Govt, counties clash over Sh7.2b to fund free maternity funds

Questions have emerged on the accountability of billions of shillings meant to fund the free maternity services in public health facilities.

Governors claim the government owes counties Sh7.2 billion in two years’ arrears, but the Health ministry has disputed the figure, arguing that only Sh1.4 billion was outstanding.

The glaring difference has raised accountability questions on the Jubilee administration’s flagship health project implemented to increase the number of safe deliveries.

Since 2014, the Government budgeted Sh4.2 billion every year to reimburse health facilities for free delivery by mothers at the rate of Sh2,500 per birth in a health centre, Sh5,000 for level four or five and Sh17,500 for a referral hospital.

But the Council of Governors (CoG) said for the past two years, the Government had reneged on its obligation and had left counties with arrears totalling Sh7.2 billion.

"The Ministry of Health is yet to disburse Sh7.2 billion to counties for the two years (2014-15 and 2015-16). There is no compliance on the part of the ministry. This is a Government project and therefore we do not understand what is occasioning the delays," said Kisumu Governor Jack Ranguma, who is the chairman of the health committee of the CoG.

Mr Ranguma, CoG Chairman Peter Munya (Meru) and CoG's media liaison leader Ken Lusaka (Bungoma) criticised the Government for the delays, saying counties had been forced to divert resources to foot the bills.

"This is a matter we even raised and discussed at the summit, which brings together the President, Deputy President and the 47 governors. So far, nothing is forthcoming. We do not know if it is sabotage to portray the county governments as inefficient and unable to run this function," Ranguma said.

Lusaka said Bungoma was owed Sh217 million for the two years. A breakdown of select counties from the CoG and inquiries by The Standard indicated that 14 counties were claiming over Sh800 million in arrears.

These include Mombasa (Sh100 million), Kiambu (Sh132 million), Kirinyaga (Sh12 million), Turkana (Sh15 million), Uasin Gishu (Sh18 million), Kakamega (Sh32 million), Mandera (Sh26 million), Kilifi (Sh72 million), Nyamira (Sh53 million) and Kisii (Sh40 million).

Others are Meru (Sh70 million), Nyeri (Sh45 million), Kirinyaga (Sh40 million) and Kisumu (Sh65 million).

But Health Principal Secretary Nicholas Muraguri yesterday denied the claim that counties were owed Sh7.2 billion.

"We only owe counties Sh1.48 billion and not Sh7.2 billion," said Mr Muraguri, blaming counties for poor book-keeping, filing claims before deliveries and failing to transfer the funds received to the respective health facilities.

The PS said the Health ministry had released Sh1.74 billion this financial year and was finalising on the release of another Sh1 billion for the third quarter of the Government's financial year (January to March 2016).

"We are up-to-date with our figures this year. However, we have arrears of Sh1.4 billion for the 2014-2015 financial year and even the Treasury is aware of it," he said.

"Every year the amount allocated is Sh4.2 billion but it comes with conditions. It is not free money, there is nothing like free lunch. You deliver a baby, we pay you. This is just a budget. It does not mean it's your (governor's) money. The actual delivery must take place and the money coming must be devolved further to the facility where the child is born," Muraguri added.

He said they were facing a few obstacles, adding that counties were not releasing the monies to the said heath facilities.

"The money is stuck at the county level, which is wrong. Governors must show evidence that the money has gone to the actual facility," he said.

He added that when the Government releases the money, it is supposed to go to the county revenue for further devolving to the facilities that handled the births. He accused counties of holding the money at the county level, and sometimes spending it on other functions.

"They are supposed to immediately dispatch the money to the health centres, dispensaries and hospitals. This (current arrangement) makes the money easy for abuse by the governors," said Muraguri.

Governors have, however, petitioned Parliament to intervene on the matter as it deliberates on the Division of Revenue Bill 2016, in which the maternity fund is part of the over Sh25 billion proposed conditional allocation to counties.

Senators have, too, raised a red flag that the mechanism for disbursement of free maternity funds was prone to abuse. The county chiefs were expected to appear before the Senate Finance and Budget Committee chaired by Mandera Senator Billow Kerrow today on the matter.

"We are ready to hear the governors' petition tomorrow (today), but we are aware the conditional grant, including the maternal health care has not been released when it should. In fact, some counties such as Makueni have never seen these funds," said Senator Mutula Kilonzo Jnr, who is a member of the committee.

Mr Kilonzo said Senate was being used as a rubber stamp to pass all these funds, including the "controversial" Sh38 billion for medical equipment leasing. He said last year, Makueni  was supposed to get Sh200 million for roads but this didn't happen.

"Last year, we proposed and we are going to reinforce it this year, that there should be a mechanism to oversight conditional grants as included in the Division of Revenue. The national government and the National Assembly are using us for purposes of voting in these grants but we have no oversight about them," he said.