KENYA—In a groundbreaking effort to combat corruption, the Ethics and Anti-Corruption Commission (EACC) of Kenya has recently published a damning report on the pervasive corruption and unethical behavior within the country’s health sector.
Sponsored by the United Nations Office on Drugs and Crime (UNODC), this comprehensive survey conducted by the EACC sheds light on the extent of the rot within the healthcare system.
The primary objective of the survey was to identify and analyze the various aspects of the healthcare sector that are susceptible to corruption and unethical practices.
The investigation focused specifically on procurement and financial management processes, which are often breeding grounds for misconduct.
With approximately 1,793 participants, including health facility staff, members of the public, contractors, and procurement and financial experts, this multi-dimensional survey covered national and county health facilities across the country.
The report’s findings are both shocking and disheartening. It reveals that a staggering 80% of health projects in Kenya suffer from inflated costs, with an estimated 84% of the cost inflation occurring during the budgeting stage.
Moreover, the study exposes that 21% of health projects are awarded due to favoritism, 20% due to conflict of interest, and 16% due to bribery.
Additionally, 6 out of 10 health projects were paid for, but the delivered work was substandard, while 31% of projects witnessed bribes being exchanged without any substantial work being carried out.
One of the key areas identified as highly susceptible to corruption and unethical behavior is the tendering stage of procurement.
Approximately 51% of health workers and 44% of contractors acknowledged tendering as the most corrupt stage.
Undermining transparency in the tendering process
The report emphasizes that influential health officials often exert their power and interfere with the tendering process.
Favouritism, bribery, and conflict of interest were identified as major issues within this stage, occurring in 41%, 16%, and 13% of cases, respectively.
Alarming statistics also emerge regarding the prevalence of bribery within the healthcare sector.
The survey reveals that 46% of respondents expected bribery, 26% demanded it, and another 26% voluntarily engaged in bribery.
County government officials were identified as the most likely recipients of bribes (59%), followed by county health officials (23%) and national government officials (14%).
The report highlights various positions within the sector, such as managers, procurement and finance officers, chief officers, county executive committee members, governors, members of county assemblies, administrators, engineers, and public health officers, as those most likely to accept bribes.
The report has caught the attention of Health Cabinet Secretary Susan Nakhumicha, who emphasized the significance of its findings for strengthening government reform measures aimed at improving efficiency and accountability within the health sector.
Disturbingly, the report indicates that a vast majority of staff in the health ministry (86%) perceive the sector to be corrupt, and this sentiment is echoed by 81% of the public at the national level.
The report also exposes specific projects plagued by irregularities, such as the construction of the proposed Kakamega Teaching and Referral Hospital.
Despite a budget allocation of US$43 million and a scheduled completion date in 2024, the project has stalled, and no documentation exists to indicate its current status.
EACC Chief Executive Officer Twalib Mbarak highlights the possibility of collusion, as the winning bid amount, budgeted amount, and engineer’s estimates aligned precisely in some cases.
Corruption’s far-reaching consequences in the health sector
Corruption in Kenya’s health sector extends beyond national boundaries, as highlighted by Transparency International’s 2019 report, “The Ignored Pandemic.”
Transparency International’s 2019 report, “The Ignored Pandemic,” sheds light on the fact that corruption in Kenya’s health sector extends far beyond national boundaries. This eye-opening study exposes the detrimental consequences of corruption on a global scale.
The report emphasizes that corruption within healthcare service delivery poses a significant threat to the achievement of Universal Health Coverage (UHC).
Widespread corruption hampers efforts to provide essential healthcare services to those in need, perpetuating a cycle of inequality and hindering progress towards global health goals.
The World Health Organization (WHO) estimates that a staggering US$7.5 trillion is spent annually on healthcare worldwide, with an average expenditure of approximately US$1,000 per person.
Despite such substantial investments, over 400 million people still lack access to basic health services.
Out-of-pocket health expenditure pushes more than 100 million people into poverty every year.
However, the cost of achieving UHC pales in comparison to the immense resources lost to corruption within the health sector.
Transparency International emphasizes that curbing corruption in the sector could free up sufficient resources to finance universal health coverage globally.
Urging the global community to take action, Transparency International warns that without addressing the most harmful forms of corruption, providing health services to the 400 million people lacking access by 2030 will remain an insurmountable challenge.
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