Healthcare experts and policymakers have raised alarm over Kenya’s ongoing healthcare challenges, emphasizing that despite the country funding 85 per cent of its healthcare budget domestically, citizens continue to face severe shortages of essential medicines and declining service quality. The call for action came during the recent Regional Health Promotion Conference, where stakeholders demanded improved transparency, accountability, and efficient resource management to ensure that healthcare funds translate into better services for Kenyans.
Contrary to popular belief that donor aid is the primary source of Kenya’s healthcare funding, only 18 per cent comes from external support, with the rest generated locally. This revelation challenges the widespread assumption that shortages in drugs and services are due to limited donor contributions. Dr Abraham Rugo, executive director of Bajeti Hub, underscored that despite the high level of self-reliance in healthcare financing, corruption and mismanagement remain the primary obstacles to quality service delivery. He questioned the whereabouts of the significant funds allocated, noting that counties spend up to 30 per cent of their annual budgets on healthcare, yet basic services remain out of reach for many citizens.
Concerns were also raised about the allocation of resources within the healthcare system. A substantial Sh120 billion—approximately 10 per cent of the healthcare budget—is directed to referral hospitals, even though primary healthcare facilities, which serve 90 per cent of Kenyans, remain underfunded. Dr Rugo criticized the Sh104 billion spent on the implementation of the Social Health Authority (SHA), arguing that such funds could have been more effectively used to improve existing infrastructure and services. He noted that corruption had crippled the previous National Hospital Insurance Fund (NHIF), and instead of reforming it, the government dismantled the institution, leading to continued financial leakage and service gaps.
Experts, including Dr Dickson Mwakangalu of Brac International, emphasized that unless investments in primary healthcare increase, Kenya’s goal of universal health coverage will remain elusive. Many community health promoters are operating without basic supplies, sometimes lacking even essential medications like paracetamol. Moses Mokua from the Faith-Based Service Consortium echoed this sentiment, pointing out that only Sh6 billion has been allocated to primary healthcare facilities, which require at least Sh18 billion to function effectively. He warned that without strict monitoring, the SHA could become a heavier financial burden than its predecessor.
There were also broader calls for African nations to develop self-sustaining healthcare financing strategies and reduce reliance on donor funding, which has become increasingly unpredictable. Donne Cameron, Co-CEO of Voluntary Service Overseas, stressed that public trust and support for universal health initiatives can only be built through transparency and community engagement. With donor contributions, including from USAID, on the decline, the need for clear leadership and inclusive decision-making has never been more urgent.
Public Health Principal Secretary Mary Muthoni acknowledged the concerns and assured citizens that internal funding mechanisms are under review to prioritize essential areas. She highlighted efforts to make medical supplies available at all levels and noted initiatives to integrate artificial intelligence in tackling diagnostic challenges.
A recent report by Auditor-General Nancy Gathungu exposed significant financial mismanagement within the Ministry of Health, revealing idle medical equipment worth millions across counties and further inflaming concerns about misallocation of public resources. The NHIF’s legacy of systemic fraud, including losses exceeding Sh21 billion and costly administrative errors, remains a cautionary tale as the SHA faces its own scrutiny.
In Parliament, Health Cabinet Secretary Debora Barasa and her team faced sharp questions from senators demanding accountability for the ministry’s budget, including an explanation for a massive 98 per cent increase in recurrent expenditure and stark disparities in county allocations. With critical funds lying idle and recurrent corruption undermining services, stakeholders insist that only through transparent leadership and strict accountability can Kenya’s healthcare system be salvaged to serve its people effectively.
