding that the goal is to identify, apprehend, and prosecute every individual facilitating fraud within the system.

Background: The Ksh11 Billion Question

The prosecutorial action follows a public warning issued in late January by Health Cabinet Secretary Aden Duale, who vowed to name all hospitals and firms linked to Ksh11 billion in fraudulent claims that had been flagged and rejected by the SHA’s internal fraud detection system.

Speaking on January 29, CS Duale was categorical that the rejected funds would not be released, citing forensic audits and professional reviews as the basis for the decision. He further pledged that all parties found to have attempted to benefit from the fraudulent claims would be publicly identified in accordance with the law.

The SHA fraud case represents one of the most significant integrity tests facing Kenya’s recently restructured public health financing system, which replaced the National Health Insurance Fund (NHIF). Analysts and health sector stakeholders are watching closely as authorities move from investigation to prosecution, with the outcome likely to shape public confidence in the SHA going forward.