Funding crisis derails Sh7.2bn maternal and child healthcare programme
The audit notes that counties were expected to contribute a combined Sh450 million for the 2023/24 financial year, but 12 counties did not provide Sh102.67 million of their share.
Thousands of women and children in 11 counties missed out on essential health services after a Sh7.2 billion programme meant to support primary healthcare was hit by severe funding delays and unmet financing conditions.
According to Auditor-General Nancy Gathungu, the Ministry of Health released Sh440.9 million to counties on June 21, 2024, just nine days before the end of the financial year, leaving many county governments scrambling to roll out the programme’s activities.
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Some counties were unable to implement any services, while others were forced to deliver projects meant for the whole year within a matter of weeks.
The affected services included critical maternal and child health interventions such as antenatal care for pregnant women, immunisation for children under one year, family planning, and delivery support by skilled health workers.
“Analysis of Danida PHC special purpose account statements from the counties revealed that the funds were transferred on June 21, 2024, nine days before the closure of the financial year,” Gathungu stated in her audit of the State Department for Medical Services.
The Danida Primary Healthcare (PHC) support programme, which began in 2021, is a joint effort between Kenya and Denmark aimed at improving health outcomes for pregnant women and children under five years.
The Danish government committed Sh3.6 billion, with counties expected to provide a matching amount.
But by June 2024, only 36 counties had received a total of Sh1.66 billion, less than half of Denmark’s pledged contribution.
Eleven counties were left out entirely after failing to raise their share of the required counterpart funding. Even though Sh136.5 million had been earmarked for them, none of it was disbursed due to their failure to meet the financial obligations.
“In the circumstances, programme activities were not implemented in the 11 counties that did not meet the funding requirements, resulting in denial of essential primary healthcare services to the public,” Gathungu noted.
Further compounding the crisis, eight counties failed to transfer Sh87.6 million to project special accounts by August 2024, while six others delayed transferring Sh45.25 million to healthcare facilities by up to two months.
The audit notes that counties were expected to contribute a combined Sh450 million for the 2023/24 financial year, but 12 counties did not provide Sh102.67 million of their share.
In addition to delayed disbursements and failure to raise required funds, internal control weaknesses in health facilities also undermined implementation.
A spot-check of 17 facilities in Laikipia, Murang’a, and Isiolo revealed numerous accountability issues, including unremitted statutory deductions, casual worker wage backlogs, missing bank reconciliations, and breaches in procurement rules.
“Physical verification of 17 healthcare facilities in three counties (Laikipia, Murang’a, and Isiolo) sampled revealed various internal control weaknesses such as inadequate financial accountability: uncontracted casual worker accumulated casual wages, non-compliance with statutory worker benefits deduction and remittance, missing bank reconciliations, discrepancies in fund utilisation, breach of procurement regulations and unused funds that hindered programme implementation,” the report noted.
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