Dennis Miskellah: SHA fraud has worsened due to facility improvement fund
By Cy Muganda, September 3, 2025Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) Deputy Secretary General Dennis Miskellah has warned that fraud in the Social Health Authority (SHA) system has become worse than during the NHIF era, following the introduction of the facility improvement fund.
Speaking on a local media station on September 3, 2025, Miskellah identified this fund, established under one of the four health laws passed last year, as a significant driver of increased fraud within the system.
“We have not protected SHA enough. The whole fraud is a reality. And in fact, it is worse than in the NHIF days,” Miskellah stated.
He explained that the facility improvement fund allows for money collected at healthcare facilities to be wired back to those same facilities, creating incentives for fraudulent behaviour.
“Right now, one of the four laws that were passed last year was a facility improvement fund, where money collected at a facility is wired back to the facility,” he stated.
Private vs public hospital dynamics
Miskellah expressed concern over widespread fraudulent activities across healthcare facilities operating under SHA, noting that the new fund has also encouraged public hospitals to engage in dishonest practices.
“Because in the NHIF days, only private hospitals were desperately looking for how to run their costs. These guys have to employ, pay employees, buy drugs and all these things. But the challenge with it is that now even public hospitals are now engaging in the fraud because they want the money to come to them,” he explained.
He provided a specific example of how doctors are now manipulating the system for financial gain.
“I know of a doctor, he has a private sector background, and he has learned to ensure that any given time, the wards are full, to ensure that they get maximal SHA reimbursements and claims,” Miskellah revealed.
SHA implementation
Miskellah criticised the implementation of SHA, arguing that policymakers failed to consider crucial differences between Kenya and Thailand when adopting the Thai healthcare model.
“The whole idea when they were forming SHA, some people went and borrowed the Thailand model, which is perfect. But what they forgot that 80% of Thais go to public hospitals, where in the public hospitals, their workers are being paid by the exchequer,” he explained.
He suggested that while SHA has adequate resources to meet the healthcare needs of the population, it remains to be seen whether the system can withstand human greed.
“So SHA is there enough for our needs, but can it be enough for our greed?” he posed.