Health Cabinet Secretary Mutahi Kagwe addresses a press conference during the opening of a high dependency maternity and new born unit at the Othaya-KNH hospital annex in Nyeri County on May 7, 2021.
| Joseph Kanyi | Nation Media GroupNews
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Sh3.6tn budget but only Sh15bn to fight Covid
Kenya has set aside a paltry Sh15.4 billion for Covid-19 fight in its expansive Sh3.6 trillion budget for the new financial year, exposing the country to resource constraints in case donors bail out.
This leaves the country at the mercy of donors and other development partners in funding vaccines and other major interventions in the fight against the global pandemic.
As countries around the world free up resources to build a financial war chest to defeat the virus, Kenya, whose budget expenditure has ballooned by nearly Sh300 billion in the new fiscal plan, is focusing on repaying interest on its mountain of debt.
It was expected that the proposed health budget for 2021/22 would have provisions for Covid-19 interventions, including buying of vaccines, testing as well as scientific research.
For instance, it is estimated that the cost of vaccinating 30 per cent of the population will be Sh34 billion, which already overshoots the total Covid allocation in the new plan.
In the 2021/22 financial year, the Health ministry has been allocated Sh121 billion, a near flat growth compared to the Sh119 billion in the current financial year, a budget that was done before the pandemic struck.
Sh65 billion
In the Sh121 billion budget, recurrent budget will consume Sh65 billion and the remaining Sh56 billion will be used for development.
But as a share of the total budget, the ministry’s budget has contracted from 3.5 per cent to 3.3 per cent, a negative trajectory the second year into the pandemic that is threatening the livelihoods of millions of Kenyans.
The estimates have also cut budgets of the two biggest referral hospitals that are at the centre of Kenya’s fight against the pandemic.
According to the budget outlay, Kenyatta National Hospital (KNH) will receive a gross of Sh15.2 billion in the new financial year while Moi Teaching and Referral Hospital (MTRH) has been allocated Sh11.2 billion.
Net allocation
The Budget Office notes that the allocation to KNH and MTRH in net terms indicates a decrease in allocation compared to the current financial year (baseline).
The net allocation to KNH and MTRH has decreased by Sh100 million and Sh200 million, respectively.
“These institutions are perennially faced with the challenge of personnel emoluments shortfalls and a reduction from the baseline will exacerbate this problem,” the brief notes.
An analysis by Parliament’s Budget Office of the Health ministry’s budget for 2021/2022, as presented to the House Committee on Health, has also revealed that Kenya has not budgeted anything to sustain donor-funded projects whose funding has come to an end.
The brief has also exposed Jubilee administration’s lack of commitment to fulfilment of the Universal Health Coverage (UHC), which is one of the big health goals of the Big 4 Agenda.
The report notes that these are the fourth budget estimates to be prepared since the unveiling of the Big 4 Agenda in 2018.
“One of the Big 4 Agenda is the implementation of UHC, where the goal is to provide access to quality and affordable healthcare for all Kenyans by 2022. Thus, 2021/22 is the only “full” financial year for the implementation of the UHC agenda hence the expectation that this goal ought to be fully realised in the course of 2021/22 financial year,” the report notes.
“Unfortunately, nothing substantial has been achieved in the last three years in terms of attainment of the UHC goal,” the brief notes.
It adds that given the manner in which UHC has been implemented in the last three years, nothing much has been achieved since Kenyans are still experiencing high expenditures.
Treasury has also not budgeted for contractual health workers.
The brief notes that proposed 2021/22 allocation for primary health is Sh60 million whereas in 2020/21, the allocation was Sh1.9 billion, representing a drastic reduction.
“The allocation was meant to cater for personnel emoluments for contractual health workers.. Given this reduction, it seems these health workers have been disengaged as a result of their contracts having ended.”
The cuts aside, the good news is that in absolute terms, Kenya has doubled the health budget in the last six years.
The budget allocation for the Health sector has increased from Sh60.6 billion in 2015/16 to Sh112 billion in 2020/21.
“The observed trend more so from 2017/18 financial year is attributed to health sector being part of the Big Four Agenda in terms of roll-out of universal health coverage hence the enhanced allocation,” the report notes.
