Seven people including medical staff and a private health facility in Mtwapa have been charged in court over an alleged scheme to defraud Kenya’s Social Health Authority (SHA) of more than KSh 2 million through fake medical claims.
The suspects, who include nurses, administrative staff, and the clinic itself Jambo Jipya Medical Clinic are accused of forging hospital documents, faking treatments, and submitting the false records to SHA for payment between November 2024 and June 2025.
In court on Monday, the accused Patrick Kimuyu Kanya, Faith Chepkirui Bil, Steven Okinyi Ojwang, Justine Baraka, Pauline Wanjiru, and Naida Mbevu all denied the charges. They were released on bond pending trial.
Fake Surgeries, Forged Records
One of the claims that caught investigators’ attention involves a patient named Mary Njeri Njoroge. According to the prosecution, a claim of KSh 30,000 was submitted to SHA, stating that she had undergone a caesarean section.
But investigators say the patient gave birth naturally and no surgery was ever done.
In another instance, forged treatment records and inpatient notes were allegedly created for two other patients Agnes Chisinde and Lucas Mwamba. Prosecutors told the court that:
Steven Ojwang and Justine Baraka faked clinical notes for both patients.
Pauline Wanjiru allegedly altered the inpatient cardex a document used to track patient care.
Naida Mbevu is accused of presenting the fake documents to SHA as genuine to facilitate payment.
When the matter came up in court, defense lawyers initially tried to have some charges dropped, arguing that the magistrate’s court had no jurisdiction. But the court dismissed that argument, saying it was properly mandated to hear the case.
The first two accused Kimuyu and Chepkirui were granted KSh 600,000 bond or KSh 200,000 cash bail, each with one contact person.
The remaining four were released on KSh 200,000 bond or KSh 70,000 cash bail, each with one surety. The case will be mentioned again on October 21.
This case comes at a time when Kenya is trying to build trust in its public health insurance system under SHA, which replaced NHIF.
While SHA is meant to make healthcare more accessible and affordable, fraud like this raises serious concerns about accountability and oversight especially when public funds are involved.
As the case unfolds in court, many will be watching to see not only how justice is served, but also what measures are being put in place to prevent similar abuse in the future.
