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TAIFA Care enrolment reaches 24 million as government intensifies war on health sector fraud

The government has reaffirmed its commitment to Universal Health Coverage (UHC) through TAIFA Care, a transformative healthcare scheme that has now enrolled 24 million Kenyans.

Cabinet Secretary (CS) for Health Aden Duale speaking at his first official meeting with the Social Health Authority Board, reaffirmed the government’s commitment to delivering quality, accessible healthcare to every Kenyan.

He stated that 5.4 million Kenyans have already accessed vital health services through the Primary Healthcare Fund, which is fully funded by the government and allows access to dispensaries, health centers, and Level 2 to 4 health facilities without any cost to patients.

“This fund is budgeted, appropriated by Parliament, and paid to the Ministry of Health to ensure that ordinary Kenyans receive the healthcare they need without paying from their pockets,” assured Duale.

To date, he announced that the government has disbursed Sh551.3 billion to 7,446 accredited facilities across the country.

These funds, according to the CS, have enabled life-saving services including safe deliveries, chronic disease management, and emergency medical care.

Further, Duale emphasized that the success of TAIFA Care is built on three key pillars: financial sustainability through consistent premium payments, zero tolerance for fraud, and universal access to quality care.

He called on employers and employees to ensure timely remittance of monthly contributions by the 9th of each month, describing it as both a legal obligation and a patriotic duty.

“Our integrated digital system provides real-time monitoring of transactions, enhancing transparency and accountability. We have also intensified the war on fraud by integrating the Kenya Medical Practitioners and Dentists Council data into the system,” he disclosed.

Duale revealed that 728 health facilities had been shut down for non-compliance, while another 301 were downgraded.

Additionally, he announced that 31 facilities in counties including Kisumu, Kiambu, Bungoma, Busia, Kajiado, Kilifi, Mandera, and Wajir have been suspended and were under investigation for fraudulent activities.

“Cases of double claims, converting outpatient cases into inpatient ones, using unauthorized pre-authorization codes, and collusion between patients and facility owners have all been uncovered. These will be forwarded to the Directorate of Criminal Investigations (DCI) and appropriate action will be taken, including full reimbursement and prosecution,” highlighted the CS.

He added that the deployment of artificial intelligence and advanced analytics has helped the Social Health Authority (SHA) to scrutinize claims and protect resources meant for genuine patients.

Addressing challenges facing informal sector workers, Duale pointed out the success of the Lipa Pole Pole initiative introduced by President William Ruto, that allows flexible daily, weekly, or monthly contributions through USSD code *147#, integrated seamlessly with M-Pesa, without interest or penalties.

“Every day, between 800 to 1,500 informal sector workers are enrolling. So far, 1.8 million have registered under TAIFA Care in just eight months, surpassing NHIF’s previous informal sector coverage by over 800,000,” noted Duale.

Further, the CS also lauded strategic partnerships with top-tier hospitals such as Aga Khan University Hospital and Nairobi Hospital, which are now offering specialized services like dialysis, cardiac surgery, and kidney transplants at SHA-approved rates with no extra cost to patients.

“For the first time, these premier hospitals are accessible to ordinary Kenyans, including mama mboga and boda boda operators. This is a true equalizer in healthcare,” he asserted.

Meanwhile, in order to reinforce human resource capacity, Duale announced the deployment of 6,484 healthcare interns to various facilities starting July 1, 2025.

He reported that posting letters were currently being collected at Afya House, marking a key step in strengthening Kenya’s health workforce.

Responding to concerns over the transition from NHIF to SHA, Duale assured staff of job security, stating that no worker would be laid off.

However, he noted that with technological advancements, administrative costs have dropped from 30 percent under NHIF to 5 percent under SHA, enabling a leaner, more efficient system.

Duale also challenged public, private, and faith-based healthcare providers to stop illegal co-charging at primary health facilities and to adopt the SHA tariff to ensure all Kenyans receive the services they are entitled to.

“Primary healthcare is fully funded. Kenyans should walk into facilities and walk out without paying. Any co-payments must be reported immediately via the 24/7 SHA hotline 147 or through the Afya Yangu app,” demanded the CS.

He reaffirmed the government’s dedication to a healthcare system built on sustainability, integrity, and universal access.

By Amina Bakari and  Kamau Daniel

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