The Central Organisation of Trade Unions (Kenya) has once again raised alarm over the state of the Social Health Authority and is now demanding urgent reforms to safeguard workers’ contributions.
The union has focused on the management of information technology systems, saying SHA should be given full control instead of relying on the Ministry of Health and the Digital Health Authority for its operations.
According to COTU, this dependency has weakened the independence of SHA and created gaps that compromise accountability.
In a statement released on Tuesday, August 26, 2025, COTU Secretary General Francis Atwoli reminded the government that SHA was created under an independent Act of Parliament and should not operate under the control of the two other bodies.
He warned that such an arrangement risks undermining the institution at a time when Kenyans expect better management of health insurance contributions.
“SHA is being used as a conveyor belt to process payments while it does not control the IT system designed to address issues left by the defunct NHIF,” Atwoli said.
The union believes that failure to grant SHA full authority over its IT system has left it unable to authenticate hospital claims, which could expose it to unnecessary blame for mismanagement and fraud. Workers, Atwoli noted, continue to contribute faithfully to the Social Health Insurance with the belief that their money is managed under a transparent and accountable process.
In his words, “It is unacceptable that an ‘amorphous’ arrangement allows DHA and MoH to control critical systems.”COTU has gone further to warn that public trust in the new health scheme will diminish unless reforms are carried out quickly.
If confidence in SHA fades, the union fears compliance will also be affected, weakening service provision and putting the entire health insurance structure in jeopardy.
The organisation has hinted that it may even reconsider its participation in the SHA Board, citing lack of authority, and will discuss the matter at an upcoming meeting at Tom Mboya Labour College.
The debate around SHA’s effectiveness has continued to draw public attention in recent months, especially after reports of funds being sent to ghost facilities.
On Monday, Health Cabinet Secretary Aden Duale defended the authority, saying claims of paying ghost hospitals were untrue.
He explained that many facilities flagged online had already been sanctioned earlier in the year and insisted that the government was determined to clean up the system.
“No amount of propaganda or blackmail will deter us from fixing our healthcare system,” Duale said.
Even so, questions remain over how fraudulent or inactive hospitals keep appearing in the payment system.
One example was the recent case where SHA was accused of releasing nearly Ksh20 million to a deserted hospital in Homa Bay.
The authority later clarified that the money had actually been sent to Nyandiwa Level 4 Hospital, which still operates under its former account name from when it was a dispensary.
Such controversies, coupled with COTU’s push for reforms, have only increased calls for the government to urgently fix loopholes in the health insurance system before public trust is completely eroded.
