NMsby/openimis-be-aletheia_py

ALETHEIA — Provider Integrity Engine and CHP Stipend Transparency Ledger (OpenIMIS backend module, Kenya SHA) # openimis-be-aletheia_py **ALETHEIA — Provider Integrity Engine and CHP Stipend Transparency Ledger** An OpenIMIS backend module built for Kenya's Social Health Authority (SHA) health financing context. Submitted to the KeHIA × iLabAfrica Digital Health Financing Hackathon 2026. --- ## What ALETHEIA Means *Aletheia* (ἀλήθεια) is the ancient Greek concept of truth and unconcealment — bringing what is hidden into the light. This module makes invisible things visible: ghost hospitals, unverified facilities, concealed fraud patterns, and delayed stipend payments in Kenya's SHA health financing system. --- ## Problem Statement ### The SHA Fraud Crisis Kenya's Social Health Authority (SHA) lost **KES 11 billion** to fraudulent claims between **October 2024 and April 2025** — less than seven months after the authority launched. The documented fraud patterns include: - **Ghost hospitals** — facilities registered in KMHFR but non-operational - **Capacity anomalies** — claims at volumes statistically impossible for a facility's licensed bed count or staffing - **Service-to-level mismatches** — tertiary procedures billed from dispensary-level facilities - **Temporal clustering** — claims submitted in volumes inconsistent with normal patient flow OpenIMIS, as Kenya SHA's claims management platform, is the natural intervention point. Without automated pre-submission checks, every fraudulent claim enters the pipeline and requires expensive human review to catch. ### The CHP Stipend Crisis Kenya deploys **107,000 Community Health Promoters (CHPs)** — the frontline primary healthcare workforce serving rural and peri-urban communities. Each CHP is entitled to a **KSh 5,000 monthly stipend** co-financed between the national government and their respective county government. As of 2025, CHPs across multiple counties experienced payment delays of **up to 13 months**, with no transparency into whether delays originated at the national or county level, or both. The dual-pa …