By Benadeta Mwaura - Reporter
Kenya, 24 April 2026 - The government has pledged to settle KSh 116 million in pending claims under the now-defunct EduAfya medical scheme by 8 May 2026, in what officials describe as a first step toward resolving longstanding debts that have strained healthcare providers and affected beneficiaries.
Appearing before the Senate, Health Cabinet Secretary Aden Duale assured lawmakers that payments covering life and last-expense claims will be disbursed within weeks.
“The life and last-expense claims will be settled by May 8. The House can hold me to that,” he said.
The KSh 116 million represents only a fraction of the total outstanding liabilities tied to the scheme.
According to the Ministry of Health, EduAfya accumulated KSh 735.8 million in unpaid claims, including KSh 320 million for inpatient services and KSh 299 million for outpatient care.
EduAfya, launched in 2018, provided comprehensive health insurance for students in public secondary schools before it was discontinued in December 2023 and folded into the new Social Health Authority (SHA) framework. However, the transition exposed gaps in claims processing, leaving hospitals and families waiting for compensation.
Duale attributed the delays to verification challenges during the shift from the defunct National Hospital Insurance Fund (NHIF) to SHA, noting that the government is now undertaking a detailed audit to reconcile and validate claims before payment.
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The audit, he said, is necessary to ensure accountability and prevent further losses of public funds. “The Ministry is undertaking a reconciliation and validation process to determine legitimate claims before payments are processed,” Duale told senators.
The issue was brought to the Senate by Nairobi Senator Edwin Sifuna, who demanded clarity over delayed compensation, including cases where families had not received the KSh 500,000 benefit promised after the death of insured students.
Beyond administrative delays, the EduAfya programme has been dogged by deeper structural issues. Government audits and parliamentary disclosures have previously flagged fraud, misuse, and double payments as key factors behind its collapse, raising concerns about financial oversight within public health schemes.
Duale has warned that similar risks threaten the sustainability of the new SHA system, revealing that multiple fraud cases linked to health facilities are under investigation. This has reinforced the government’s push for stricter verification processes before releasing funds.
The settlement of the KSh 116 million is therefore not just a payment exercise, but part of a broader attempt to restore confidence in Kenya’s evolving health financing system. Still, with hundreds of millions of shillings in claims yet to be cleared, hospitals and affected families remain cautious, watching whether the 8 May deadline will finally translate into actual disbursements.