The cost of eight out of 10 health projects in the country is always inflated, a report on corruption and unethical behaviour in Kenya’s health sector has revealed.
According to the report by the Ethics and Anti-Corruption Commission (EACC) released yesterday, 84 per cent of project cost inflation occurred at the budgeting stage.
The cross-sectional survey was conducted in national and county health facilities across the country, with approximately 1,793 respondents being interviewed—1,190 health facility staff, 495 members of the public and 61 contractors involved in project implementation, and 47 procurement and financial experts.
The study also revealed that 21 per cent of the health projects were awarded due to favouritism, 20 per cent due to conflict of interest and 16 per cent due to bribery.
Conducted to identify the nature, extent, causes and processes that are susceptible to corruption and unethical behaviour in procurement and financial management, the survey was sponsored by the United Nations Office on Drugs and Crime.
It further found that 21 per cent of health projects are subject to cost manipulation at the design stage, while 15 per cent are subject to distorted procurement plans.
When asked to identify procurement stages in health projects that are prone to corruption and unethical behaviour, about half of the health workers (51 per cent) and contractors (44 per cent) identified tendering as the most corrupt stage. At the tendering stage, EACC Director Preventive Services Vincent Ongoko said that high-level people exert influence to interfere with the process.
“There are always so many loopholes at the tendering stage because this is where most of the well-connected and influential people get through to the billions of money,” he said.
At the tendering stage, favouritism was identified in 41 per cent of cases, bribery in 16 per cent and conflict of interest in 13 per cent. The report also found that six out of 10 health projects were paid for but the work was substandard, and at the end of the projects 31 per cent were bribed without any substantial work being done.
Some 45 per cent of contractors said that it was common for them to make irregular payments or gifts to get things done. In addition, 30.6 per cent knew in advance what was to be offered.
Respondents said that bribery was expected by 46 per cent, demanded by 26 per cent and voluntary by 26 per cent. County government officials were cited as the most likely to receive bribes at 59 per cent, followed by county health officials at 23 per cent and national government officials at 14 per cent.
Managers, procurement and finance officers, chief officers, county executive committee members, governors, members of county assemblies, administrators, engineers and public health officers were identified as most likely to take bribes.
Health Cabinet Secretary Susan Nakhumicha said she was fully aware that corruption was holding her ministry back. She added that it was shameful that the Ministry of Health, which deals with people’s lives, was the most corrupt public institution in the country and promised to implement the recommendations of the report.
“I will stand tall and lead this ministry to do the right thing for the benefit of every Kenyan. The findings could not have come at a better time. I will crack the whip and we must deliver for Kenyans. The results of the survey provide critical information that will strengthen the various reform measures the government is taking to improve efficiency and accountability in the health sector,” she said.
The report indicates that the majority of people working in the Health ministry—86 per cent —perceive the health sector to be corrupt, with 81 per cent of the public at the national level holding this perception. In the counties, the figures were 60 per cent for health workers and 70 per cent for the public.
The report highlighted some of the projects that cost billions of taxpayers’ money and had a number of irregularities. For example, the construction of the proposed Kakamega Teaching and Referral Hospital, which was budgeted at Sh6 billion, has since stalled with no documents to show the status of the project. The county had allocated Sh510 million in its budget estimates for the completion and equipping of the first phase of the hospital in the 2021-22 financial year. The first phase of the 750-bed hospital was expected to cost Sh2.5 billion and was supposed to be completed in 2021.
EACC Chief Executive Officer Twalib Mbarak said health projects were randomly selected and would take inordinate amounts of time to complete. “In some cases, the amount tendered by the winning bidder, the budgeted amount and the engineer’s estimates were the same, indicating the possibility of collusion.”
EACC Chairman David Oginde pointed out that corruption is killing the health sector as many Kenyans are denied the right to quality services because of greedy and selfish Kenyans.
The report recommends that counties and national government procuring entities implement anti-graft measures such as anti-corruption committees and automation of revenue collection and procurement processes.