A new audit has raised serious concern over how money is being managed under Kenya’s Social Health Authority.
Auditor General Nancy Gathungu has flagged billions of shillings that cannot be fully accounted for in the health system meant to support the sick and vulnerable.
The report focuses on the Emergency, Chronic, and Critical Illness Fund (ECCIF), which is supposed to help patients after they exhaust normal insurance cover.
But auditors say the money trail is unclear.
The audit found that about KSh 3.9 billion in payments and transition costs lack proper supporting documents.
It shows KSh 1.3 billion was spent on benefits and member transitions without evidence, while another KSh 2.6 billion appears in unexplained financial gaps.
“The schedule did not include important details including member numbers, names of the beneficiaries, and the approved claim amount,” the report states.
Without these details, it is difficult to confirm whether the money reached real patients or was lost through errors or misuse.
The audit also highlights a major funding problem. The authority expected to collect KSh 48.8 billion, but only received about KSh 1.4 billion.
“In addition, the audit also raised concerns over underfunding of the fund,” the report says.
This huge shortfall has raised fears about whether the system can continue operating as planned.
Auditors also found that key procedures were ignored. Regulations require strict checks before claims are approved, but there is no evidence these checks were done.
There is also no proof that patients were properly verified as having exhausted their normal insurance before being moved to the emergency fund.