NAIROBI, Kenya – Health Cabinet Secretary Aden Duale has disclosed that the current government inherited a staggering Ksh30 billion in what he termed 'fictitious' debt at the National Hospital Insurance Fund (NHIF) from the previous administration. Duale specifically highlighted that Ksh5.6 billion of this alleged debt was linked to the Linda Mama maternal healthcare programme.

The Cabinet Secretary made these assertions on Tuesday, September 30, 2025, during the commissioning of the Dr Abdulrahman Al-Sumait Complex and the groundbreaking ceremony for the School of Engineering Phase III at Umma University in Kajiado County. His comments underscore the significant financial challenges the new administration claims to be addressing within the health sector.

NHIF Debt: A Legacy of Mismanagement?

Duale did not mince words, stating, “When we came into office, we were confronted with a fictitious NHIF debt amounting to Ksh30 billion. Shockingly, Ksh5.6 billion of this was linked to the Linda Mama programme. This was not just a matter of numbers. It reflected years of weak oversight, inefficiency and mismanagement that compromised the quality of care delivered to mothers and their children.”

The CS's remarks paint a grim picture of the financial state of the country's national health insurer, suggesting that systemic issues led to the accumulation of substantial, questionable liabilities. The Linda Mama programme, designed to provide free maternal healthcare services, is a critical component of Kenya's public health initiatives. Allegations of mismanagement within this programme could erode public trust and impact the delivery of essential services to vulnerable mothers and children.

Reforms Under the Social Health Authority (SHA)

In response to these alleged challenges, Duale affirmed that the current administration has initiated comprehensive reforms within the health sector. These reforms are primarily being implemented under the umbrella of the new Social Health Authority (SHA), which is set to replace the NHIF. The SHA aims to improve healthcare access and quality for all Kenyans through a more robust and transparent framework.

The transition from NHIF to SHA is a cornerstone of the government's agenda to achieve Universal Health Coverage (UHC). The new authority is expected to address the inefficiencies and financial irregularities that Duale claims plagued its predecessor. Key objectives of the SHA include:

• Enhanced Oversight: Implementing stricter financial controls and accountability mechanisms to prevent future accumulation of fictitious debts.
• Improved Service Delivery: Ensuring that funds are utilized efficiently to provide high-quality healthcare services to beneficiaries.
• Broader Coverage: Expanding the reach of health insurance to a larger segment of the population, aligning with UHC goals.
• Transparency: Fostering greater transparency in financial reporting and programme management to rebuild public confidence.

Linda Mama Enhanced Under Linda Jamii

Duale also highlighted that the Linda Mama programme, despite its past challenges, has been enhanced and integrated into the broader Linda Jamii initiative. This enhancement is intended to safeguard the health of mothers and children more effectively under the new health framework. The government's commitment to maternal and child health remains a priority, with efforts focused on ensuring that these vital services are not disrupted by past financial woes.

The Linda Jamii initiative represents a holistic approach to family health, aiming to provide comprehensive care from pregnancy through early childhood. By integrating Linda Mama, the government seeks to streamline services, improve coordination, and ensure that resources are allocated efficiently to achieve better health outcomes for mothers and their offspring.

Public Debate and Policy Implications

The Cabinet Secretary's allegations are expected to ignite significant public debate and could influence near-term policy execution. Stakeholders, including healthcare providers, civil society organizations, and the public, are likely to demand greater clarity on the specifics of the alleged debt, the timelines for its resolution, the costs associated with the reforms, and the safeguards being put in place to prevent recurrence.

Analysts suggest that the government will need to provide detailed evidence to substantiate the claims of 'fictitious' debt and outline a clear strategy for addressing the financial legacy of the NHIF. The success of the Social Health Authority and the broader UHC agenda will largely depend on the government's ability to demonstrate effective financial management and restore public trust in the country's health insurance system.