Step by Step: How State shuts down health facilities in Kenya

The Ministry of Health has intensified oversight of health facilities to ensure that services paid for are actually provided, closing and downgrading hundreds of hospitals and clinics.

Principal Secretary in the State Department for Medical Services, Ouma Oluga, outlined the step-by-step process that authorities follow before a facility is shut down.

During an interview on Tuesday on Radio Generation, he explained that the process begins when someone applies to open a facility.

The applicant selects a suitable location, builds or modifies the structure, and decides on the services to offer.

A sanitation inspection, usually conducted by the county government, ensures the facility meets waste management and public health standards.

“Most sanitation inspections are done by county governments… how you will manage waste, whether your facility is in a residential area and it will disturb other people,” Oluga said on Radio Generation.

Once the sanitation report is approved, the facility applies to the Kenya Medical Practitioners and Dentists Council. Inspectors evaluate the infrastructure, medical services, equipment, and public health measures. These inspectors include health professionals, building experts, and equipment specialists.

“Now what many people do is that they open a facility… they bring physicians and nurses, they bring equipment… the inspectors give them the license because they have seen those things then," the PS explained.

Facilities are classified by the services they provide, from level two to level four. Problems occur when facilities later remove staff or equipment but continue claiming the same services.

In such cases, the Social Health Authority (SHA) flags the discrepancy, often following complaints from patients through a public hotline.

“We have a call center, 147… we receive 3,000 calls every day… we check, we find that that hospital has actually claimed that they offered services, so we send the regulator,” Oluga said.

After verification, the regulator downgrades the facility or recommends closure. SHA removes the facility from the payment system for services it no longer provides.

If fraud is confirmed, legal procedures are followed under the Social Health Insurance Act. The facility is gazetted, and the case can be referred to the Directorate of Criminal Investigations for prosecution.

“We have to collect this data, get a report from the regulator, Gazette it, and then follow through," Oluga stressed.

The PS noted that these measures are essential to ensure accountability, prevent cheating, and protect both patients and public funds. They also rely on societal cooperation, as dishonesty in claiming services remains a challenge.

Earlier this month, Health Cabinet Secretary Aden Duale suspended 40 health facilities after investigations revealed they were defrauding the Social Health Authority (SHA) system.

The CS explained that the suspension is part of ongoing efforts by the government to curb fraudsters within the healthcare sector.

He reiterated President William Ruto's stern warning to fraudsters in the healthcare sector that any malpractice would be dealt with firmly and according to the law.

"If you are trying to game the system, beware: You are already on our radar. The system is flagging such attempts, and investigations are ongoing," Ruto stated during a high-level launch of the National Equipment Service Project at State House, Nairobi, on August 7, 2025.

In June, 2025 atotal of 875 health facilities were closed down due to non-compliance by the Kenya Medical Practitioners and Dentists Council (KMPDC)

Speaking in Garissa County during the launch of Health Facility Digitalization, CS Duale also revealed that over three million health institutions have been eliminated due to fraudulent NHIF records.

“Only licensed and accredited facilities will now be empanelled under the Social Health Authority (SHA),” he said.