A staggering revelation from Auditor General Nancy Gathungu has cast a dark cloud over Kenya's public education sector: an inexplicable KSh2.2 billion overpayment in the EduAfya medical scheme. This alarming discovery of gross financial mismanagement, or outright fraud, within a program meant to safeguard the health of public secondary school students, highlights a troubling pattern of alleged corruption that plagues crucial public services.
Launched in 2018 under the previous administration, the EduAfya scheme represented a significant promise: comprehensive health insurance for students in public secondary schools, administered by the then-National Health Insurance Fund (NHIF) in partnership with the Ministry of Education. With the government annually remitting a premium of KSh1,350 per student, the aim was to ensure millions of young Kenyans had access to vital healthcare. Instead, it appears to have become a conduit for illicit financial gain.
Unpacking the "Billions Vanishing Act": The Audit's Grim Findings
The Auditor General's special report, covering the program's operations from the 2020/2021 to 2023/2024 financial years, lays bare a series of deeply concerning irregularities:
- Excessive Remittances: The audit found that while the total insurance premiums due were KSh14.17 billion, an astonishing KSh16.47 billion was transferred to NHIF. This represents an unjustified excess of KSh2.29 billion, immediately raising questions about oversight and the integrity of the payment process.
- Underserved Schools and Potential "Ghost Beneficiaries": Out of 9,312 secondary schools whose capitation was paid into the EduAfya scheme, only 8,846 schools had students who reportedly accessed medical services. For the remaining 466 schools, which had remitted KSh273.75 million, there was no verifiable record in NHIF's database or the National Education Management Information System (NEMIS) indicating that their students received any medical attention. This strongly suggests the presence of "ghost schools" or "ghost students" within the system, siphoning off funds without providing any corresponding service.
- Massive Unaccounted for Sums: Of the KSh16.47 billion disbursed to NHIF, a mere KSh5.39 billion was recorded as actual healthcare services delivered to learners. This leaves an inexplicable gap of over KSh11 billion, leading the Auditor General to conclude that there was no reasonable assurance that the services rendered were proportional to the colossal sums paid.
- Ineligible Beneficiaries and Post-Contract Services: The audit further exposed that 15,468 individuals not registered as eligible public secondary school students (including primary and junior secondary pupils not covered by the scheme) accessed services valued at KSh40.16 million. Even more shockingly, 65 medical visits amounting to KSh35,550 were recorded up to February 28, 2024, a full two months after the EduAfya contract officially lapsed on December 31, 2023.
These findings collectively point to profound systemic weaknesses in financial oversight, data integrity, and internal control mechanisms within the EduAfya scheme.
A Troubling Pattern: Previous Warnings Ignored?
The current audit echoes earlier concerns regarding the EduAfya scheme. Even before its official termination in December 2023 (as part of the consolidation into the new Social Health Authority – SHA – benefits package), issues were widely reported. A public petition in 2023 highlighted problems like low student uptake due to NEMIS technicalities, system failures, lack of public awareness, and inadequate healthcare infrastructure. Critics argued that despite billions allocated, hundreds of thousands of students likely did not receive the intended benefits.
Furthermore, the Ethics and Anti-Corruption Commission (EACC) had previously detailed how officials allegedly siphoned funds. Their reports cited practices such as "induced demand" where healthcare providers would allegedly organize transport for students or conduct outreach programs to inflate claims, along with issues like missing invoices, double registration of beneficiaries, and concurrent claims for individuals already covered under other NHIF schemes. These indicators clearly highlighted a system ripe for abuse.
Indeed, Health Cabinet Secretary Aden Duale, in explaining the scheme's termination to the Senate in May 2025, specifically cited "fraud, misuse, and double payments" linked to the NEMIS system as key drivers for discontinuing EduAfya, promising to publicly name the institutions involved.
The Broader Impact: Eroding Public Trust and Threatening UHC
The EduAfya scandal is more than just a case of financial mismanagement; it represents a grave breach of public trust and a significant setback for the nation's development agenda.
- Undermining Universal Health Coverage: As Kenya transitions towards Universal Health Coverage (UHC) through the new Social Health Authority (SHA), such large-scale corruption in a foundational scheme like EduAfya severely erodes public confidence in the government's capacity to manage critical national health programs effectively and transparently.
- Direct Harm to Students: The ultimate victims are the students themselves. Funds intended to secure their health and ensure uninterrupted learning were seemingly diverted, potentially leaving many vulnerable or without the essential medical care they were promised.
- Urgent Call for Accountability: This scandal intensifies the public demand for swift, decisive, and impartial action against all those culpable. It underscores the urgent necessity for robust accountability frameworks, stringent financial management, and thorough investigations that lead to prosecutions and recovery of stolen funds, rather than just reports.
The "Billions Vanishing Act" within the EduAfya scheme serves as a stark and painful reminder that the fight against corruption in public institutions is not merely an economic imperative, but a fundamental prerequisite for building a just, equitable, and healthy society for all Kenyans. The nation now awaits concrete action from the government, particularly the EACC and the Auditor General's office, to ensure justice is served and to prevent such egregious misappropriation of public funds from ever recurring.
