The scandals, leadership changes that derail bid to step up health sector

Former Health CS Deborah Barasa (centre), former Medical Services PS Harry Kimtai during the official handover to Health Cabinet Secretary Aden Duale at Afya House, Nairobi, on April 1, 2025. [File, Standard] Kenya Kwanza's health manifesto was widely celebrated, appearing to offer hope for Kenya's ailing healthcare system. President William Ruto inspired confidence and raised expectations. But three years later, delivering on his ambitious health agenda has proven an uphill task. Unlike previous administrations, the President eloquently anchored his plan on preventive and promotive healthcare rather than curative care, which is often financially burdensome. However, the health docket, one that literally deals with matters of life and death - has seen three Cabinet Secretaries since he took office, none of whom have successfully brought the President's vision to life. Mr Aden Duale, appointed in March this year as the third Health CS, declared himself a "bulldozer." Yet, as he soon discovered, the docket is far more complex than his previous assignments and demands strong technocratic leadership. Despite his bold declarations, little progress has been seen. The ministry continues to grapple with fraudulent claims under the new Social Health Authority (SHA). An estimated Sh24 billion is believed to have been lost through fraudulent claims, prompting Duale to hand over 1,188 files to the Directorate of Criminal Investigations (DCI). However, critics see this as shifting goalposts. Under the Social Health Insurance Act, 2023, Duale was expected to establish a Dispute Resolution Tribunal to handle such claims. The tribunal is yet to be set up, raising questions about whether the DCI can conduct thorough investigations and bring the culprits to book. Rural and Urban Private Hospitals Association of Kenya (Rupha) chairperson, Brian Lishenga, accused Duale of failing to manage the ministry. "He came into the ministry and declared himself a bulldozer, it is this that has made him to fail because instead of building systems, he has been destroying systems. He has not allowed other officers in the ministry to perform their roles," says Dr Lishenga. Apart from SHA fraud, the ministry under Kenya Kwanza administration, lost a Sh3.7 billion tender to an international supplier following illegal procurement by the Kenya Medical Supplies Authority (Kemsa) with the influence from top government official. The scandal led to sacking of the Public Health Principal Secretary, whereas Kemsa Chief Executive Terry Ramadhani was suspended before being awarded an ambassadorial position. Duale's predecessor Dr Deborah Barasa was behind opaque procurement of Sh104 billion digital health system under SHA, that was single sourcing, a system yet to be operationalised as the health scheme has moved back to manual system as announced two weeks ago. Susan Nakhumicha, the first CS at the docket was sacked during the heated Gen Z Protests. Under Ms Nakhumicha, defunct National Health insurance Fund (NHIF) was accused of working with hospitals to defraud taxpayers money. During her tenure, there was also illegal procurement of Sh2.5 billion HIV testing kits, in 2024. Kenya Healthcare Federation CEO Tim Theuri attributed the scandals to selective application of law. "There is a lot of interference by advisors, especially the last three years. Top officials are doing business with the government. This is when most scandals have been reported," says the official. Under President Uhuru's tenure, major scandals reported include the Sh7.8 billion Covid-19 procurement scandal, Over prized CT Scans through the MES programme (Sh7 billion inflated costs). 2025 to 2016, and mobile clinics at a cost of Sh5 billion. While President Ruto promised to actualise Universal Health Coverage (UHC) by employing more health professionals, the promise remains a dream. Currently, employment of UHC health workers has been a thorny issue, with county and national governments disowning the employees. This is despite Kenya Kwanza promising to employ 20,000 health workers to bridge the shortage and put the country back on the road to realisation UHC. At least 9,000 health professionals were recruited in 2020 under UHC program. There has also been goal shifting on roles of county and national government under Kenya kwanza administration. For instance, handling of human resource. Counties accused President Ruto of failing to involve them during the roll-out of 107,000 Community Health Promoters.

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