NAIROBI, Kenya – Eighteen county hospitals have been accused of diverting nearly Sh1 billion in patient fees and other collections instead of banking the money in official revenue accounts, raising fresh questions about accountability in devolved health services.
A new report by Auditor General Nancy Gathungu shows that 18 Level Four hospitals and one Level Five hospital withheld a total of Sh955.8 million during the financial year ending June 2024, in violation of the Public Finance Management Act (PFMA).
The money—collected from patient charges, pharmacy sales, laboratory services, and both outpatient and inpatient care—was supposed to be remitted to the County Revenue Fund (CRF) before being spent.
Instead, auditors found that the funds were diverted or retained by the facilities, undermining transparency in their use.
Top Offenders
Bungoma County Referral Hospital topped the list, failing to remit Sh363.6 million, followed by Naivasha County Referral Hospital with Sh299.5 million.
Kajiado County Referral withheld Sh91 million, while Bahati Sub-County Hospital failed to transfer Sh58.7 million.
Other hospitals flagged include:
- Kangundo Level Four – Sh26.1 million
- Lamu County Referral – Sh18.7 million
- Miathene Level Four – Sh16 million
- Kiandege Level Four – Sh15.3 million
- Kilungu Sub-County – Sh14.9 million
- Langalanga Level Four – Sh12.2 million
- Tawa Sub-County – Sh10.7 million
- Marindi Level Four – Sh8.5 million
- Ikutha Sub-County – Sh7.8 million
- Kabazi Sub-County and Matuu Level Four – Sh4.7 million each
- Soin Sub-County – Sh1.3 million
- Nyamaraga Level Four – Sh990,000
- Suba Sub-County – Sh861,563
- Wesu Hospital – Sh233,126
Additional Irregularities
The audit, which covered 250 hospitals nationwide, also found that six other facilities could not account for Sh214.3 million in revenue altogether.
These include Nyahururu County Referral, Mpeketoni Sub-County, Ruiru Level Four, Rumuruti District, Mwingi Level Four, and Ojola Sub-County hospitals.
Gathungu stressed that the PFMA is explicit in requiring counties to channel all collections into the CRF.
“Audit review revealed that revenue from exchange transactions amounting to Sh955.8 million from 18 Level Four hospitals and one Level Five hospital was not paid into their respective County Revenue Fund accounts,” she noted.
“This is contrary to Section 109(2) of the Public Finance Management Act, 2012, which requires the County Treasury for each County Government to ensure all money raised or received by or on behalf of the County Government is paid into the County Revenue Fund account.”
The revelations add to growing scrutiny of counties’ handling of devolved health services, a sector already plagued by complaints of underfunding, mismanagement, and frequent strikes by medical workers.
