One of the most alarming findings relates to the Facility Improvement Support Fund (FIF), a critical resource meant to upgrade health services across Nairobi. The report, which covers the first quarter of the Financial Year 2024-2025, reveals that Nairobi County did not budget for the FIF. As a result, the Ksh 382.45 million collected during the review period was spent without proper documentation or oversight, in violation of the Facility Improvement Financing Act, 2023
Nairobi Governor Johnson Sakaja is under scrutiny yet again following a damning report that highlights glaring gaps in the management of the health sector, including poor record-keeping and inadequate regulations on the use of funds.
The latest report from the Controller of Budget, Margaret Nyakang’o, paints a grim picture of how health funds, which consume up to 40% of the county’s revenue, are being handled. Despite these substantial allocations, the county government has failed to provide clarity and transparency on how the money is spent, leaving room for potential misuse and mismanagement.
One of the most alarming findings relates to the Facility Improvement Support Fund (FIF), a critical resource meant to upgrade health services across Nairobi. The report, which covers the first quarter of the Financial Year 2024-2025, reveals that Nairobi County did not budget for the FIF. As a result, the Ksh 382.45 million collected during the review period was spent without proper documentation or oversight, in violation of the Facility Improvement Financing Act, 2023.
“The county did not budget for the anticipated FIF in the approved budget for FY 2024/25,” the report states, adding that the funds were retained and spent at the facility level without adhering to budgetary processes.
Worse still, the county has yet to develop the necessary regulations to operationalize the FIF Act, making accountability nearly impossible. Health facilities receiving these funds failed to submit reports on their usage, directly contravening Section 18(e) of the FIF Act. This lack of oversight raises serious concerns about potential embezzlement and the administration’s commitment to prudent financial management.
While the health sector grapples with under-regulation and poor planning, Governor Sakaja’s administration has allocated only Ksh 200 million, 0.5% of the county’s overall budget, to county-established funds in FY 2024-2025. Additionally, Ksh 100 million has been set aside for the Emergency Fund, as required by law, but these allocations pale in comparison to the health sector’s needs.
Sakaja’s administration has also launched initiatives like the Biashara Fund, a revolving fund aimed at supporting businesses owned by women, youth, and people with disabilities. Although well-intentioned, such projects appear misaligned with the pressing need to fix the health sector, a sector that impacts all Nairobi residents directly.
Governor Sakaja, who campaigned on a promise to transform Nairobi into a “city of opportunity,” faces growing criticism for failing to address fundamental governance issues. Despite the city’s reputation for having the highest number of Hustler Fund subscribers and a respectable repayment rate of 73.8%, the administration’s inability to establish basic accountability frameworks in health services undermines public trust.
As Nairobi County announces plans to construct 20 new markets to support over 500 hawkers, the question remains: Will Governor Sakaja prioritize systemic reforms in critical sectors like health? Without decisive action to address the mismanagement of funds, his administration risks further eroding public confidence in its ability to deliver on its promises.
The health sector, a lifeline for millions of Nairobians, deserves more than just rhetoric. It requires robust governance, accountability, and a commitment to ethical leadership, qualities that are currently in question under Sakaja’s watch.
