In Kenya, medical equipment and healthcare facilities worth more than Sh100 million are gathering dust in county storage rooms, unused and neglected, while many citizens continue to face dire challenges in accessing essential health services. The 2023/24 financial year report by Auditor-General Nancy Gathungu has cast a spotlight on the glaring inefficiencies plaguing the country’s devolved health sector, raising critical questions about the prudent use of public funds.
The report paints a troubling picture of how county governments have funneled significant resources into acquiring modern medical equipment and building hospitals, only for these investments to remain dormant for months or even years. This misalignment between spending and service delivery points to poor planning, mismanagement, and a breach of the Public Finance Management Act, 2012, which mandates the efficient and effective use of public resources. The consequence is a tragic waste of potential in a country where access to quality healthcare remains a pressing concern for millions.
Several counties are named in the report, including Kilifi, Kitui, Machakos, Nyeri, Nakuru, Siaya, Kisumu, Migori, and Kisii, where medical infrastructure has been completed or delivered but remains non-operational. For instance, in Kilifi, the county government acquired digital X-ray machines valued at Sh14.4 million in February 2024, yet by October, one remained in storage, unused. Similarly, a medical incinerator procured at a cost of Sh33.5 million in March 2024 remained idle seven months later.
In Nyeri County, a fully equipped operating theatre at Naromoru Level Four Hospital, complete with an air conditioning system costing Sh9.7 million, remains unused, denying the local population access to surgical services. Siaya County has also failed to utilize an X-ray machine at Got Agulu Hospital due to the absence of a qualified radiographer. Meanwhile, in Kitui, a Sh2.2 million building intended for housing an X-ray machine stands empty, with another X-ray machine procured for Sh70 million in the 2017/18 financial year never installed or put to use. An oxygen plant valued at Sh14.5 million, supplied to Kitui County Referral Hospital in 2016/17, is similarly wasting away, stored outdoors in an unsecured area, exposed to the elements.
Machakos County, despite listing 67 clinical officers and 61 doctors on its payroll, has also come under scrutiny. The Integrated Health Management System audit found no recorded activity from these medical professionals between September 2023 and March 2024, suggesting that staff may not have been deployed effectively or at all. Nakuru County faces parallel issues, with completed health projects worth Sh30.2 million remaining unused due to a lack of critical equipment and power generators.
In Kisumu, maternity units at Dago Kotiende and Kowino, along with renovations at Chulaimbo Hospital totaling Sh10.8 million, have yet to serve a single patient months after completion. Migori County is grappling with a Sh2.9 million ablution block that has not been handed over, while Kisii has spent Sh3.2 million on health projects that are similarly languishing in disuse.
The Auditor-General’s findings underscore a fundamental failure in healthcare governance across several counties. While large sums of taxpayer money have been spent under the banner of improving health services, the absence of proper oversight and implementation has rendered these investments ineffective. The gap between intention and execution not only represents fiscal waste but also denies ordinary Kenyans the right to timely and adequate healthcare, deepening inequality and eroding public trust in government initiatives.
