Governor Achani questioned over opaque SHIF deductions, Sh132M KEMSA debt
By Reporter
The Senate Committee on Health has exposed operational bottlenecks and financial mysteries within Kwale County’s healthcare sector.
The development arose as Senators interrogated Governor Fatuma Achani alongside her executive team and hospital medical superintendents as part of the Senate Mashinani programme, which decentralises parliamentary proceedings to allow lawmakers to inspect devolved services and engage local executive leadership directly.
The most glaring revelation emerged during discussions on the Social Health Insurance Fund (SHIF) reimbursements, where medical superintendents disclosed that deductions under the National Equipment Programme (NEPS/MES) are being made directly from facility reimbursements without monthly statements, cost breakdowns, or contractual details.
Vice Chairperson Sen. Mariam Sheikh Omar pressed county leadership to explain how healthcare facilities can operate when their core revenue streams are systematically siphoned without audit trails.
“It is unacceptable for health facilities to receive arbitrary deductions from SHIF reimbursements without clear cost breakdowns or contractual transparency,” stated Sen. Mariam Sheikh Omar.
Sen. Tabitha Mutinda, a member of the committee, raised red flags over the county’s low medical fill rate, which sits at just 52%, creating a 40% shortfall in essential drugs.
Responding to the panel on the cause of the deficit, Governor Achani defended her administration’s management, explaining that while Kwale carries a KSh132 million pending bill with KEMSA, requisitions are already before the Controller of Budget to clear the debt in full.
“Currently, we have two operating theatres, but we are currently having a budget that has been approved. We are doing seven additional theatres that are a theatre complex, so we are expecting some delivery soon,” Governor Achani noted when pressed on infrastructure deficits.
Addressing stalled Intensive Care Unit (ICU) equipment and missing Magnetic Resonance Imaging (MRI) machines previously supplied under the MES framework, Governor Achani added, “When the programme ended, there was no clear deadline on who was supposed to service the equipment. Most of the equipment was obsolete. But as a county, we have budgeted for new equipment so that we finish the ICU.”
Kisii Senator Richard Onyonka took aim at an unitarised KSh834 million listed under “Others” on the county’s financial submission, demanding immediate accountability.
Kwale’s finance team clarified that approximately KSh500 million of the figure represents anticipated SHIF reimbursements for the current financial year, pledging to submit a fully itemised schedule.
Sen. Hamida Kibwana zeroed in on emergency services and human resource strain, warning that Kwale’s fleet of 15 ambulances is severely compromised by having only 15 drivers, leaving no room for shift rotations during 24/7 emergencies.
On workforce retention, Senators instructed the county executive to enforce strict bonding policies so that health workers undergoing specialised training, such as those stationed at Msambweni County Referral Hospital, return to serve local residents.
To address mounting electricity expenses, Senators urged Kwale to adopt solar power, pointing out that Kiambu County saved KSh700 million through solarisation.
Governor Achani confirmed that Kwale is already rolling out solar installations across facilities ranging from rural dispensaries to Level 5 hospitals.
Striking a collaborative tone during her closing remarks, Governor Achani expressed optimism regarding the county’s healthcare trajectory despite prevailing fiscal constraints.
“We’ve taken note of the issues raised and I want to assure the Senate and the committee that it is our mandate as county government and we’ll deliver to the people of Kwale despite the challenges we have in budgets,” Governor Achani stated.
“We’ve made progress from where we were last time. I assure the committee that next time we are meeting, Kwale will be a model county.”
Adjourning the session, Committee Vice Chairperson Sen. Mariam Sheikh Omar commended the Governor and county leadership for their submission, emphasising that the success of devolution hinges on prioritising healthcare delivery, drug availability, and eliminating non-existent workforce overheads.
She urged Kwale County to maintain tight controls over pharmaceutical supplies and audit payroll systems to eliminate ghost workers, ensuring that public resources directly benefit residents.
