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Follow Up Assessment of the Medical Equipment Leasing Project: Should it be Extended?

The leasing of medical equipment, commonly known as the MES project in Kenya, having lapsed by end of 2022, was intended to turn around specialized health service provision in the country through private public partnership arrangements. County health facilities were supplied with diagnostic medical equipment on a lease basis and in turn would remit lease payments annually to contractors through the national Ministry of Health. This study is a follow up on a past IEA Kenya value for money assessment of the MES project in Kenya. Overall, it sought to answer the lingering question of whether plans for its extension are justifiable or not. As a prelude, this study sought to respond to two other research questions. The first on the current implementation status of the MES project and the second on whether the project’s intended objectives have been realized. The analysis was based on a review of purposely-identified two main government reports, the Senate Ad Hoc Committee on the MES project report for 2019 and the Office of the Auditor Generals reports on the Financial Statement of National Government and County Governments for the financial year 2019/20 and 2020/21. Media articles and other relevant literature were also reviewed and synthesized for complementary information.

Study findings reveal some success stories particularly in regard to improved scale up and access to diagnostic medical care. However due to cases of failure of delivery of medical equipment compounded by underutilization of delivered medical equipment in just over 25% of the counties, overall service delivery was sub-optimal. Lack of transparency in fiscal information made it difficult to establish the total cost incurred in the implementation of the MES project against estimated project cost. Besides, the MES project transactions and lease payments are riddled with audit irregularities and accountability questions. Furthermore, establishment of whether implementation of the MES project has realized its intended objective of enhancing geographical equity in access and affordability of key health services to all Kenyans was constrained. Fragmented and incomprehensive information on the MES project is largely the reason behind this challenge.