George Kebaso @Morarak
The Universal Health Coverage (UHC) pilot project, which will be launched today by President Uhuru Kenyatta in Kisumu, could herald a new chapter for Kenya’s healthcare system.
To underscore the importance of the project, one of his Big Four agenda pillars— expanded manufacturing, affordable housing and healthcare and food security— on which he has hinged his legacy, the President spent cnsiderable time on it in his Jamhuri Day address yesterday, insisting it was a panacea to the country’s health sector woes.
Today, he will be in Kisumu, one of the four pilot counties to launch it. “The residents of Isiolo, Kisumu, Nyeri, and Machakos counties will receive free health care services in all health facilities from their local health centres all the way to the referral facilities. We will use the lessons learnt from this pilot (project) to refine and scale up the programme to the rest of the country over the next 18 months,” he said.
But on the way to the success of this noble initiative stands the graft monster, a vice that is ever lurking in the shadows to dig its deadly fangs into any public project.
Already, the National Hospital Insurance Fund (NHIF), which the government is leveraging on to finance the UHC, is in the headlines over the theft of billions of shillings by its top managers. And this is a stark warning that the road to the launch of the programme is bumpy.
The Kenya Association of Private Hospitals (KAPH) chief executive Officer, Timothy Olweny has cautioned that lack of comprehensive investigation into the scandals would adversely affect the smooth implementation of the UHC where an estimated Sh3.9 billion has already been pumped into the pilot programme.
Corrupt Health ministry
“There is urgent need to sort the mess in the health sector in the country,” he said in a recent interview on K24 television channel.
On his part, Aids Healthcare Foundation (AHF) country director Samuel Kinyanjui says the definition of UHC remains unclear while theft of billions of shillings is unexplained.
“The root cause of the failed health market remains undefined, and the preoccupation with inputs such as funding, staffing, medicines and infrastructure blinding the industry governance and policy makers from the goal of UHC,” he told People Daily recently.
Kinyanjui said high fees for services is the main cause of the high wastage of over 40 per cent of public health resources. He wishes this could have been sorted out before the launch, or even by the time of the actual rollout in the next two years.
Already, billions of shillings may have been lost through mega scams at the NHIF alone, a body tasked with leading the implementation of UHC.
At least 18 senior officials at NHIF are in court for allegedly misappropriating Sh1.1 billion from the fund. Senior Assistant Director of Public Prosecutions Emily Kamau summed up the enormity of the scandal, saying the offense should be equated to murder as many people might have died because of the loss of the money.
The medical leasing equipment leasing project in which two hospitals in all counties were to receive state-of-the-art equipment from companies contracted by the government has also stroked controversy. Initially, the MES programme was estimated at Sh38 billion but was later hiked to Sh63 billion.
Ministry of Health officials who appeared before the Senate recently, explained that the Sh25 billion variance was intended to equip an additional 21 hospitals with equipment.
In yet another suspected scandal, the country risks losing more than Sh8 billion in procurement of 37 CT scanners that were quoted to cost Sh227 million each. These had been budgeted for under the MES arrangement at a cost of Sh4.5 billion. The National Assembly’s Public Accounts Committee (PAC) put the cost of a scanner at about Sh40 million.
When the ministry officials appeared before the PAC, it was revealed that MOH did not purchase the scanners under the initial plan but instead awarded a fresh tender to a Chinese firm in a government-to-government agreement.
In the contract, the Chinese government is set to foot 80 per cent of the cost to be repaid by the Kenyan tax payers- while the government will pay the remaining 20 per cent.
The National Treasury has since paid Sh1.7 billion towards the contract. The MPs expressed their concern that there was a plan to inflate the price of a CT scanner four fold to benefit senior government officials in the Ministry of Health and the National Treasury.
As the UHC is being launched today, already more leaders are challenging the MOH to give a true picture of the project cautioning that billions of shillings should not be spent on the pilot phase yet no result is seen. “Those charged with the responsibility should tell the President how better the project would be implemented,” Kisumu Senator Fred Outa has said.
Lack of acountability
In May 2017 – at the height of revelations concerning a Sh5 billion health ministry scandal – the US government suspended financial support valued at close to Sh2.1 billion to the ministry due to corruption, weak accounting procedures and lack of accountability.
Through its Embassy in Nairobi, the US wrote to President Uhuru Kenyatta asking him to address the matter urgently by pegging the success of UHC to elimination of corruption in the sector.
The move affected outreach and training programmes by the ministry, which has ever downplayed the cuts describing them as only a small portion of the overall US health investment in Kenya, which exceeds Sh65 billion annually.
A leaked audit by the ministry’s internal audit office revealed billions of shillings were lost through irregular payments. The cash was paid to companies associated with influential personalities in the political and business class. The money is enough to buy 16 state-of-the-art cobalt cancer-fighting equipments to add to the only one available at the Kenyatta National Hospital.