Exposed: The deep rot in ailing health sector

Health CS Susan Nakhumicha (left) during the release of the health report on graft by the EACC in Nairobi. [Samson Wire, Standard]

Bribery and favouritism are the main forms of corruption witnessed in the procurement of projects in the country's health sector.

This is according to new findings by the Ethics and Anti-corruption (EACC), released on Wednesday.

The report was released barely a week after the Kenya Medical Supplies Authority (Kemsa) reported irregularities in the procurement of mosquito nets worth Sh3.7 billion.

According to the EACC report titled 'Corruption and Unethical Conduct in the Kenyan Health Care Project - a Study of Procurement and Financial Management Practices, malpractices in the issuance of the tender are witnessed in three phases - pre-tender, tender and post-tender.

Pre-tender phase is reported to witness corruption and unethical conduct at the initiation, and planning stages of projects.

The report exposed the insidious plague that bedevils its procurement and financial management systems. The health staff interviewed ranked favouritism at 20.8 per cent, conflict of interest at 19.5 per cent and bribery at 16.7 per cent, witnessed at the project initiation stage according to the report.

Planning stage

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Manipulation of costs, distorting procurement plans, and favouritism were the main forms of corruption ranked at 21.1 per cent, 14.9 per cent, and 14 per cent respectively, witnessed at the planning stage.

At the tendering stage, favouritism stood at 41.7 per cent, while bribery and conflict of interest stood at 16.8 and 13.5 per cent respectively.

"We are witnessing a number of malpractices happening at the budgeting stage, an issue affecting the implementation of projects in the Ministry of Health," said Director, of Preventive Services at EACC Vincent Okong'o.

County government employees topped the list of shame of those who were receiving bribes, according to health staff interviewed during the survey. They were followed closely by county health employees at 22.5 per cent and national government employees at 13.7 per cent.

At least four out of every ten contractors indicated that it was common for them to pay some irregular payments or gifts to get things done. Also, three out of every ten employees admitted knowing in advance what was to be offered as an irregular payment or gifts, according to the report.

The commission also found out that making payments for substandard works and bribery were the most prevalent forms of corruption and unethical conduct during the post-tendering phase of health projects.

In the report, making payment for substandard works stood at 64.1 per cent, bribery at 11.5 per cent, while the alteration of the bill of quantities stood at 6.9 per cent.

The report also reveals that bribery payments were mainly in the form of cash with the highest amount of bribe paid for healthcare projects being Sh3 million.

Docket clean-up

The least was Sh5,000. Others were forced to part with 10 per cent of the project value as a bribe. Health Cabinet Secretary Susan Nakhumincha vowed to clean up the docket.

She said the report provides an opportunity to reform the healthcare system and make it accountable to Kenyans. "The report is a step towards the battle against corruption in the sector. Action will be taken against any individuals who will be found capable of malpractice, as per the report."

On termination of healthcare projects before completion, Embu, Kitui, and Meru counties ranked the highest while Mombasa, Kisii and Marsabit had the lowest.