Audit reveals 80 hospitals, including KUTRRH and Mama Lucy, lack title deeds
The audit further shows that 36 other hospitals had various idle assets, including medical equipment, motor vehicles and unserviceable property that were not being utilised.
At least 80 hospitals across Kenya, including Kenyatta University Teaching, Referral and Research Hospital (KUTRRH), Mama Lucy Kibaki Hospital and Nyeri County Referral Hospital, do not have titles for the land they occupy, a new Auditor General report has revealed.
According to the latest report, the problem extends to other major facilities such as Garissa County Referral Hospital, Kisii Teaching and Referral Hospital, Kisumu County Referral Hospital, and Migori County Referral Hospital, which also lack documentation proving ownership of their land.
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The audit further shows that 36 other hospitals had various idle assets, including medical equipment, motor vehicles and unserviceable property that were not being utilised.
Auditor General Nancy Gathungu also highlights that 206 Level Four, Five, and Six hospitals recorded unsupported expenditures and inaccuracies in financial statements amounting to Sh10.3 billion.
Of this total, Sh2.6 billion relates to unsupported expenditure for 65 hospitals, as relevant documentation and support schedules were not provided, contrary to public finance management regulations, while Sh7.6 billion is attributed to inaccuracies in the financial statements.
Among the hospitals with unsupported expenditure are Makueni County Referral Hospital with Sh424.5 million, JM Kariuki Memorial Hospital with Sh337.3 million, Pumwani Maternity Hospital with Sh280 million, Njoro Sub-County Hospital with Sh214.2 million, Mama Lucy Kibaki Hospital with Sh212.5 million, Gilgil Sub-County Hospital with Sh166.8 million, Bahati Sub-County Hospital with Sh138.4 million, Nyambene Sub-County Hospital with Sh110.3 million, and Annex Hospital in Nakuru with Sh109.5 million.
Hospitals with minimal financial issues include Olenguruone Sub-County Hospital with Sh150,000, Ntimaru Sub-County Hospital with Sh117,252, Ojola with Sh104,000, Soin with Sh70,411, Marafa Sub-County Hospital with Sh59,826, and Kisegi Level 4 Hospital with Sh21,000.
“A key challenge lies in weak governance and oversight, where many hospitals operate without functional audit committees and non-existent internal audit units. The audit revealed inadequate financial management systems across various hospitals,” Gathungu said.
Beyond financial mismanagement, the audit raises concerns about compliance with the Kenya Quality Model for Health Policy Guidelines for Level 4 and Level 5 hospitals. It reveals widespread failures in meeting staffing and infrastructure requirements, resulting in the unavailability of many essential services and inadequate physical and equipment infrastructure necessary for quality health service delivery.
Gatgungu said out of 184 hospitals, 54 did not offer surgical services, 51 did not offer paediatric services, 51 did not offer gynaecology services, 54 did not offer radiology services, and 73 did not offer renal dialysis services.
Pharmaceutical management was also found to be inadequate. Fourteen hospitals lacked sufficient storage space to maintain drug quality, in violation of Pharmacy and Poisons Board guidelines, which require storage areas to have capacity for orderly storage of usable products, quarantined products, released, rejected, returned, or recalled products.
On bed capacity, the report shows that 126 hospitals had a combined capacity of 6,231 beds, far below the required optimum of 18,900. Among Level 5 hospitals, nine had only 32 functional ICU beds against a requirement of 76, while ten hospitals had 28 HDU beds compared to the required 120.
The audit also highlights the issue of idle assets, noting that 36 hospitals had medical equipment, motor vehicles and unserviceable assets that were not being used, underscoring inefficiencies in resource management.
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