NAIROBI — Kenya’s former flagship health scheme for public secondary school students has collapsed under the weight of fraud and financial mismanagement, the government revealed this week.
Health Cabinet Secretary Aden Duale told lawmakers on Tuesday that the EduAfya Programme once hailed for providing free, comprehensive medical cover to millions of teenagers was brought down by abuse, inflated claims, and double payments to hospitals.
“There were several challenges that were found fraud, misuse, double payments to health institutions arising from a single treatment,” Duale said during a session before the Senate Health Committee. “I can provide the names and institutions.”
Launched in 2018 under the National Hospital Insurance Fund (NHIF), EduAfya aimed to give all public secondary school students access to outpatient, inpatient, and emergency care. It was linked to the government’s NEMIS (National Education Management Information System) database and ran until December 2023.
But behind the scenes, Duale said, some health facilities were gaming the system.
According to the minister, irregular payments and systemic weaknesses made the programme unsustainable. The government has now folded it into the broader Social Health Authority (SHA), a new structure meant to unify all state-backed health insurance schemes under one roof.
“The government resolved to re-consolidate all special schemes into one—the SHA benefit package,” Duale said. “The aim is to ensure equity in healthcare access.”
That move has stirred concern among some lawmakers and educators who say the shift leaves students without a clear replacement for their previous cover.
Nairobi Senator Edwin Sifuna pressed the minister for answers: “Why was the EduAfya medical scheme, which provided comprehensive medical insurance to secondary learners, discontinued under the current Social Health Insurance Fund programme?”
In response, Duale insisted that care would not stop just shift. Under SHA, every child will now access medical services through their household’s registration within the new framework.
“Every child shall have a right to the highest attainable standard of health care in our country,” he said. “Under SHA, children belong to the household and therefore are eligible to benefit from the three funds.”
The three-tiered SHA system is built around primary, emergency, and chronic care, replacing what the government says were fragmented and costly stand-alone schemes like EduAfya.
Yet the transition has not been smooth.
Just a month after the SHA’s launch, patients across the country have complained of delays, confusion, and poor communication in accessing care—problems that risk deepening mistrust in the state’s health reform agenda.
Several MPs have called the rollout “chaotic” and said patients, especially in rural areas, are being turned away due to system failures.
Duale acknowledged the growing pains but defended the new model as more sustainable in the long term. He also promised to devolve health workforce budgets, shifting control from Nairobi to counties, in line with the Constitution.
“Health is a devolved function,” he said. “I will not violate the Constitution. This is part of our commitment to ensure every child, regardless of location, is protected from vaccine-preventable diseases.”
As Kenya races to deliver Universal Health Coverage, the government’s hope is that consolidation will cut waste, plug leaks, and provide fairer care. But critics warn that unless oversight improves, new schemes could fall prey to the same problems that doomed EduAfya.
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