Makueni County Healthcare

The Makueni County government is this week conducting new registration for a universal healthcare program in the 60 sub-wards in the county.  The Makueni University Healthcare program will provide essential health services to county residents at eight sub-county hospitals, and the county referral hospital.

It is being lauded and Makueni Governor Kivutha Kibwana who previously battled with the county assembly (parliament) that he was elected alongside in 2013, now appears to be enjoying a resurgence after his re-election on August 8 which he easily won, while 29 of the 30 county assembly legislators (MCA’s) were voted out.

The MCA’s had tried to impeach the Governor and he subsequently moved to dissolve the entire county government. A commission on inquiry looked into the disputes at Makueni and made some recommendations to the President, but as he never forwarded the report to the Senate for debate and approval, the situation was never fully resolved, until the 2017 election.

In promoting the Makueni health care program, the county government states the high level of poverty (60%) in the region as a reason why they set out to provide free health care to senior citizens (above 65 years of age) in the county through a pilot program in 2016. They deemed it a success and decided to expand it to universal health care and they have already enrolled another 33,344 households, excluding the senior citizens. The ongoing registration aims to net 180,000 new households and the benefits of the program will be improved health care with no out-of-pocket expenses for households which have previously resorted to selling livestock or land to meet family medical expenses. During the test phases, Kshs 138 million was expensed, with the bulk of that going to pharmacy expenses (33%), then inpatient (24%) and laboratory (15%) expenses.

The Makueni program will pay for emergency healthcare, laboratory, radiology, theater, cancer screening, drugs, and ambulance evacuation, among other expenses. The cost is Kshs 500 per year for a household and that will cover a nuclear family – beneficiary, spouse(s) and dependents of school going age. It is separate from the government’s national hospital insurance fund (NHIF), and Makueni will not cover services outside the county, such as scans, MRI’s, post-mortems, ICU, dialysis, and other specialized services not available within the county.

The ambitious and novel Makueni program is similar to one in Muranga county that sought to mobilize savings for county investments, but which was scuttled by regulators and wary investors.

The latest Auditor General (OAG) reports on Makueni noted that the county government received (2015) revenue of Kshs 6.3 billion (that included Kshs 5.9 billion from the national government) and that Kshs 5.4 billion was spent, leaving a Kshs 0.9 billion surplus. The OAG noted the disruption of the government activities but gave an adverse opinion on the Makueni county assembly (legislators) accounts while those of the county government (executive) were qualified. The executive was flagged for operating bank accounts at banks other than the Central Bank, and also for issues with the procurement of assets and construction of dams. The report on the assembly noted issues with lack of supporting documentation, hiring of professionals, including lawyers in the case against the governor, and trips that Makueni MCA’s had made to Mauritius, Boston, London, Malaysia Dubai and Singapore.

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