Glaring gaps in Kenya’s management of Covid-19

A nurse prepares to administer The Oxford–AstraZeneca COVID-19 vaccine. [Wilberforce Okwiri, Standard]

The Covid-19 pandemic has affected Kenya, causing serious socio-economic problems. However, the Government needs to be lauded for some of the measures it has instituted to combat Covid-19 in Kenya. Its overall strategy is underpinned by scientific advice, unlike some neighboring countries. The committee that forms the key advisory organ on matters Covid comprises well-educated experts in the field. 

However, there exist serious gaps in the government’s overall Covid 19 management strategy. The most glaring gap is the underfunding of key Covid-19 containment responses. An analysis of the various supplementary and main budgets passed by the National Assembly since the official announcement of the Covid-19 pandemic in March 2020 reveals several things. There have been reductions in the budgets of ministries of Health and Water and Sanitation. These two ministries are important in fighting the pandemic.

In the 2019-2020 supplementary budget, for instance, both the Health ministry and that of Water and Sanitation budgets were reduced by 11 percent. By contrast, the State Department for Infrastructure budget went up by Sh12.5 billion. Whereas in the main budget of June 2020, allocation to the Ministry of Health was increased by 10.3 per cent compared to the previous year, a funding gap of about Sh95.3 million remained. The Sh2.7 billion allocation to Kenya Covid-19 Emergency Response Project in that budget was low.

For Kenya, global aid is a major source of funding for its health security systems. With the proliferation of Covid-19 worldwide, Kenya’s fragile healthcare systems have become even more vulnerable with the reduction of donor support. 

This underfunding of the Ministry of Health has led to low testing and vaccination rates. The total number of Covid-19 vaccine doses administered per 100 Kenyan people is low (at 0.025) compared to countries like Ghana and South Africa. Reinforcing the problem of low vaccination rates is the government’s decision to halt a private vaccine despite affirming that it was safe.

The effect of this decision is to make well-up Kenyans scramble for the free public vaccine with the poor. Every vaccine given to a Kenyan who can afford the private one is one vaccine taken away from a poor Kenyan.

The other gap in the government response to the Covid-19 pandemic is its underfunding of social protection schemes and removal of economic cushioning measures. Granted, in the 2019-2020 supplementary budget, the allocation for social protection rose by Sh8.75 billion though it was not sustained in the 2020-2021 budget.

In the same year, taxes were reduced, including VAT and income tax for certain categories of persons. These economic cushioning measures were lifted in January this year and were not reinstated when the government effected a second lockdown in March 2021.

As a result, Kenya’s labour market continues to shed numbers. Transport, entertainment and hospitality industries remain the hardest hit by the Covid-19 containment measures recently adopted by the government.

Counties’ inadequate responses to the Covid-19 pandemic is another major gap. Health is a devolved function under Schedule Four of the Constitution of Kenya 2020. Counties are expected to employ adequate frontline workers like doctors and nurses to combat the pandemic. Counties are expected to have fully functional Covid-19 recovery wards with adequate oxygen supplies.
They ought to have Covid-19  testing capacity to avoid congestion of tests in Nairobi. Well-run counties should procure vaccines directly from suppliers abroad.

Contrary to this, Covid-19 management in Kenya seems heavily centralised in Nairobi. There is every possibility Kenya’s deaths and hospitalisation data do not reflect the reality at county levels.

Devolved resources have delayed reaching counties from the National Treasury, hence stressing devolved health systems further.

There have been reports of unpaid health workers in various counties. That is was behind recent strikes by some health workers. It would be impossible for Kenya to respond to the pandemic adequately when such gaps exists .

The best-case scenario would entail having counties do their own testing and publish local data on a day-to-day basis in a centralised portal.

Counties need to undertake independent mass vaccination programmes. This would spur competition amongst county chiefs who have a political incentive to appear to be working. Health ministry mandarins have no such incentive. The net effect of such competition is to increase rates of vaccination and testing.

At the national level, the overall remedy lies in the government upscaling its social protection schemes and reintroducing economic cushioning measures as Kenya prepares the 2021-2022 budget.