Health Ministry protests budget cut by Sh200 billion

Health CS Susan Nakhumicha and Medical Services PS Harry Kimtai before the Senate Health Committee. [Elvis Ogina, Standard]

The Ministry of Health has decried the budget cut by Sh200 billion for the financial year 2024/25.

According to budget estimates, the Ministry had requested Sh319.4 billion only to be allocated Sh100 billion

Out of the estimated allocation, Sh60.5 billion goes to recurrent expenditure while Sh39.5 billion to development.

Appearing before the National Assembly Health Committee chaired by Robert Pukose, the Medical Services Principal Secretary Harry Kimtai, said the allocation by the National Treasury will greatly impact Kenya Kwanza’s health agenda.

Kimtai said the ministry’s proposed allocation was also meant to cater for the payment of doctors, who recently called off their national-wide strike.

"The decision in allocation will significantly affect the implementation of Universal Health Coverage (UHC), which requires the funding of Primary Health Care Fund, Emergency, Chronic and Critical Illness Fund, operationalisation of the Social Health Authority and the operations of the day to day running of the State Department," he said.

While the ministry had requested Sh50 billion for Primary Healthcare, it has been allocated only Sh4.1 billion as per the budget estimates.

The Emergency, Chronic and Critical Illness Fund has a budget deficit of Sh49 billion, after Treasury allocated only Sh500 million out of the requested Sh49.5 billion.

The Sh500 million was sourced from the ministry without any additional allocation from The Treasury.

"Money allocated to Primary Healthcare Fund was sourced from our envelope. There is no additional support from the National Treasury," Kimtai told the health committee.

In its budget, the ministry requested for Sh94.9 billion for the implementation of the Social Health Insurance Fund (SHIF), that will replace the National Health Insurance Fund (NHIF).

The money, had been earmarked for scaling up of the SHIF in the implementation of the Social Health Insurance Act, 2023, Primary Health Care Act, 2023 and Digital Health Act, 2023.

On Social Health Authority, the PS said there is a need to engage the National Treasury, for smooth actualisation.

“The department needs more money because we have directives. We try to look at how we access the funds through the committee. It is good for the committee to note and appreciate we need additional funding to increase our ceiling,” Kimtai told the Dr Pukose-led committee.

“On cancer, we need additional funding. Sh500 is little, we shall be going back to National Treasury,” he added.

The National Treasury has also reduced an allocation for free delivery from Sh4 billion to Sh2 billion.

Maternal Health programme budget has also been reduced from Sh4 billion to Sh2 billion.

In a heated debate, Nandi Woman Representative, Cynthia Muge demanded an explanation on why the allocation had been slashed.

Muge warned that pregnant women and those due for delivery may end up dying due to a lack of adequate funds to support quality maternal services.

As per Health data, at least 6,000 to 8,000 women die every year during delivery. 

Kenya also records at least 21 neonatal mortality per 100,000 live births.

“On maternity, there is a reduction from Sh4 billion to Sh2 billion. I want to know the impact, and justification of the budget. This is something that is urgent and must be addressed,” she said.

In response, the Director of Health Financing at the Ministry of Health, Elizabeth Wangia, said under the new health scheme, all schemes were collapsed, hence, vulnerable pregnant women should be assisted through testing as provided for in the Act.

Seme MP James Nyikal, who did not find the explanation satisfactory, wanted to know if the government is scrapping Linda Mama programme.

“If an indigent woman is in labour and your identification has not taken place, what happens? This gap should be looked into. Does it mean Linda Mama has stopped?” Posed Dr Nyikal.

Nyeri Town MP, Duncan Mathenge called for clarity from the ministry on the status of Linda Mama.

“According to the Act, it is mandatory for everybody to be registered, including when a newborn should be registered. I am assuming, at the point of registration, comes a classification. There is an overlap. Where's the new indigent women coming from? The system should include everybody,” Nyikal said.

There was however no clarity from the ministry on the matter.

Additionally, several projects have been unfunded, including the Manager Equipment Service (MES).

Despite new HIV infections recorded in the country as per data by the National Syndemic Disease Control Council (NSDCC), the HIV programme has not been factored into the budgetary allocation.

The ministry had requested Sh14.1 billion for the procurement of HIV, family planning and vaccine commodities.

The programme has in the past been heavily donor-funded, but donors are pulling out after Kenya moved to a low-middle income country bracket.

“The programme over the years has been highly donor-funded, whose funding is coming to an end. There has been a steady reduction in donor funding for these programmes and therefore calls for the need to increase Government of Kenya counterpart funding to offset the deficit, especially for these medical commodities that are critically needed by a vast majority of the Kenyan Populace," said the PS. 

Further, Mathenge took issue with the National Treasury, over the budget cut, despite the high demand for healthcare by Kenyans.

“What is the nexus between what Parliament approves, and what the Treasury considered? What if all these are not looked at?” He posed.

Under the supplementary budget, the ministry requested an additional Sh100 million in funding for pathology and other services for Shakhahola massacre victims.

The money was meant to boost the government’s pathology department, which has been undertaking its work in Shakhahola since April 2023.

Among other items, the money is to cater for domestic travel, subsistence, specialised materials and supplies, fuel, oil and lubricants and other operating costs.

Government pathologist Dr Johansen Oduor, defending the request, told the committee that at least 429 bodies have been exhumed, 32 of which have undergone DNA tests.

Dr Oduor said although he was not sure of the actual amount spent on the Shakahola exercise, about Sh30 million could have been used.

“...mainly for per diem. We have seven psychologists, morticians, and drivers. Apart from the per diems, we have supplies for embedding the bodies…We also need a supply of body bags and fuel to go to the ground every day,” he told the committee

Initially, he said he thought it was a short exercise, after being informed that only two bodies were to be exhumed.