A Sh7.2 billion programme for pregnant women and under-five children faces turbulence amid funding crises that have left counties struggling to deliver crucial health services.
Danida Primary Healthcare (PHC) support programme—a partnership between Kenya and Denmark—almost stalled last year as the Ministry of Health (MoH) funded counties just days before the end of the financial year, Auditor-General Nancy Gathungu has disclosed.
The MoH released Sh440.9 million on June 21, 2024, just a week to the end of the financial year, leaving the counties under pressure as others were forced to implement projects meant for the year weeks later.
The delays hampered children’s immunisation programme, family planning, and anti-natal care (ANC) for pregnant women, the Auditor-General’s report on the State Department for Medical Services shows.
“Analysis of Danida PHC special purpose account statements from the counties revealed that the funds were transferred on June 21, 2024, nine days before the closure of the financial year,” said Ms Gathungu.
The audit also said the MoH funded 36 counties only, leaving 11 counties without the much-needed funding to support the primary health services.
The Danida PHC programme was started in 2021 to run until this year, with the main objectives of ensuring that children under one year are fully immunised, pregnant women get at least four ANC visits, births are attended by skilled health personnel and women of reproductive age use modern family planning methods.
The programme had Sh3.6 billion in funding from the Danish government with counties expected to raise half of the financing requirements to match the disbursements.
By the end of last June, the 36 counties had received Sh1.66 billion under the Danish programme, which was less than half (46.1 percent) of the funding from Denmark.
The 11 counties missed out on the funding due to failure to provide counterpart funding, though the audit noted that Sh136.5 million in funding for the programme had been allocated to them during the year ending June 2024.
“In the circumstances, programme activities were not implemented in the 11 counties that did not meet the funding requirements resulting in denial of essential primary healthcare services to the public,” said Ms Gathungu.
Among the counties that received the funding late, the audit revealed, that eight had not transferred Sh87.6 million in funds to the project’s special accounts by August 2024, while six delayed transfering Sh45.25 million to health facilities by two months.
The audit notes that the programme continues to be affected by the failure of counties to provide counterpart funding as required in the programme agreement.
While all the counties were expected to provide Sh450 million in the year ending June 2024, 12 counties failed to raise their share of Sh102.67 million.
Ms Gathungu also faults internal control weaknesses in health facilities implementing the programme, including some that have been unable to account for spent funds.
“Physical verification of 17 healthcare facilities in three counties (Laikipia, Murang’a, and Isiolo) sampled revealed various internal control weaknesses such as inadequate financial accountability: uncontracted casual worker accumulated casual wages, non-compliance with statutory worker benefits deduction and remittance, missing bank reconciliations, discrepancies in fund utilisation, breach of procurement regulations and unused funds that hindered programme implementation,” said the audit.
