Ending corruption can make funds available for health care

In a recent media interview, Kenya's President Uhuru Kenyatta announced that his government loses 2 billion Kenyan shillings (KES) to corruption every day. This grave remark has become the subject of debate in Kenya. What could that KES 2 billion do to transform Kenya’s health sector if it wasn’t lost to corruption?

Henix Obuchunju, a radio host and member of Maternal and Newborn Health (MNH) Coalition in Kenya, tried to answer this question when he discussed health sector accountability in his podcast.

To put these figures into context, let’s look first at the size of Kenya’s economy, then narrow in on Nairobi City County, the epicentre of the country’s economic, social and political activities. Kenya’s annual government budget is slightly under the KES 3 trillion mark. Projections by the health department show that Nairobi City County needed an estimated KES 25 billion to be able to offer health services to its population of 5 million people in the 2020/21 financial year.

Although Nairobi’s health budget increased between 2019 and 2021, the current budget allocated to health is KES 10 billion. Therefore, to provide Universal Health Coverage for its citizens, Nairobi City County needs an additional KES 15 billion.

Now, think of the KES 15 billion shortfall against the President’s KES 2 billion daily loss claim. You will see that the amount of money lost to corruption in just eight days would be enough to cover the capital city's health care annual budget gap. But curbing corruption will require strong political will.

Tracking health budgets increases accountability

Health budget expenditure analysis is a good way to track how government resources are spent, which is a key step towards enhancing budget accountability. Options E4A-MamaYe Health Budget Advisor, economist Nicholas Mwendwa, who appeared as a guest in the podcast, said:

“Two billion shillings in the health sector can massively transform maternal and newborn outcomes in Nairobi City County.”

  • Nurse talking to a patient in a public health facility
  • Nurse attending to an expectant mother in a public hospital

The MNH Coalition is bringing together civil society and media to perform such an analysis, which will show the status of implementation of the health budget and reveal any gaps. The findings will be used to inform decision-making. The Coalition’s chairperson, David Odhiambo, who also spoke on the podcast, outlined how the Coalition has managed to track budget allocations and the use of funds in the Nairobi City County health budget:

“As a Coalition, we package this budget information and present it to decision-makers in our county.”

For example, the Coalition has developed a health financing scorecard and an evidence brief for advocacy. These scorecard and evidence brief will be used in engagement with decision-makers to make a case for more funding for the health sector.

But the Coalition faces hurdles in its accountability work. David said that tracking the health budget expenditure by Nairobi Metropolitan Services (NMS) has proved to be difficult. The NMS is yet to publish key public budget documents on expenditure and procurement – documents that are required by law. However, the Coalition is taking effective steps to address these challenges: it is building stronger relationships with central government and engaging political leaders in Nairobi who have a mandate to oversee the NMS.

Addressing corruption: an essential step in achieving Universal Health Coverage

Corruption is not just a Kenyan problem. It is estimated that at least 10–25% of global spending on health care is lost directly through corruption, amounting to a loss of hundreds of billions of dollars each year (García, Lancet, 2019). But even though corruption is one of the biggest barriers to achieving Universal Health Coverage around the world, it is rarely openly discussed. Civil society and media collaboratives, such as the MNH Coalition in Nairobi, enable citizens to voice their concerns by engaging them in budget decisions. This increases transparency which is essential to fighting corruption and is therefore a key step towards better resourcing of Kenya’s health sector.


This story is written by Henix Obunchunju, a journalist and member of the MNH Coalition of Kenya

Share this article