Why the National Government Continues to Struggle to Execute its Budget: Case of Annual National Budget Implementation Report for FY 2022/23

Why the National Government Continues to Struggle to Execute its Budget and Service Delivery Consequences

Implementation of the National Government budget for the FY 2022/23 was marked by two important events. The first, is the political transition from the previous administration to the current, Kenya Kwanza government that came into power in September 2022. The second, a slow-down in economic activities on the back of rising stock of public debt and high cost of living. Notably, the national government budget was revised twice in part to respond to the consequences of these events.

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.

Brief for the Public Forum on the Leasing of Medical Equipment Project in Kenya

Kenya has been experiencing a rise in cases of non-communicable and traffic accident injuries. This has been compounded by inadequate medical personnel and low specialized health infrastructure owing to the reality of fiscal constraints. Collectively, this has in part been the Achilles’ heel in Kenya’s health sector.

In response to this challenge, the government through the Ministry of Health (MoH) launched the Managed Equipment Services (MES) project on behalf of the 47 devolved units.

This brief presents some insights as a follow-up[1] on the implementation of the MES project as part of IEA Kenya’s governance for health work.

[1] IEA Kenya (2020) Leasing of Medical Equipment Project in Kenya: Value for Money Assessment

Public Forum on the Leasing of Medical Equipment Project in Kenya

This presentation was made by John Mutua during the Public Forum on the Leasing of Medical Equipment Project in Kenya held on Tuesday, 18th  April 2023.

Public Forum on Economic Effects of Russian Invasion of Ukraine on Kenya

This presentation was made by John Mutua and Kwame Owino during the public forum on Economic Effects of Russian Invasion of Ukraine on Kenya  held on Tuesday, 22nd Nov  2022

Analysis of Q3 and Q4 Budget Implementation Report of FY 2021/22 for Kisumu County Government

Webinar #19 0f 2022: Analysis and Comments on the Draft National Tax Policy

This presentation was made by John Mutua during the Virtual public forum on Analysis and Comments on the Draft National Tax Policy held on Thursday, 4th August  2022.

Analysis of Kisumu County First Quarter and Second Quarter of 2021/22 Budget Implementation Report