A multibillion-shilling healthcare initiative meant to transform maternal and child health services in Kenya has stumbled, leaving thousands of vulnerable women and children without access to essential medical support. The Sh7.2 billion programme, a collaborative effort between Kenya and Denmark under the Danida Primary Healthcare (PHC) support scheme, was severely undermined by delayed disbursement of funds, unmet county contributions, and systemic weaknesses in implementation and oversight.
Launched in 2021 with the noble intention of enhancing primary healthcare, particularly for pregnant women and children under the age of five, the programme had shown promise in its design. Denmark committed to injecting Sh3.6 billion into the project, with participating counties expected to match this contribution to ensure joint ownership and accountability. However, by June 2024, only Sh1.66 billion had been released, less than half of the promised amount, and 11 counties failed to raise their share of the funds altogether.
The situation took a critical turn when the Ministry of Health transferred Sh440.9 million to the counties on June 21, 2024—just nine days before the end of the fiscal year. According to Auditor-General Nancy Gathungu, this delay severely hampered the counties’ ability to roll out the programme’s services. Many local governments were left with virtually no time to plan, execute, or monitor the intended interventions, effectively sabotaging the initiative’s impact on the ground.
Crucial services meant to benefit from the funding such as antenatal care, immunisation for infants, family planning, and skilled delivery support were either rushed or not implemented at all. For the 11 counties that could not raise the required counterpart funding, the outcome was even worse. Though a total of Sh136.5 million had been earmarked for these regions, none of the funds were disbursed due to their failure to meet financing obligations, completely excluding them from the programme’s benefits.
The audit of the State Department for Medical Services revealed troubling trends beyond just delayed disbursements. Several counties also failed to comply with fund transfer protocols. Eight counties had not transferred Sh87.6 million to the designated project accounts by August 2024, and six counties delayed transfers totaling Sh45.25 million to healthcare facilities by up to two months. Meanwhile, 12 counties failed to contribute Sh102.67 million out of the expected Sh450 million required for the 2023/24 financial year.
Further investigations into 17 sampled facilities in Laikipia, Murang’a, and Isiolo painted an even grimmer picture. The audit uncovered poor financial accountability practices, including unpaid wages for casual workers, failure to remit statutory deductions, incomplete bank reconciliations, and procurement violations. Funds meant for life-saving interventions sat unused, and systemic inefficiencies in financial management compounded the delays.
As a result, thousands of Kenyan women and children, especially in underserved regions, were denied access to basic yet critical health services. The programme’s failure reflects a broader issue of fiscal mismanagement and lack of prioritisation in public health. Without urgent reform in how such programmes are funded, coordinated, and monitored, similar initiatives will continue to falter, leaving the most vulnerable at risk.
