Majority of tenders in Health Ministry awarded unethically
Four out of 10 tenders in the Ministry of Health were awarded on basis of favouritism while another three were awarded after a bribe was given, a report on corruption and unethical behaviour in Kenya’s health sector has revealed.
The total expenditure in the health sector between 2017 and 2022 was Sh955 billion, which was approximately six per cent of the cumulative national budget.
The 2022 Economic Survey showed that the total budget expenditure by counties on health care was Sh508 billion, out of which Sh420 billion was recurrent while Sh88 billion was development representing 82 per cent and 18 per cent respectively.
Half of the health sector staff and 43.5 per cent of contractors identified tendering phase as most prone to corruption and unethical conduct
Loop holes in procurement regulations caused three out of 10 contractors to give half of their revenue from tendered project as unofficial payment to corrupt public officers in the health sector.
In some areas members of the public are aware of health care projects being implemented in their areas but majority were not involved in planning and execution phases.
“Makueni, Kisumu and Migori counties had the highest levels of public involvement in the implementation of health care projects. On the other hand, Garissa, Wajir and Nairobi counties had the lowest levels of public involvement,” the report said.
Despite health being a devolved function, health care projects under the county governments were the most underfunded accounting for 86 per cent compare to those projects under the national government at nine per cent.
In Meru, Tharaka-Nithi and Embu counties had more health care projects that had been completed at costs above planned budget which was attributed to among other reasons insufficient budget allocation, embezzlement of funds, inflation of cost and bribery.
The report conducted in partnership with United Nations Office on Drugs and Crime says that late disbursement of funds and change of contract terms led to projects running late after the contract period expired in counties.
Health workers in Kajiado, Meru and Machakos have the highest levels of awareness on instances of fraudulent variations in tenders while their counterparts in n Kitui, Makueni, Uasin-Gishu, Nakuru, Narok, Bungoma and Kisii were not aware of instances of fraudulent variations.
Due to high level of interests in health sector tenders, there is undue influence by external actors in procurement processes in health care projects where it has been revealed that in Wajir, Embu and Machakos counties undue influence in procurement processes is rampant.
Governors, MCAs and MPs are identified as key players in influencing procurement processes. Due to the political interference, half of the public felt that the award of contracts was not a fair and transparent process.
“Key recommendations drawn from the study included debarment of contractors who mismanage projects and engage in corruption and unethical conduct; debarment from practice and where applicable practicing licenses withdrawn of government officers who collude with contractors in committing procurement and financial malpractices; entities ensure transparency and accountability in project planning, prioritization and execution; and robust public participation before and during project implementation,” Ethics and Anti-Corruption Commission Chief Executive Officer Twalib Mbarak said.
On their part, contractors pointed out that external actors influenced procurement processes by leaking information, favouring specific contractors, terminating and re-advertising of tenders where they lost about 50 per cent of their bids.
The report further say that cost inflation, undue influence and collusion were most prevalent forms of corruption and unethical conduct at the budgeting phase
The health staff who were key respondents during the study identified favouritism, conflict of interest and bribery as the main forms of corruption and unethical encountered at the initiation stage while manipulating of costs, distorting procurement plans and also favouritism were the main forms of corruption and unethical conduct encountered at the planning stage of health projects.
These unethical practices in health care related public procurement hampers government’s efforts to deliver timely services to Kenyans at fair prices.
Global Corruption Report indicates Kenya’s health care system as having issues with conflict of interest, lacking accountability mechanisms, transparency and professionalism resulting to abuse and misappropriation of the funds meant to alleviate disease. Previous studies by EACC depict a health sector bedevilled by rampant corruption
Majority of the health staff observed that Information Management Systems (IMSs) were used in procurement and financial management while those who opposed the opinion said the system was ineffective which eased manipulation of information.
Health Cabinet Secretary Susan Nakhumicha admitted during the launch of report that corruption is a significant drawback in the efforts to reform Kenya’s healthcare system.
She said she will prioritise automation of health services as a viable accountability measure by removing human interface in the process. “I expect all agencies under the Ministry of Health to review their internal controls in line with the recommendations given by EACC in the report.”
The report featured some of the health projects worth billions of shillings and are marred with irregularities. Kakamega Teaching and Referral Hospital, which was budgeted at Sh6 billion, has since stalled with no documents to show the status of the project featured prominently.