Sick Counties that can’t account for their health expenditures

While Makueni and Nyandarua Counties were getting clean audit reports after spending millions of shillings in development, some Western counties are having question marks owing to their misappropriation, especially in the health sector.

Auditor-General Edward Ouko has flagged irregular spending of money meant to improve health services in several counties in the Nyanza and Western regions.

The expenditure has undermined key health services in those areas. In Vihiga County, Mr Ouko has raised queries about Sh7 million meant for 42 Level Two and Level Three Health facilities.

The money was part of a grant from the Danish International Development Agency (Danida). The county, Mr Ouko says, failed to account for Sh4.6 million received from the donor and the national government.

Mr Ouko said no documents were provided to indicate how the money was spent. He said the expenditure was initiated by an account with no proper knowledge of child development issues. The venue of the workshop and facilitators were not identified.

Irregular payments of Sh2.1 million to 86 officers who attended the Malezi Bora Initiative workshop have been captured in the report. They were each paid Sh5,000 per day for five days.

In Trans Nzoia, the Auditor-General is questioning the delayed construction of the County Teaching and Referral Hospital. Mr Ouko said an audit verification of the facility carried out in November 2018 showed the project stalled in June 2018.

In the previous financial year, Sh182.7 million had been paid for the project and interim certificates for works issued by a private consultant, raising queries on implementation of the project.

Mr Ouko said the issuing of the certificates by a private consultant had contravened Section 48 of the Public Procurement and Asset Disposal Act 2015, which requires an inspection and acceptance committee to issue the interim and completion certificates.

No reasons were provided for why the contractor had abandoned the project despite paid Sh195 million. The project was to be completed by February 2.

In Kakamega, Sh269.3 million had not been paid to mothers identified as beneficiaries under the Linda Afya Ya Mama na Mtoto programme.

At the time of the audit in November 2018, 30,716 mothers had not received the cash.

In Nyamira, the county paid Sh576 million for leased medical equipment. But the agreement between the county and the national government was not provided for audit.

The money being deducted at the source by the National Treasury increased from Sh5 million to Sh200 million as from July 2018. No explanation was provided.

The county also purchased five Intensive Care Unit ventilators for a total of Sh16 million. But the machines have not been put into use due to lack of skilled staff to operate the equipment.

The executive also procured a faulty laundry machine for Sh8.5 million that has since fallen into disuse.

In addition, the executive procured five heart-related machines for Sh3 million. But physical verification revealed that four of the defibrillators had not been put to use and were lying idle.

In Siaya, Sh95.7 million was included in the budget estimates but no intergovernmental agreement in line with the Constitution was made available for audit verification. The supplementary budget estimates for various votes did not adhere to the budget ceiling as set out in the County Fiscal Strategy Paper, contrary to the Public Finance Management regulations.

The county was therefore in breach of the law and value for money was not realised, the auditor states.

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