Favoritism, conflict of interest, bribery, manipulation of costs, distortion of procurement plans, manipulation of tender application are major hinderances in effective implementation of healthcare projects.
In addition to tribalism, nepotism, making payment on substandard works, alteration of bill of quantities (BQs) and delayed payments with regard to project completion dates have been identified as the main forms of corruption and unethical conduct encountered in the procurement of health care project, latest Ethics and Anti-Corruption Commission (EACC) report reveals.
According to EACC survey on corruption and unethical conduct in the Kenyan health care projects report dubbed ‘ A study in procurement and financial management practices’ there are significant challenges in the overall healthcare project chain which includes professional malpractice, non-adherence to laws and regulations, ineffective oversight and monitoring as well as poor planning substantially hampers implementation of projects.
The report ranks Ministry of Health as the second-most corrupt institution in Kenya.
Speaking during the launch of the report Health cabinet secretary Nakhumicha S. Wafula said that the launch of the EACC Survey Report signifies a significant step forward in the battle against corruption and unethical conduct in Kenya’s healthcare projects. The Ministry of Health, together with the government, is determined to diligently study the report and take decisive actions to address the highlighted challenges.
“The report’s recommendations will inform legal, policy, and administrative interventions to address the deep-rooted issues plaguing the sector. One key area of focus is the Conflict-of-Interest Bill, 2023, recently approved by the Cabinet,” She said adding that, “If enacted, this legislation will help curb conflicts of interest in procurement and financial management related to health projects, mitigating corruption risks.”
While EACC Chief Executive Officer, Twalib Mbarak said that the report presents findings on magnitude and processes most prone to corruption and unethical conduct; extent of adherence to public procurement and financial management laws; effectiveness of information management systems; anti-corruption measures in procurement and financial management; and challenges in the implementation of health care projects.
“I call upon all stakeholders in the health sector to review the findings of the study and to put in place mechanisms for implementing the recommendations to improve health care delivery in the country,” Twalib said.
Key recommendations drawn from the study includes debarment of contractors who mismanage projects and engage in corruption and unethical conduct, debarment from practice and where applicable practicing licenses withdrawn of government officers who collude with contractors in committing procurement and financial malpractices.
The report also calls for stakeholders to ensure transparency and accountability in project planning, prioritization and execution and robust public participation before and during project implementation.
According to the report, 80.6 per cent of members of the public have acknowledged the prevalence of corruption and unethical conduct in the health sector projects implemented in counties.
Delay in completion of projects
Delay in completion of healthcare projects is high in Tharaka-Nithi, Embu and Homa- Bay counties and low in Makueni, Kitui and Turkana counties.
The report shows that Makueni, Kitui, Kiambu and Narok completed most of their projects within the allocated budget
The report also revealed that procurement opportunities for healthcare projects were more accessible in Makueni, Kakamega and Nakuru counties while Wajir, Garissa and Kajiado recorded the lowest levels.
The survey targeted 2,180 respondents who included hospital employees (1280), members of the public (500), contractors (150), county experts (50) and six senior government officials.
The survey relied on cross-sectional research design as its framework for data collection and analysis. It was conducted in national and county health facilities drawn from 25 sampled counties across the country.
EACC said data was collected through face-to-face in-depth interviews with the target respondents.
“The data collected was cleaned, coded and analyzed using International Business Machines (IMB) Statistical Product and Services Solution (SPSS) software,” the report adds.