AHMED SADIK: Why integrity, not just funding, will define Kenya’s health future

Kenya’s health sector is at a critical juncture.

As reforms such as the Social Health Authority (SHA) take shape, recent claims have revealed how fragile the system remains without integrity at its core.

Fraudulent practices by hospitals and providers have undermined a program designed to bring universal healthcare closer to citizens, exposing how easily even well-intentioned policies can be derailed by ethical lapses.

Recent investigations by the Ministry of Health have exposed the depth of malpractice among several hospitals and healthcare providers.

The fraudulent activities range from ghost admissions and inflated claims to the unethical conversion of outpatient visits into inpatient stays, all designed to siphon funds from the SHA.

These funds were meant for Kenyans in desperate need of genuine medical attention.

Health Cabinet Secretary Aden Duale captured the gravity of the scandal in stark terms, saying the culprits were “stealing from the sick and the poor”.

His remarks underscored the gravity of the violations, not mere errors, but deliberate actions that betrayed both the law and basic human decency.

Such practices are not only criminal but morally indefensible. They are a betrayal of the public trust.

Integrity is not an optional add-on in healthcare. It is the bedrock upon which trust is built.

Every patient who walks into a hospital does so in a vulnerable state, often in pain, sometimes desperate.

That vulnerability demands honesty and compassion from healthcare providers.

When integrity is compromised, and profit takes precedence over ethics, patients are left wondering whether treatments prescribed are genuinely necessary or merely fabricated to pad invoices.

This breach of trust corrodes the very essence of healthcare: the assurance that providers are acting in the best interest of those they serve.

The consequences of fraud extend beyond individual cases. Every shilling lost to false claims is a shilling that could have been used to buy medicine, repair equipment, or pay healthcare workers.

In a system already struggling with drug stockouts, equipment shortages, and overstretched personnel, such theft compounds existing weaknesses.

The poorest Kenyans, who rely most heavily on public facilities, bear the brunt of this dishonesty.

They are the ones who go without essential drugs, who wait in long queues for overstretched doctors, and who pay the ultimate price when care is delayed.

Yet, amid this crisis lies a rare opportunity for transformation.

CS Duale has pledged to take firm action against those found guilty, promising not only legal consequences but also the revocation of licenses and closure of non-compliant facilities.

Such measures are essential to restoring public trust. They signal that the Ministry will not turn a blind eye to malpractice and that integrity remains central to Kenya’s health agenda.

Kenya is not the first country to confront corruption in healthcare. Lessons abound from across the world, where strong oversight and ethical accountability have been used to safeguard resources and rebuild trust.

Rwanda, through its Mutuelles de Santé community-based health insurance scheme, has achieved near-universal coverage.

Its use of digital health records and strict accountability structures has kept fraud at bay while ensuring equitable access to care.

Singapore, globally recognised for its zero-tolerance stance on corruption, tightly monitors every claim under its Central Provident Fund system, leaving little room for malpractice.

In the United Kingdom, the National Health Service has established a dedicated Counter Fraud Authority tasked with investigating, prosecuting, and recovering funds lost to fraud.

 These models underscore a critical point: integrity is not just about morality; it is about designing systems that make corruption nearly impossible.

For Kenya, the lessons are clear. Reforms must include stronger digital systems to track claims, enforce accountability, and reduce loopholes. A dedicated anti-fraud unit within the health sector could mirror the NHS model, focusing exclusively on rooting out corruption and ensuring that stolen resources are recovered and redirected to patient care.

Community-based oversight mechanisms, revived and empowered, could also act as watchdogs at the local level, ensuring that fraud does not thrive in silence.

But system reforms alone will not suffice.

Restoring integrity demands a cultural shift.

Hospital administrators must enforce strict internal oversight; healthcare professionals must recommit to their oaths of service; and medical training institutions must elevate ethics to the same level of importance as technical skills.

A new generation of health workers must understand that integrity is not peripheral but central to their professional identity.

Equally important is the role of the public. Citizens must be empowered to recognise and report unethical practices.

Whistleblowers need real protection, not just token assurances, so that those who expose wrongdoing are not punished for their courage.

Strengthened community health committees can provide a platform for ordinary Kenyans to exercise oversight, ensuring the system remains people-centred and accountable.

The scandal confronting the SHA is a wake-up call. It reminds us that the success of universal health coverage is not only about policy design or resource allocation but also about values.

If integrity is absent, the most well-funded and well-designed systems will fail. But if integrity is entrenched, if leaders, providers, and citizens alike demand honesty, transparency, and accountability, then Kenya can indeed transform its health sector into one that delivers with dignity, fairness, and effectiveness.

This is not a moment for half measures. The country must seize the opportunity to build a culture of integrity, one that protects public resources, upholds ethical standards, and ensures that no Kenyan is denied care because funds meant for them were stolen.

The Ministry’s current resolve must be matched by unwavering action, and counties, communities, and citizens must all play their part.

If integrity becomes the backbone of Kenya’s health sector, then universal healthcare will cease to be a slogan and instead become a lived reality for millions. The time to act is now.

Ahmed Sadik is a governance expert. He writes regularly on integrity, institutional accountability and public sector reforms