REPUBLIC OF KENYA

HEALTH SECTOR REPORT

MEDIUM TERM EXPENDITURE FRAMEWORK (MTEF) FOR

THE PERIOD 2024/25-2026/27

DECEMBER, 2023

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TABLE OF CONTENTS
LIST OF ABBREVIATIONS 4
EXECUTIVE SUMMARY 7
CHAPTER ONE: INTRODUCTION 11
1. BACKGROUND 11
2. SECTOR VISION AND MISSION 12
3. STRATEGIC GOALS/OBJECTIVES FOR THE SECTOR 12
1. GOAL 12
2. OBJECTIVES 12
4. SUB-SECTOR AND THEIR MANDATES 13
1. STATE DEPARTMENT FOR MEDICAL SERVICES 13
2. STATE DEPARTMENT FOR PUBLIC HEALTH AND PROFESSIONAL STANDARDS 14
1.5 AUTONOMOUS AND SEMI-AUTONOMOUS GOVERNMENT AGENCIES 15
1.5.1 STATE DEPARTMENT FOR MEDICAL SERVICES 15
1.5.2 STATE DEPARTMENT FOR PUBLIC HEALTH AND PROFESSIONAL STANDARDS 18
1.6 ROLES OF STAKEHOLDERS 23
CHAPTER TWO: PERFORMANCE REVIEW FY 2020/21-2022/23 27
1. REVIEW OF PROGRAMME PERFORMANCE REVIEW FY 2020/21-2022/23 27
1. STATE DEPARTMENT FOR MEDICAL SERVICES 27
Programme 1: Curative and RMNCAH Services 27
Sub-Programme 1.1: Communicable Disease Control
27
Sub-Programme 1.2 Non-Communicable Diseases Prevention and Control
29
Sub-Programme1.3: Reproductive Maternal Newborn Child and Adolescent Health (RMNCAH) 31
Sub-Programme 1.4: Immunization Management 32
Sub programme 1.5 Curative services
32
Programme 2: National Referral and Specialized Services 34
Sub-Programme 2.1 National Referral Services 34
Sub-Programme 2.2 Health Infrastructure and Equipment 45
Sub-Programme 2.3: National Blood Transfusion Services (KNBTS) 45
Sub-Programme 2.4: Health Products and Technologies 52
Programme 3: Health Research and Innovations 57
Sub-Programme 3.1 Health Innovations 57
Sub-Programme 3.2 Medical Research 59
Programme 4: General Administration 67
Sub-Programme 4.1 General Administration & Human resource Management & Development 67
Sub-Programme 4.2 Finance and Planning 68
Sub-Programme 4.3 Social Protection in Health 69
2.1.2 STATE DEPARTMENT FOR PUBLIC HEALTH AND PROFESSIONAL STANDARDS
Programme 1: Preventive and Promotive Services 74
Sub-Programme 1.1: Communicable Disease Control 74
74
Sub-Programme 1.2: Non-Communicable Diseases Prevention & Control
78
Sub - Programme 1.3: Radiation Safety and Nuclear Security
78
Sub-Programme 1.4: Reproductive Maternal Neonatal Child and Adolescent Health (RMNCAH)
79
Sub - Programme 1.5: Environmental Health
81
Sub - Programme 1.6 Disease Surveillance and Response
82
Programme 2: Health Research and Development and Innovation
85
Sub – Programme 2.1: Capacity Building and Training
85
Sub – Programme 2.2: Research and Innovation
92
Programme 3: General Administration, Planning and Support Services
92
Sub-Programme 3.1: Health Standards and Quality Assurance
Sub-Programme 3.2: Human Resource Management and Development 92
Sub-Programme 3.3. Health Administration 93
94
Programme 4: Health Policy, Standards and Regulations
94
Sub-Programme 4.1: Health Policy, Planning and Financing
94
Sub-Programme 4.2: Health Standards and Regulations
94
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 2. ANALYSIS OF EXPENDITURE TRENDS FOR THE FY 2020/21-2022/23 117
1. ANALYSIS OF RECURRENT EXPENDITURE (KSH. MILLION) 117
2. ANALYSIS OF DEVELOPMENT EXPENDITURE (KSH. MILLION) 118
3. ANALYSIS OF PROGRAMME EXPENDITURE 119
4. ANALYSIS BY CATEGORY OF EXPENDITURE ECONOMIC CLASSIFICATION 121
5. ANALYSIS OF SAGAS RECURRENT BUDGET VS ACTUAL EXPENDITURE 124
3. ANALYSIS OF PERORMANCE OF CAPITAL PROJECTS FY 2020/21-2022/23 139
4. ANALYSIS OF PENDING BILLS FOR THE FY 2020/21 - 2022/23 (KSHS MILLION) 160
5. ANALYSIS OF COURT AWARDS 167
CHAPTER THREE: MEDIUM TERM PRIORITIES AND FINANCIAL PLAN FOR THE MTEF PERIOD 171
1. PRIORITIZATION OF PROGRAMMES AND SUB-PROGRAMMES 171
1. Programmes and their Objectives 172
3.1.2 Summary of Programmes, Key Outputs, Performance Indicators and targets for FY 2024/25 - 2026/27 175
3.1.3. Programmes by Order of Ranking 254
3.2 ANALYSIS OF SECTOR AND SUB-SECTOR RESOURCE REQUIREMENT VERSUS ALLOCATION
255
3.2.1 SECTOR AND SUB-SECTOR RECURRENT REQUIREMENTS /ALLOCATIONS (AMOUNT KSH.
MILLIONS) 255
3.2.2 SECTOR AND SUB-SECTOR DEVELOPMENT REQUIREMENTS/ALLOCATIONS (AMOUNT KSH.
MILLION) 258
CHAPTER FOUR: CROSS-SECTOR LINKAGES, EMERGING ISSUES/ CHALLENGES 290
1. CROSS-SECTOR LINKAGES 291
2. SECTORAL LINKAGES WITHIN THE SECTOR 291
3. INTER SECTORAL LINKAGES AND STAKEHOLDERS 292
4. EMERGING ISSUES 300
5. CHALLENGES 300
CHAPTER FIVE: CONCLUSION 302
CHAPTER SIX: RECOMMENDATIONS 304
ANNEXURES 306
ANNEX I: REFERENCE 306
ANNEX II: COUNTY CONSULTATION PRIORITIES CONSIDERATIONS 307

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LIST OFABBREVIATIONS

ACRONYM/ABBREVIATION DEFINATION
ACT Artemether Combination Therapy
AIA Appropriation in Aid
AIDS Acquired Immune Deficiency Syndrome
AIE Authority to Incur Expenditures
ALARM Advanced Labour and Risk Management
ALOS Average Length of Stay
AMR Antimicrobial Resistance
AMREF African Medical and Research Foundation
ARV Anti-Retroviral
ASAL Arid and Semi-Arid Lands
AU African Union
AYP Adolescents and Young People
BETA Bottom-up Economic Transformation Agenda
BFCI Baby Friendly Community Initiative
CAPR Community AIDS Programme Reporting system
CASPs County AIDS Strategic Plans
CBA Collective Bargaining Agreement
CBOs Community Based Organizations
CBRN Chemical Biological Radiological and Nuclear
CDC Centre for Disease Control
CHEWs Community Health Extension Workers
CHMTs Community Health Management Teams
CHPs Community Health Promoters
CLTS Community Lead Total Sanitation
COBPAR Community Based Programme Activity Reporting Tool
COC Clinical Officers Council
CoE Centres of Excellence
COFOG Classification of the Functions of Government
COG Council of Governors
COVID-19 Corona Virus Disease 2019
CRWPF Central Radioactive Waste Processing and temporary storage Facility
CSOs Community Service Organizations
DHIS-2 District Health Information System Version 2
DSTB Drug-Sensitive Tuberculosis
E&PWSD Elderly and Persons with Severe Disabilities
EBS Event based surveillance
EMRs Electronic Medical Records
eMTCT Elimination of Mother to Child Transmission
ERS Economic Recovery Strategy
ETAT Emergency Triage Assessment and Triage
FBOs Faith Based Organizations

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FOPNL Front of Pack Nutrition labelling
FY Financial Year
GAMR Global AIDS Monitoring Report
GAVI Global Alliance for Vaccines and Immunizations
GDP Gross Domestic Product
GF Global Fund
GoK Government of Kenya
HAIs Hospital Acquired Infections
HCI Human Capital Index
HISP Health Insurance Subsidy Program
HLMA Health Labour Market Analysis
HRH Human Resources for Health
IAEA International Atomic Energy Agency
ICT Information, Communication and Technology
IDSR Integrated Disease Surveillance and Response
iHRIS Integrated Human Resource Information system
IPC Infection Prevention Control
KENRA The Kenya Nuclear Regulatory Authority
KHATF The Kenya Hospital Authority Trust Fund
KHHRAC The Kenya Health Human Resource Advisory Council
KHIS Kenya Health Indicator Survey
KHPOA The Kenya Health Professions Oversight Authority
KIPRE Kenya Institute of Primate Research
KMIS Kenya Malaria Indicator Survey
KMLTTB Kenya Medical Laboratory Technicians and Technologists Board
KMPDC Kenya Medical Practitioners and Dentists Council
KMTC Kenya Medical Training College
KNBTS Kenya National Blood Transfusion Services
KNDI Kenya Nutritionists and Dieticians Institute
KNMS Kenya National Micronutrient Survey
KNPM Kenya Nutrient Profile Model
KNRA Kenya Nuclear Regulatory Authority
KPI Key Performance Indicator
KQMH Kenya Quality Model for Health
KTTA Kenya Tissue Transplant Authority
LMIS Logistics Management Information System
MOH Ministry of Health
MTEF Medium-Term Expenditure Framework
MTP Medium Term Plan
NASIC National Stewardship Inter-Agency Committee
NCD Non-Communicable Disease
NCK Nursing Council of Kenya
NHWA national health workforce accounts
NNAFP non-polio Acute Flaccid Paralysis

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NQCL National Quality Control Laboratory
PC-ERS Post COVID-19 Economic Recovery Strategy
PCN Primary Care Networks
PET/ CT Positron Emitted Tomography Computed Tomography
PGEC Postgraduate Education Certificate
PHOTC Public Health Officers and Technicians Council
PPB Pharmacy and Poisons Board/ Council
PPM Public-Private Mix
PPR Programme Performance Review
RMNCAH Reproductive, Maternal, Neonatal, Child and Adolescent Health
SDPHPS State Department of Public Health and Professional Standards
SHA Social Health Authority
SP Sub Program
TADSAS Tobacco, Alcohol, Drugs and other Substances of Abuse
UHC Universal Health Coverage
VAS Vitamin A supplementation
WISN Workload Indicators for Staffing Needs

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EXECUTIVE SUMMARY

The State Departments for Medical services(SDMS) and Public Health and Professional Standards
(SDPHPS) both domiciled in the Ministry of Health (MOH) were established through the Executive
Order No. 1 of 2023 and they play a crucial role in the Kenyan health sector.

The Health sector is responsible for developing, implementing, and monitoring policies related to
specialized medical services including population health, research and innovation, public health,
sanitation, preventive and promotive health services, professional standards, health education
management, food quality, hygiene and nutrition, quarantine administration, radiation, control and
management of tuberculosis and malaria. Additionally, the Sector provides strategic leadership and
support to health professional bodies, aiming to maintain professional standards and promote
excellence in healthcare practice.

The State Department of Medical Services comprises of four programmes namely, National Referral
and Specialized Services, Curative and Reproductive Maternal Neonatal Child and Adolescent
(RMNCAH), Health Research and Innovation, and Administrative Support Services. The SDPHPS on
the other hand operates through four budgetary programs: Preventive and Promotive Health, Health
Resource Development and Innovation, Health Policy, Standards and Regulations, and General
Administration.

The sector priorities are aligned with the Kenya Constitution, Vision 2030, Kenya Health Policy,
Bottom-up economic Transformation Agenda, the UHC Policy, Fourth Medium Term Plan (2023-
2027), Post-COVID19 Economic Recovery Strategy (PC-ERS) and the various regional and
international obligations including the Sustainable Development Goals (SDGs) and Africa Union
Agenda 2063.

Over the review period, the budgetary allocation for the Sector increased from Kshs.120.8 billion in
2020/21 FY to Kshs.129.8 billion in 2021/22 FY but then dipped to Kshs. 116.4 billion in 2022/23 FY.
The actual expenditure for the period was Kshs.105.5 billion, Kshs.109.4 billion and Kshs.98.7 billion
for 2020/21, 2021/22 and 2022/2023 financial years respectively, translating to absorption rates of
87.5%, 84.3% and 84.8% over the same period. The resources were utilized to achieve the following:

Reduction of Prevalence of HIV from 4.3% in 2020 to 3.7 in 2022; new HIV infections from 32,027
to 22, 154; and AIDS related mortality from 19,486 to 18,473 during the same period. Kenya made
strident efforts to combat Drug-Sensitive tuberculosis (DSTB), Multi-Drug Resistant Tuberculosis
(MRTB) and malaria by developing new TB drugs, optimization of the existing ones, production of
244,927 units of bleach (TBCide) and developing, piloting and adopting a new malaria vaccine

The SDMS established a diagnostic and reporting centre at KNH in the FY 2020/21, constructed and
operationalized an Oxygen plant with a capacity to produce 1,500 litres of oxygen per minute at Mwai
Kibaki Hospital and development and equiping the Chandaria Cancer and Chronic Diseases Centre
(CCCDC) at Moi Teaching and Referral Hospital (MTRH). To enhance capacity for cancer detection,
treatment and care, the State Department established an Integrated Molecular Imaging Center (IMIC)
and IMIC Hospitality Centre at KUTRRH and established. These interventions will enhance service
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delivery at level-6 facilities in the country to cater for the increased demand for referral services. The
Department ramped efforts to for Covid-19 vaccination with 31.9% of adult population being fully
vaccinated by the end of the review period.

Establishment and equipping of the East Africa Kidney Institute (EAKI) is ongoing with construction
works at 84% completion as of 30th June 2023 and the construction of a National Commodity storage
center at KEMSA is at 88% completion. The Managed Equipment System(MES) project has continued
to be of immense benefit to the supported hospitals and the availability of appropriate medical
equipment in 121 hospitals across all the 47 counties. MES project has enhanced equity of health care
especially in availability of surgical operation, dialysis therapy, screening of cancers, and radiological
diagnoses.

SDMS has continued to invest in Health Products and Technologies (HPTs) through implementing and
utilizing KEMSA-LMIS 3, enabling KEMSA to fulfil and efficiently deliver essential health products
and technologies. All essential HPT lists were reviewed to increase the scope and depth of coverage
by increasing the number of products available and the level of care decentralized to improve accessed
to UHC. The National Medicines and Therapeutics Committee was operationalized to enhance rational
use of Medicines in the Country. Subsequently, 47 counties also formed and operationalized their
County MTCs.

In addition, a nationwide health facility census conducted in FY2022/23, will inform the roll out of
primary healthcare networks and guide future plans, policies, and budgets.

During the MTEF period 2020/21 to 2022/23, the sector faced some emerging issues and challenges
which impacted negatively on the achievement of the planned outputs and health outcomes. These
include: emerging and re-emerging diseases due to increases cross-border travel, especially after
relaxation of international travel during COVID 19 period; re-emergence of neglected tropical diseases
such as kala azar and elephantiasis among others; and the rise in Non-Communicable Diseases
(NCD)incidences; reduction in Donor funding to support the health sector and the tightening fiscal
space has greatly impacted implementation of programmes, activities and projects. Other obstacles
include existing gaps in infrastructure and human capacity, inadequate legal and policy frameworks
for sector regulation, insufficient funding, climate change concerns, and the prioritization of pending
bills over development resources in sector allocations.

Similar to other countries in the region, Kenya is currently grappling with a human resource crisis
within the public health sector due to labor emigration. Many professionals are seeking better
employment opportunities in developed nations.

To mitigate these challenges, it is crucial to formulate and implement strategies that address labor
retention, attract talent, and provide incentives for professionals to remain within the country.
Additionally, efforts must be made to enhance the capacity of local health institutions and improve
working conditions to retain skilled personnel and ensure quality service provision.

To overcome some of the implementation challenges experienced in previous financial years, the
Sector will fast track review and strengthening of the legal, policy framework and operations to
improve efficiency. It will also strengthen collaboration with various stakeholders including
development partners and the private sector. It shall also improve research, development and
8
innovation so as to enhance efficiency, effectiveness and productivity. The sector will also invest in
emergency preparedness and response to secure the health and lives of Kenyans. In conclusion, the
Sector will strengthen its efforts towards realizing Universal Health Coverage.

Over the MTEF period 2024/2025 – 2026/2027, the sector will implement eight (8) programmes; four
by each State Department as outlined in paragraph 3 above.

Health research and innovation is key to unlock bottlenecks experienced in the health sector and
develop capacity to develop solutions for current and emerging health issues. To achieve this, the sector
will provide end to end digital solutions for health facilities, develop and implement a national
information exchange and put in place a comprehensive health information management system. The
sector will also establish partnerships and collaboration in order to improve research capacity, acquire
technologies for manufacturing of HPTs and achieve technology transfer.

The sector will prioritize Digitization of Health services. This will increase efficiency, transparency,
and ensure seamless service delivery between providers. It will also enhance claims management at
health facilities and commodity management through provision of end-to-end supply chain
management. It will also collaborate with the county governments to ensure retention of funds
collected at health facility level for improvement of the facility operations. In partnership with the
county governments, the sector will establish and operationalize Primary Care Networks in the
counties that will offer effective services to the community, through proper referrals and engagement
of multidisciplinary teams at community level. County governments, the National Treasury and the
State Department will consider ring-fencing funds for essential medicines and supplies.

The sector will ensure that more focus is put on local manufacturing of Health products and
technologies to enable commodity security and enhance self-reliance. Achievement of Universal
Health Coverage will be a core theme during the MTEF period to ensure achievement of the objectives
of BETA, Kenya Health Policy and international commitments on health.

The Sector has set programme targets for the years 2024/25, 2025/26, and 2026/27, which contribute
to the achievement of strategic objectives.

To implement these programmes, the sector requires KSh. 1,240 billion, with KSh. 371.9 billion for
FY 2024/25, KSh. 411.4 billion for FY 2025/26, and KSh. 456.8 billion for FY 2026/27. Specifically,
a total of KSh. 131.4 billion, KSh. 148.9 billion, and KSh. 168.3 billion will be needed for recurrent
expenditure in the financial years 2024/25, 2025/26 and 2026/27 respectively. Additionally, for
development expenditure, a total of KSh. 204.4 billion, KSh. 262.4 million, and KSh. 288.4 billion
will be necessary in the financial years 2024/25, 2025/26 and 2026/27, respectively, over the three-
year period.

However, it is important to note that the sector allocations for the FY 2024/25 and the Medium Term
are lower than the projected requirements, resulting to shortfall of KSh. 224.3 billion, KSh. 255.0
billion and KSh. 295.9 billion respectively.

In Conclusion the MTEF report for the Health Sector highlights the Ministry’s strategic direction,
performance objectives, and budgetary priorities for the coming years. By focusing on digitization of
health facilities, research and innovation, improving access to specialized health services while
9
offering financial protection to vulnerable members of the community, local manufacturing of health
products, strengthening public health infrastructure, disease prevention, and professional standards,
the department aims to improve the overall health and well-being of the community while ensuring
regulatory compliance and maintaining high-quality healthcare services.

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CHAPTER ONE: INTRODUCTION

1.1 BACKGROUND
The Government has committed to improve the quality of life for all Kenyans by ensuring Equitable,
Accessible, Affordable and Quality Health Care of the Highest Standard under the social pillar.

This commitment mandates the National Government to provide leadership on health policies and
standards, technical assistance and capacity building. Through the Bottom-Up Economic
Transformation Agenda (BETA) and in an effort to deliver Universal Health Coverage, the government
in collaboration with County Governments and key stakeholders in the spirit of Afya Bora Mashinani
will continue to prioritize Kenya Vision 2030 Flagship Projects for the Health Sector as outlined in
Fourth Medium Term Plan (2023 -2027). These include: Social Health Protection; Community Health
High Impact intervention; Family Health & Strategic Public Health Programme; National Health
Institutions; Local Manufacture of Life-Saving Essential Health Products and Diagnostics; Human
Resources for Health; Health infrastructure and Medical Tourism.

Executive Order No. 1/2023 reorganized the Health Sector into two State Departments, namely the
State Department for Medical Services and the State Department for Public Health and Professional
Standards. Subsequently, Executive Order No. 2 of 2023 enumerated the functions and institutions
falling under each State Department.

The State Department of Medical Services comprises of four (4) programmes namely, (i) National
Referral and Specialized Services; (ii) Curative and Reproductive Maternal Neonatal Child and
Adolescent (RMNCAH) (iii) Health Research and innovation and (iv) Administrative Support
Services. The Programmes ensure that the State Department carries out its mandate as per the Fourth
Schedule of the Constitution namely, health policy, health regulation, national referral facilities,
capacity building, and technical assistance to the counties.

The State Department for Public Health and Professional Standards is made up of four (4) programmes
namely, (i) Preventive and Promotive services, (ii)Health Resource, Development and Innovation, (iii)
General Administration Planning and Support Services and (iv) Health Policies Standard and
Regulations. The programmes will ensure that quality healthcare services are guaranteed through the
provision of policies on healthcare, standards, human resource development, and public health
standards and sanitation management. It also provides strategic leadership and support to all health
professional bodies, development of a framework to ensure the sharing of professional experiences
and embedding in future clinical practice.

The healthcare sector is labor intensive and human resources represent the most important input into
the provision of healthcare, as well as the largest proportion of healthcare expenditure. Strengthening
the health workforce through policy and planning will help address the balance between supply and

11
 demand for healthcare workers; ensure equitable distribution; improve quality; and enhance
the use of data and evidence to improve health and health workforce outcomes. Kenya is
currently experiencing a shortage of healthcare workers and an unbalanced distribution of health
personnel between and within counties mainly due to fiscal restraints on hiring within the public sector
due to policies that cap salaries and freeze hiring.

The Government is committed and determined to realize the constitutional right to health in the
shortest time possible by delivering a Universal Health Coverage (UHC) system built on three pillars
as follows:
 Publicly financed primary healthcare (preventive, promotive, outpatient & basic
diagnostic services), that gives patients a choice between public, faith based and private
providers, based on a regulated tariff;
 Universal seamless social health insurance through NHIF comprising a mandatory
national contributions and private insurance as complementary covers; and
 National fund for chronic and catastrophic illness and injury costs not covered (or with very
restrictive cover) by insurance (cancer, diabetes, strokes & accident rehabilitation, pandemics)
to be funded by combination of insurance levy and Government.

This Report presents an analysis of the Health Sector performance and achievements for the period
2020/21 to 2022/23, the priorities and resource requirements for the period 2024/25 to 2026/27, cross
sector linkages, emerging issues, challenges, and recommendations. The report further outlines the
priority investment areas of the Health Sector and its role in economic development as
highlighted in the Subsequent Chapters.

2. SECTOR VISION AND MISSION

The vision, mission, core values and strategic objectives have been developed in the framework of the
mandate and strategic plans.

Vision: “A healthy, productive and globally competitive nation”

Mission: “To build a progressive, responsive and sustainable Health care system for accelerated
attainment of the highest standard of health to all Kenyans’’

3. STRATEGIC GOALS/OBJECTIVES FOR THE SECTOR

1. GOAL
The Goal of the sector is “To attain equitable, affordable, accessible and quality health care for all.”
2. OBJECTIVES
The Sector objectives are as stated in the health Policy (2014-2030). The policy objectives reflect the
country's agenda for improving population health. They include:

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 i. To eliminate communicable diseases;
ii. To halt and reverse rising burden of NCDs;
iii. To reduce the burden of violence and injuries;
iv. To provide essential healthcare;
v. To minimize exposure to health risk factors;
vi. Strengthen collaboration with private and health related institutions;
vii. Strengthen health professionals’ regulatory mechanisms; and
viii. Strengthen health workforce production and management systems.
The focus areas of investments in the Health Sector includes Health financing, Leadership and
governance, Health Products and Technologies, Health information, Service delivery, Health
Infrastructure, Research & innovation, Health workforce and Development.

4. SUB-SECTOR A N D THEIR M A N D AT ES
1. STATE DEPARTMENT FOR MEDICAL SERVICES
The functions of the State Department for Medical Services are described under the Executive Order
No. 2 of 2023 as shown in Table 1.1.
Table 1.0.1: State Department for Medical Functions and institutions

Functions Institutions
i. Medical Services Policy i. National Health Insurance Fund (State
ii. Medical research Corporations Act, Cap. 446, National Health
iii. Curative health services Insurance Fund Board Order, National
iv. Health Policy and management Health Insurance Fund Act, No. 9. of 1998)
v. Pharmacy and Medicines Control ii. Kenya Medical Supplies Authority
vi. National Health Referral Services. (KEMSA) (Kenya Medical Supplies
vii. Cancer management policy Authority Act, 2013)
viii. E-Health iii. Kenyatta National Hospital, (State
ix. Immunization Policy and Corporations Act, Cap. 446,
Management. iv. Moi Teaching Referral Hospital (Legal
x. Reproductive Health Policy and Notice No.78 of 1998, State Corporations
management. Act, Cap. 446)
xi. Non-Communicable diseases v. The National Cancer Institute of Kenya
(NCD) control and management. (Cancer Prevention and Control Act, 2012)
xii. Control and protection against vi. National AIDS Control Council
HIV/AIDS and STI Amendment Order (2022) that establishes
xiii. Control and management of Leprosy the National Syndemic Diseases Control
Council
vii. Kenya Medical Research Institute (KEMRI)
(Science Technology and Innovation, 2013)

13
 viii. Kenyatta University Teaching, Referral and
Research Hospital State Corporations Act
Cap 446
ix. Kenya tissue and Transplant Authority

x. Kenya Biovax institute limited

xi. Spinal Injury hospital
xii. Mathari National Teaching and Referral
Hospital

1.4.2 STATE DEPARTMENT FOR PUBLIC HEALTH AND PROFESSIONAL

STANDARDS
The functions of the State Department for Public Health and Professional Standards are described
under the Executive Order No. 2 of 2023 as shown in Table 1.2.

Table 1.2: State Department for Public Health and Professional Standards Functions and
Institutions
Functions Institutions
i. Public Health and Sanitation Policy; i. Kenya Medical Practitioners and Dentist
ii. Preventive and Promotive Health Council (KMPDC)
Services; ii. Kenya Health Professions Oversight
iii. Policy on Human Resource Authority (KHPOA)
Development for Health Care iii. Kenya Medical Training College (KMTC)
Workers; iv. Kenya National Public Health Institute
iv. Health Education Management; (KNPHI)
v. Food Quality, Hygiene and v. Kenya Hospital Authority Trust Fund
Nutrition Policy; vi. Counselors andPsychologists Board
vi. Quarantine Administration; vii. Physiotherapy Council of Kenya
vii. Radiation Policy; viii. Clinical Officers Council ofKenya (COC)
viii. Administration of the legal and ix. Kenya Medical Laboratory Technicians
institutional framework for the and Technologists Board (KMLTTB)
control of the production, x. Nursing Council of Kenya (NCK)
manufacture, sale, labeling, xi. Kenya Nutritionists and Dieticians Institute
advertising, promotion, sponsorship (KNDI)
and use of tobacco products; xii. Health Records andInformation Managers
ix. Control and Management of Board
Tuberculosis (TB) and other Lung xiii. Pharmacy and Poisons Board (PPB)
Diseases; and Malaria Control and xiv. National QualityControl Laboratories (NQCL)
Management; and xv. Public Health Officers and Technicians
x. Control and Management of Council (PHOTC)
Leprosy xvi. Kenya Nuclear Regulatory Authority (
14
 KNRA)
xvii. Kenya Institute of Primate Research (KIPRE)
xviii. Kenya Health H um an Resource
Advisory Council (KHHRAC)
xix. Tobacco control board
xx. Occupational therapy Council of Kenya

1.5 AUTONOMOUS AND SEMI-AUTONOMOUS GOVERNMENT AGENCIES

The Sector comprises 32 Autonomous and Semi-Autonomous Government Agencies (AGAs and
SAGAs).

1 . 5 . 1 STATE DEPARTMENT FOR MEDICAL SERVICES

The State Department’s Semi-Autonomous Government Agencies (SAGAs) include:
i. Kenyatta National Hospital (KNH)
Kenyatta National Hospital (KNH) was established through Legal Notice No. 109 of 6th April 1987
and as amended under Legal Notice No. 38 of 1st March, 2021. The Hospital is mandated to receive
patients on referral from other hospitals or institutions within or outside Kenya for specialized health
care; Provide facilities for medical education for the University of Nairobi Medical School, and for
research either directly or through other co-operating health institutions; Provide facilities for
education and training in nursing and other health and allied professions and Participate as a national
referral hospital in national health planning.
ii. Moi Teaching and Referral Hospital (MTRH)
Moi Teaching and Referral Hospital (MTRH) is a State Corporation established through Legal Notice
No. 78 of 12th June 1998 under the State Corporations Act (CAP 446). It is a Level 6B National Referral
Hospital located in Eldoret town, Uasin Gishu County, in the North Rift region of Western Kenya.
MTRH is the training facility for Moi University College of Health Sciences, Kenya Medical Training
College (KMTC) Eldoret Campus and University of Eastern Africa Baraton.
iii. Kenyatta University Teaching, Referral and Research Hospital (KUTRRH)
Kenyatta University Teaching, Referral and Research Hospital (KUTRRH) was established as a state
corporation under the State Corporations Act Cap 446 through a Legal Notice No.4 of 2019. The
mandate of the hospital is to receive patients on referral from other hospitals or institutions within or
outside Kenya for specialized health care.
iv. Kenya Medical Supplies Authority (KEMSA)
Kenya Medical Supplies Authority was established under the Kenya Medical Supplies Authority Act
No. 20 of 25th January 2013 as a successor to the Kenya Medical Supplies Agency, established under
Legal Notice No. 17 of 3rd February 2000. The Authority ‘s mandate is Medical logistics provider with

15
the responsibility of supplying quality and affordable essential medical commodities to health facilities
in Kenya through an efficient medical supply chain management system.
v. Kenya Medical Research Institute (KEMRI)
The Kenya Medical Research Institute (KEMRI) is a State Corporation established in 1979 under the
Science and Technology (Repealed) Act, Cap 250 Laws of Kenya, subsequently under the Science,
Technology and Innovation Act, 2013 and as currently established under Legal Notice No. 35 of 31st
March 2021.
The objective of the Institute shall be to carry out health research, innovation, capacity-building and
service delivery for the improvement of human health and quality of life, and advise the Government
on matters related thereto. KEMRI is responsible for providing leadership in health research &
development, shaping the health research agenda, setting norms and standards, articulating evidence-
based policy options, and monitoring and assessing health trends as well as dealing with trans-
boundary threats and disease outbreaks.
vi. National Health Insurance Fund (NHIF)
The National Health Insurance Fund (NHIF) is a parastatal established under the NHIF Act No. 8 of
1998 with an independent Board of Management. The Fund is mandated to facilitate access to quality
healthcare through strategic resource pooling and healthcare purchasing in collaboration with
stakeholders. NHIF works to secure financial risk protection against the cost of healthcare services for
all Kenyan residents through prudent financial management of resources.
vii. The National Syndemic Diseases Control Council – (NSDCC) formerly National AIDS
Control Council (NACC)
The National Syndemic Diseases Control Council (NSDCC) is a State Corporation established under
Section 3 of the State Corporations Act, Cap 446, through the National Syndemic Diseases Control
Council Order, 1999 as amended by legal notice number 143 of 2022. The amendment comprises an
expanded mandate to manage Syndemic diseases, including HIV, sexually transmitted infections,
malaria, leprosy, tuberculosis, and lung disease. The key mandate of NSDCC is to: Develop policies
and guidelines relevant to the prevention and control of Syndemic diseases as well as mobilize
resources and Government Ministries, Counties and institutions, non-Governmental organizations,
community-based organizations, research bodies, the private sector and universities to participate in
Syndemic diseases control and prevention.
viii. National Cancer Institute of Kenya
The National Cancer Institute of Kenya (NCI Kenya) is a state corporation established by the Cancer
Prevention and Control Act (No. 15 of 2012). This was in recognition of the need for a coordinated
response to the growing cancer burden in Kenya. The mandate of the NCI Kenya is to coordinate and
centralize all activities, resources and information related to cancer prevention and control in Kenya.
ix. Mathari National, Teaching and Referral Hospital
Mathari Hospital, established in 2020 as a State Corporation under the State Corporations Act Cap 446
through Legal Notice No. 165, is a level 6 tertiary healthcare facility. The hospital’s mandate is to

16
Provide highly specialized services including Specialized psychiatric services, Forensic psychiatry
services, Child and adolescent mental health services, Receive and manage referrals of persons with
mental disorders from other facilities for specialized care and to Provide training and research facilities
in the field of psychiatry and mental health for doctors, nurses, clinical officers and other allied health
workers.
x. National Spinal Injury Referral Hospital.

The National Spinal Injury Referral Hospital was founded in 1944 as a facility to care for World War
II soldiers who had spinal cord injury. The hospital is not yet confirmed as a SAGA, but the request
has been discussed with the previous Health Parliamentary team and the completion process is
underway.

The main mandate of the hospital is to achieve effective accessible, equitable and secure health services
for patients with spinal injuries that will bring the realization of Universal Health Coverage (UHC) in
Kenya. Hospital offers Curative Spinal Services such as spine, plastic and general surgeries; nursing
care; medical care; diagnostic laboratory and radiology, Rehabilitative Services including
physiotherapy, occupational therapy, psychosocial therapy and orthopaedics as well as Promotive and
Preventive Spine care; including chronic pain management; health education on spine care to general
public and former patients.
xi. Kenya Tissue and Transplant Authority

The Kenya Tissue and Transplant Authority (KETTA) formerly, Kenya National Blood Transfusion
Tissue and Human Organ Transplant Service is a State Cooperation established under Legal Notice
No. 142 of 1st August 2022. The Authority is mandated to ensure access to the safe and ethical use of
human cells, tissues and organs and the safety, biosafety, and well-being of donors and recipients in
medical services relating to human-derived medical products through the establishment and
maintenance of systems that comply with safety and legal requirements. The Authority currently runs
a hub and spoke model approach to increase access to blood transfusion services in the Country through
blood donor recruitment, collection, and laboratory processing to ensure blood transfusion safety. The
Authority has a network of 6 Regional Blood Transfusion Centers and provides commodities for blood
collection to all the blood establishments.

xii. Kenya Biovax Institute (KBI)

Kenya Biovax Institute (KBI) Limited is a State Corporation incorporated under the Companies Act
2015 on 16th September 2021. Kenya Biovax Institute is a purpose-led, biotechnology institution with
focus on manufacturing, commercialization and R&D for specialized HPTs, including human
vaccines, biotherapeutics and diagnostics.

xiii. The Social Health Authority

On 19th October 2023, H.E. The President assented to the Social Health Insurance Act that birthed the
Social Health Authority. The Act came into effect on 22nd November 2023 after gazettement by the
17
Cabinet Secretary for Health and it provides for a transition period of one year from the appointment
date. The Act also provides, under Clause 7 of the Transitional Provisions, that the annual estimates
for the National Health Insurance Fund for the financial year in which the appointed day occurs shall
be deemed to be the annual estimates of the Authority for the remainder of that financial year.
The Act aims to;
 Provide a framework for improved health outcomes and financial protection in line with the
right to health and universal health coverage.
 Realign healthcare systems, processes and programs for responsiveness, reliability and
sustainability of healthcare in Kenya.
 Enhance the pooling of resources and risks based on the principles of solidarity, equity and
efficiency so as to guarantee access to healthcare services to all.
 Promote strategic purchasing of healthcare services.
The functions of the Social Health Authority among others include:
 Management of Funds established under the Act.
 Receipt of all contributions and other payments required to be made to the Funds by Act.
The Act established three Funds under the Social Health Authority namely: The Primary Healthcare
Fund, The Social Health Insurance Fund and The Emergency, Chronic and Critical Illness Fund. The
role of each of the Funds and sources of financing are as outlined below:

I. THE PRIMARY HEALTHCARE FUND

Section 20 of the Social Health Insurance Act, 2023 establishes the Primary Healthcare Fund whose
objective is to purchase primary healthcare services from health facilities. Sources of funds shall be
monies appropriated by the National Assembly; any grants, gifts, donations, or bequests; monies
allocated for that purpose from fees or levies administered; monies accruing to or received by the Fund
from any other source.

II. THE SOCIAL HEALTH INSURANCE FUND

The Social Health Insurance Fund was established under Section 25 of the Act. Sources of funds shall
be contributions under the Act; monies appropriated by the National Assembly for vulnerable persons
and indigents; gifts, grants, innovative financing mechanisms or donations.

III. EMERGENCY, CHRONIC AND CRITICAL ILLNESS FUND

The Emergency, Chronic and Critical Illness Fund was established under Section 28 of the Act to
defray the costs of management of chronic illness after depletion of the social health insurance cover
and to cover the costs of emergency treatment. Sources of funds shall be monies appropriated by the
National Assembly; gifts, grants, donations or endowments or monies from any other lawful source.

1.5.2 STATE DEPARTMENT FOR PUBLIC HEALTH AND PROFESSIONAL

STANDARDS
The State Department’s Semi-Autonomous Government Agencies (SAGAs) include:

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 i. Kenya Medical Training College (KMTC)
Kenya Medical Training College is a body corporate established under the provisions of the
Kenya Medical Training College Act, (Cap 261) of the laws of Kenya as amended by Act No.5
of 2019). The College is mandated with the role of training of the various health disciplines, to
serve Kenya and beyond. The College has a population of over 62,807 students in 74 campuses
spread across 44 counties in the country. The College contributes 85% of the local mid-level
healthcare workforce.

ii. Kenya Nuclear Regulatory Authority (KENRA)

The Kenya Nuclear Regulatory Authority (KENRA) is a State Corporation, established on 10th
January 2020, by the Nuclear Regulatory Act, 29 of 2019. It is mandated to ensure the safe,
secure and peaceful use of nuclear science and technology and provide for the protection of
persons, property and the environment against the harmful effects of ionizing radiation through
the establishment of a system of regulatory control.

iii. Kenya Medical Practitioners and Dentists Council

The Kenya Medical Practitioners and Dentists Council is established under Section 3 of the
Medical Practitioners and Dentists Act Cap 253 of the Laws of Kenya. The mandate of the
Council is to regulate the practice of medicine, dentistry and health institutions in the country.
This Act was enacted by Parliament in 1977 and came into operation on 1st January 1978.

iv. The Kenya Health Human Resource Advisory Council (KHHRAC)

The Kenya Health Human Resource Advisory Council (KHHRAC) is established under the
Health Act 2017, Part V Sections 30-44, and is mandated to review policy and establish uniform
norms and standards on the management of interns and medical specialists, intergovernmental
transfers (county to county and between the two levels of government), welfare and the scheme
of service for health professionals and maintenance of a master register for all health
practitioners in the country.

v. The Kenya Health Professions Oversight Authority (KHPOA)

The Kenya Health Professions Oversight Authority is a corporate body created by part VI of
the Health Act no. 21 of 2017 with the mandate of providing oversight in training, registration
and licensing of health professionals; coordinating joint health inspections; receiving and
facilitating resolution of complaints and arbitrating disputes and conflicts; and monitoring
execution of respective mandates and functions of health regulatory bodies. It has been
categorized by the State Corporation Advisory Council (SCAC) as a Regulatory Corporation
category PC 6.

vi. Nursing Council of Kenya (NCK)

The Nursing Council of Kenya (NCK) is a regulatory body under the Ministry of Health
established on 10th June 1983 by an Act of Parliament under the Nurses Act Chapter 257 of
the Laws of Kenya. It is mandated to make provision for the training, registration, enrolment
19
 and licensing of nurses and midwives: to regulate their conduct and to ensure their maximum
participation in the health care of the community and for connected purposes

vii. Clinical Officers Council (COC)

The Clinical Officers Council was established under the Clinical Officers Act, Cap 260. The
Act was assented on August 24, 1988 and repealed in 2017 and replaced by Act No 20 of 2017.
The mandate of the Council is to make provision for the training, registration, and licensing of
clinical officers, regulate their practice, and for connected purposes.

viii. Kenya Medical Laboratory Technicians and Technologists Board (KMLTTB)

The Medical Laboratory Technicians and Technologists Act was assented on January 6, 2000,
and commenced on December 22, 2000. The mandate of KMLTTB is to provide for training,
registration and licensing of medical laboratory technicians and technologists.

ix. Kenya Nutritionists and Dieticians Institute (KNDI)

The Kenya Nutritionists & Dieticians Institute (KNDI) was established to provide for training,
registration, and licensing of nutritionists and dieticians; to provide for the registration of the
standards and practice of the profession; to ensure their effective participation in matters
relating to nutrition, dietetics; and for related purposes under the Nutritionists & Dieticians Act
No. 18 of 2007.

x. Public Health Officers and Technicians’ Council (PHOTC)

The Public Health Officers and Technician’s Council is a statutory body established under the
Public Health Officers (training, registration and licensing) act no. 12 0f 2013 to regulate
training registration and licensing of public health officers in Kenya.
The mandate of the council is to; exercise general supervision and control over training,
practice and employment of public health officers and technicians in Kenya and to advise the
government to all aspects thereof.

xi. Pharmacy and Poisons Board/ Council (PPB)

The Pharmacy and Poisons Board (PPB) was established under Cap 244, of the Pharmacy and
Poisons Act 1957 and last revised in 2009. The mandate of the Board is to: make provision for
the control of the profession of pharmacy and the trade in drugs and poisons; regulate and
register pharmacists Authorizing pharmacists to sell medicines and related products, as well as
for remedial measures in cases of violation of professional conduct and discipline.

xii. Tobacco Control Board (TCB)

Tobacco Control Board is established under Section 5 of Tobacco Control Act 2007. Its
mandate includes advising the Minister on the national policy to be adopted with regard to the

20
 production, manufacture, sale, advertising, promotion, sponsorship and use of tobacco and
tobacco products.

xiii. National Quality Control Laboratory (NQCL)

The National Quality Control Laboratory was established in 1992 as a body corporate, under
the Pharmacy and Poisons (Amendment) Act of 1992 (Cap 244, Laws of Kenya). It was
prequalified by World Health Organization (WHO) in 2008. NQCL is mandated to carry out
the examination and testing of drugs and any material or substance from or with which and the
manner in which drugs may be manufactured, processed or treated and ensuring the safety and
quality control of drugs and medicinal substances; (b) performing chemical, biological, bio-
chemical, physiological and pharmacological analysis and other pharmaceutical evaluation;
and (c) testing, at the request of the Board and on behalf of the Government, of locally
manufactured and imported drugs or medicinal substances with a view to determining whether
such drugs or medicinal substances comply with this Act or rules made thereunder.

xiv. Physiotherapists Council of Kenya

The Physiotherapist Council of Kenya is established under the Physiotherapist Act no. 20 of
2014 to regulate the Training, Registration, and Licensing of physiotherapists in Kenya.

xv. Health Records and Information Managers Board

Health Records and Information Managers Board is established under section 7 of the Health
Records and Information Managers Act, 2016 (No. 15 of 2016) and amendments provided for
in the Health Laws (Amendment) Act, 2019. The Board is mandated to regulate training,
registration, licensing and practice of Health Records and Information Managers.

xvi. Counsellors and Psychologist Board

The Counsellors and Psychologist Board is established under part 2 of the Counsellors and
Psychologist Board Act, 2014 (No. 14 of 2014). The Act provides for the training, registration,
licensing, practice and standards of Counsellors and Psychologists.

xvii. The Kenya National Public Health Institute

The Kenya National Public Health Institute was established under CAP 446 Laws of Kenya
and came into operation under Legal Notice no.14 on 21st Jan 2022. It is mandated to establish
mechanisms to facilitate quick detection of outbreaks and emergencies; Conduct vulnerability
and risk assessment, and mitigate various health-threatening issues in collaboration with non-
health entities including Ministries responsible for matters relating to environmental health,
animal health, and trade; academic institutions and non-governmental organizations.

xviii. Kenya Hospital Authority Trust Fund

The Kenya Hospital Authority Trust Fund (KHATF) was established in 1968 by the then,
Minister of Health through a Trust Deed in exercise of the powers conferred upon the Minister
21
 by National Hospital Insurance Fund Act of 1966 Section 42(3). The objective of the fund as
spelt out in section 1 of the Trust Deed was the “furtherance of medical education in association
with the University College of Nairobi”.

xix. Occupational Therapy Council of Kenya

The Occupational Therapy Council is established under the Occupational Therapists (Training,
Registration and Licensing) Act No. 31 of 2017. The mandate of the Council is to regulate the
training, registration, licensing and the practice of occupational therapists.

xx. Kenya Institute of Primate Research (KIPRE)

The Kenya Institute of Primate Research (KIPRE), former Institute of Primate Research, is a
biomedical research facility which has existed since 1958. KIPRE ethically utilizes non-human
primates and other experimental animals for research resulting in the production and
commercialization of vaccines, drugs, therapies, medical interventions and services to improve
human health. It is located in Karen with research focusing on Tropical and infectious diseases,
Reproductive Health and Biology; Non-communicable diseases; Phage therapy for microbial
resistance, Snake bite research and intervention and One-Health research on emerging
pathogens and diseases that involve Human, Wildlife, Livestock and the Environment. KIPRE
is established vide Legal Notice no. 273.
Furthermore, KIPRE’s research capacity and compliance with international best practices has
enabled it gain recognition by United States National Institutes of Health Office of Laboratory
Animal Welfare, accredited by African Network for Drug and Diagnostics Initiative (ANDI)
as center for drug development and testing, recognized as a World Health Organization (WHO)
Collaborating Centre and the facility is accredited by the American Association for Assessment
and Accreditation of Laboratory Animal Care International (AAALAC). KIPRE was recently
certified for Good Financial Grant Practices (Silver Medal) and it’s the first in the entire African
Continent to achieve this compliance.

The research capacity at KIPRE and its international acclaim offers the institution a solid
foundation to operate as a premier biomedical research facility in Kenya and Africa.

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1.6 ROLES OF STAKEHOLDERS
The Health Sector is governed through the steering leadership of the Government. The major
stakeholders in the Sector are as illustrated in Table 1.3:
Table 1.3: Stakeholders in the Health Sector

Name of Stakeholder Role of the Stakeholder

The National Treasury Providing budgetary support for investments, operations and
maintenance of the Sector besides the remuneration of all
employees.

State Department for Coordination of planning, policy formulation and tracking of

Economic Planning results in the State Department.

National Council for Provides advocacy and resource mobilization support,

Population and Development coordination of public and private stakeholders, and
programme support for RMNCAH interventions towards
international Commitments on population and development.

National Assembly and Senate Legislation and oversight on matters relating to health including
law enactment and budgetary approval.

County Health Departments In accordance with Schedule 4 of the Constitution counties

departments of Health are specifically mandated with: County
health facilities; County health pharmacies; Ambulance
services; Promotion of preventive and promotive health care
services; licensing and control of sale of food in public places;
veterinary services; cemeteries, funeral parlours and
crematoriums; enforcement of waste management policies.

Non-State Actors in Health They include the private sector, faith-based organizations
(FBOs), non-governmental organizations (NGOs), Community
Based Organizations (CBOs) and Civil Society organizations
(CSOs). Non state actors contribute to Health service delivery
through advocacy and resource mobilizing, provision of service
delivery, social mobilization at community level to influence
health seeking behaviour, promotion of best practices and
address human rights and gender issues.

23
Academic Institutions Universities and middle level colleges play crucial roles in
health research, development of Human resources for Health,
provision of tertiary health care and funding.

WHO Support the State Department with technical advice on Health

systems strengthening approaches; both national and counties.

Global Fund The Global Fund is a multi-sectoral partnership designed to

accelerate the end of AIDS, tuberculosis, and malaria at
national and county levels. Key programmatic activities are for
the procurement of diagnosis and treatment commodities;
facilitate preventive measures. In addition, the support is to
improve the quality of care; enhance use of quality data for
decision-making; social behaviour; support community
approaches and address human right and gender.

PEFFAR (USAID &CDC) Supports the State Department in provision of Financial and
Human resources and technical assistance for the HIV and TB
programs at the National and county levels.

GAVI Support for Vaccines and Immunization programmes

World Bank Support health systems strengthening interventions in both

national and county government levels

JICA Leadership and Governance, infrastructure, community health

both National and Counties

UNICEF Supports maternal, children & adolescents, nutrition and

healthcare, strengthening of health and nutrition systems,
Scorecard (RMNCAH) and water and sanitation (WASH)
programs at both National and county levels.

UNFPA Support on Population Health and family planning

commodities; maternal health programme (RMNCAH)

UNAIDS Co-ordinate the joint UN team for multi sectoral HIV response;
support M&E of HIV response

DANIDA Health System strengthening in the Counties.

Organization of Petroleum Support for Burns and Paediatric centre.

Exporting Countries (OPEC)

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Saudi Arabia Fund for Support for cancer centre in Kisii Hospital and Burns and
Development Paediatric centre.

Arab Bank for Economic Support for cancer centre in Kisii hospital and burns &
Development in Africa Paediatric centre.
(BADEA)

Private sector consortium- Coordinates all private practice members;

local manufacturers of health
products

Faith-Based Organizations Coordinates Faith based health services among them are
SUPKEM, CHAK and KCCB

Kenya Health Federation The federation works with commercial and public institution,
professionals, non-state actors to promote strategic public
private partnerships

Other state actors Multisectoral collaboration to implement programs that have

impact on Health including; Ministry of Environment and
Forestry, Ministry of Water, Sanitation and Irrigation; Ministry
of Agriculture and livestock development; Ministry of Labour
and Social Protection; Ministry of Public Service, Gender, and
Affirmative Action, Ministry of Information, Communications
and the Digital Economy, Ministry of Interior and National
Administration Ministry of Roads and Transport, Ministry of
Education, Ministry of Trade, Investments and Industries,
Judiciary through inter-sectoral collaboration in promotion of
health services, disease prevention and addressing the social
determinants of health. In addition, Kenya National Bureau of
Statistics (KNBS) and Kenya Institute for Public Policy
Research and Analysis (KIPPRA) conduct surveys and provide
information for policy and planning purposes.

Clients/ Consumers of Health Household and communities have a major role in the demand
Services and utilization of quality, accessible and affordable services

East Africa Community EAC has a key role in advocating for and safeguarding cross
(EAC) border health

Advocacy groups These are non-profit organization and advocacy

groups that focus on public health issues and
professional standards working to influence policy and

25
 promote public health initiatives.

Schools These includes primary and secondary schools

whereby primary health care is reinforced
Other state actors Multisectoral collaboration to implement programmes
that have an impact on Health.
(MDAS)

26
CHAPTER TWO: PERFORMANCE REVIEW FY 2020/21-2022/23
This Chapter details the Sector performance for FY 2020/21-2022/23 and an analysis of the previous
budgetary allocations, actual expenditures and achievement of programme outputs. The Ministry of
Health is mandated to support the attainment of the health goals of the people of Kenya through
implementing priority interventions. In order to achieve these priorities, the Sector is expected to
formulate a credible budget that in the long-term guarantees efficiency and effectiveness in public
spending.

1. REVIEW OF PROGRAMME PERFORMANCE REVIEW FY 2020/21-2022/23

1. STATE DEPARTMENT FOR MEDICAL SERVICES

Programme 1: Curative and RMNCAH Services

Sub-Programme 1.1: Communicable Disease Control

a) NASCOP

The prevalence and incidence of HIV in Kenya is reported at 4.3% and 0.59% respectively as at 2021,
attributed in part to significant behavioral change and increased access to Anti -Retroviral Treatment
(ART’s). As of December 2022, approximately 1,377,252 people were living with HIV, with
1,330,565 currently on ART, indicating a robust treatment coverage of 96.61%, a noticeable
improvement from 81.52% in 2020.

HIV-targeted testing of High-risk populations during the FY 2022/2023 was set at 7,632,170, however
only 4,241,677 were reached, achieving roughly 55.6% of the target. This shortfall occurred primarily
due to delays in the procurement and distribution of HIV rapid test kits to service delivery locations.
An impressive 98% of pregnant women in 2022, accessed antenatal care (ANC). However, only 15%
initiated their first ANC visit during the first trimester, and HIV status knowledge decreased from 80%
during ANC to 15% at six weeks post-natal. Maternal ART coverage reached 89.56%, though it lagged
in ASAL regions. The estimated HIV Mother to Child Transmission (MTCT) rate for 2023 is 8.6%,
with a case rate of 1,359 per 100,000 individuals. New infections in children now occur predominantly
during the extended breastfeeding period, attributed to treatment interruptions among Women Living
with HIV (WLHIV) (47%) and incident infections among previously HIV-negative women (23%).

b) National AIDS Control Council (NACC)

The National AIDS Control Council continued to implement a multisectoral and multifaceted HIV
response to accelerate the achievement of Universal Health Coverage and greater program impact. The
achievements for the period under review is highlighted in the summary table showing the performance
of the HIV program from 2020 to 2022.

27
Summary table showing the performance of the HIV program
2020 2021 2022
HIV Prevalence 4.30% 4.00% 3.70%
PLHIV 1,435,271 1,437,267 1,377,784
Incidence 0.09% 0.10% 0.59%
HIV Infections 32,027 34,540 22,154
Mortality 19,486 22,373 18,473
MTCT Rate 9.70% 8.90% 8.60%
Source: 2023 HIV Estimates

Mid-Term Review of the HIV Programme in Kenya marked a significant milestone in the ongoing
efforts to combat the HIV epidemic within the country. The review process provided valuable insights
into the progress, challenges, and opportunities that shape the country’s journey towards achieving
KASF II objectives.

The key HIV-related policy documents developed in the period under review included: Costing HIV
prevention in Kenya, 47 County Profiles, 2022 World AIDS Day Progress Report, 2023 HIV
Estimates, the Actuarial Analysis of Integrating HIV treatment within the NHIF Benefit Package,
Epidemic Appraisal Report, HIV Implementation and Financing Proto-type bill, and the Health Sector
Transition Road map,2022.

Multisectoral County HIV Coordination forums were operationalized in all 47 Counties to support
development of HIV related policies as well as monitor and review progress on the implementation of
the Kenya AIDS Strategic Framework II and the County AIDS Implementation Plans. In FY 2021/22
10 counties were supported to ensure mainstreaming of HIV programs in county work plans and
budgets, thus strengthening Domestic Resource Mobilization (DRM) process.

One of the HIV prevention strategies is the human-centered design approach which allows
communities to identify and design their own interventions. Some of the achievements for the period
under review include the utilization of the Communities of practice (CoPs) such as engagement of
male champions who distributed 5,871,526 condoms in non-health settings in 2022/23. The numbers
dropped from 6,451,258 in 2021/22 due to national and global supply chain challenges of essential
commodities including condoms. For effective distribution of condoms, 168 condom dispensers
against a target of 205 were procured and installed in institutions of higher learning in FY 2022/23.

The institution sustained messaging on HIV prevention and treatment as well as universal health
coverage in the context of HIV with over 82,433,925 million people reached against a target of 25
million through the triple threat initiative, sensitization through PLHIV networks and interpersonal
engagement with fisherfolk and other vulnerable populations, Advocacy on COVID-19 vaccination,
engagement of community gate keepers and opinion leaders, Documentary on Universal Health
Coverage in the context of HIV and AIDS (media reports indicated that over 3,999,000 people
reached).

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Sub-Programme 1.2 Non-Communicable Diseases Prevention and Control

Non Communicable Diseases (NCD’s) accounted for 41% of the deaths in 2021/22, compared to
43.5% in 2020/2021.

a) NCD Prevention and Control

In NCD data management, an electronic patient health records system for diabetes and hypertension
was rolled out in 98 health facilities. This has enhanced reporting of diabetes and hypertension
indicators. Pilot projects included integration of NCD care in Primary health level were conducted
during this period in Busia, Trans Nzoia and Makueni Counties that saw improved health outcomes
such as increasing control rate of hypertension from 38% FY 2021/22 to 55% FY 2022/23.

b) National Cancer Control Program

In Kenya, cancer is the second leading cause of non-communicable diseases (NCDs) after
cardiovascular diseases. The annual incidence of cancer is increasing and was reported as 42,116 cases
in 2020. The overall five-year cancer prevalence rate is 82,620 (54,156 cases among women and
28,464 cases among men). In the year 2022/23 the Ministry developed and launched its third National
Cancer Control Plan 2023-2027 and a Cancer Monitoring, Evaluation and Learning (MEAL)
Framework for 2023-2027, and launched the Garissa Comprehensive Regional Cancer Centre.

In FY 2022/23 over 6,000 primary health workers were trained on early cancer diagnosis through e-
learning platforms on the MOH Virtual Academy and another 6,500 primary health workers on cervical
and breast cancer screening and treatment of precancerous lesions across the 47 counties. 257
community health promoters in 10 counties were trained in cancer screening. Through support from
partners 150 thermal ablation devices were distributed in 22 counties. The proportion of women
screened for cervical cancer against the set target for the year nationally reduced from 42.8% in
2021/22 to 30.9% in 2022/23. There was a significant increase in outpatient visits at public cancer
centers from 75,928 in 2020/2021 to 105,760 in 2021/2022 and 115,627 in 2022/2023 where 23
essential anticancer medicines continued to be provided at no cost to the patients through a conditional
grant through KEMSA.

c) Geriatric Medicine

Since the launch of the Healthy Aging and Older Persons Strategy (2022-2026) in 2022, fifteen Health
care providers have been trained on Integrated Care for Older People (ICOPE) in Siaya County.

d) Violence and Injury Prevention and Control

There has been a 1.9% decrease in the number of road traffic fatalities between 2021/22 (4723) and
2022/23 (4634). Between 2021/22 and 2022/23, 270 healthcare workers were trained on trauma and
injury management. For the FY 2022/2023, 200 Community Health Promoters (CHP’s) and other

29
community members such as boda boda riders were trained on prevention of injuries and basic first
aid in Nairobi and Nakuru counties.

e) Mental Health

The Mental Health Division managed to train 1,591 healthcare workers against a target of 1000 during
the FY 2022/2023. An achievement of 159% due to integration of mental health and psychosocial
support training in Covid 19 response and Ebola Preparedness. A mental health training manual was
developed to train the Community Health Promoters (CHP’s) and 75 CHP’s were trained against a
targeted 700 due to inadequate funding. Plans are underway to integrate mental health into primary
healthcare and this will enhance scale up.

f)Mental Health Board

The Kenya Mental Health Board was appointed in August 2022 and by the end of the FY 2022/2023
and due to inadequate funding, they could not inspect mental health units and facilities and hence could
not report on the mental status of the country.

g) National Cancer Institute

NCI-Kenya has also been proactive in its efforts to promote universal health coverage (UHC) by
enhancing access to cancer education; through contextualized cancer awareness messages in ten
vernacular languages, procured spots on ten vernacular FM stations. NCI-Kenya successfully
disseminated cancer education materials targeted at persons with disabilities (PWDs) through the
National Council for Persons with Disabilities (NCPWD) platforms and to the members of the public
through the website and social media handles of the Institute number of people reached is 17,000,000
in FY2022/23.

The Institute initiated the institutionalization of cancer prevention and control initiatives in 22
Ministries, Departments, and Agencies (MDAs) with the involvement of senior management officials,
developed a sensitization package on cancer prevention and control workplace programs, and
successfully sensitized the 22 MDAs on the package. The institute also maintained a register of focal
persons, ensuring continuity, scale up and accountability in these initiatives.

The institute developed a county sensitization package on resource allocation, supporting specific
counties in developing cancer control frameworks. Digitization of the standard guidelines for
establishment of cancer management Centers and the cancer registry training materials to improve
quality of services. 8 cancer registries were established.

NCI-Kenya focused on policy development and regulatory frameworks. The institute developed
regulations to operationalize the Cancer Control Act awaiting public hearings in various counties. NCI-
Kenya made significant strides in the designation and certification of 78 cancer treatment centers to
contribute to improving cancer care accessibility and quality.

30
Sub-Programme1.3: Reproductive Maternal Newborn Child and Adolescent Health
(RMNCAH)

a) Maternal, Neonatal and Child Health Services

In FY 2022/23, the proportion of women who attended at least four ANC visits was reported at 51.9%,
against a target of 57%. Postnatal care within 2-3 days of delivery was at 37.9%, below the 50% goal,
with the specific causes for these shortfalls still under investigation. The recent Kenya Demographic
Health Survey (KDHS 2022) shows that under-five mortality rate has decreased from 52 to 41 deaths
per 1,000 live births, and infant mortality rate from 39 to 32 deaths per 1,000 live births. The neonatal
mortality reduced at a slower rate and currently stands at 21 from 22 deaths per 1,000 live births. The
SDG targets to reduce neonatal mortality rate to 12 per 1,000 live births and under-five mortality to 25
per 1,000 live births by 2030.

In FY 2021/22, a total of 2.2 million copies of Mother Child Health Handbook (MOH 216) were
printed and distributed to all counties. Priority needs to be given to have this book printed annually to
ensure continuous supply to counties.

A slight improvement noted for the facility neonatal deaths from a target of 11 deaths per 1,000 live
births to 10.1 deaths per 1,000 live births. This was due to scaling-up of high impact interventions,
supplies and equipment, capacity building of essential new-born care, development and rolling out of
quality of care standards, data reviews meetings, improved technical assistance to counties

Facility based neonatal death rate (per 1000 live births)

Source: KHIS, 2022

Furthermore, Vitamin A supplementation coverage surpassed the target at 83.3% in FY 2022/23

credited to concerted efforts during the Malezi Bora weeks and collaboration across Early Childhood
Development centers (ECDs). Moreover, a strategy initiated in 2023 focused on deworming
interventions in counties with higher Schistosomiasis prevalence, following a notable success of
treating 4.5 million children in the FY 2022/23.

31
b) Family Planning

Kenya has made incredible progress in improving its contraceptive prevalence rate (CPR) which has
led to a reduction in the Total Fertility Rate (TFR) from 3.9 in 2014 to 3.4 in 2022. The percentage of
women of reproductive age (WRA) receiving family planning (FP) commodities increased from 52.4%
in 2021/22 to 74% in 2022/23.

Sub-Programme 1.4: Immunization Management

In FY 2022/23, the estimated proportion of children under one fully vaccinated was 84.7% a decrease
as compared to FY 2021/22 of 88%. This discrepancy was due to spatial vaccine shortage affecting
coverage. The proportion of facilities with Cold chain equipment has been maintained at >90% with
specialized cold chain equipment in 3500 facilities. In FY 2021/22 to FY 2022/2023 the proportion of
health Facilities with functional cold chain equipment reduced from 90% to 85%. This was attributed
to the inability of the National and County governments to access and to purchase the spare parts to
maintain the Cold Chain equipment.

a) Community health services

The innovative electronic Community Health Information System (eCHIS) piloted in FY 2021/2022
in Isiolo and Kisumu has since been expanded to include six more counties: Kakamega, Siaya, Vihiga,
Migori, Nakuru, and Nyeri. In these regions, Community Health Promoters have been leveraging on
the eCHIS platform to deliver high-quality, integrated community health services directly to
households, marking a significant advancement in localized healthcare delivery.
As at June 2023, Counties were able to establish new Community Health Units linked to public health
facilities in an endeavor to enhance Universal Healthcare Coverage, with 113% coverage in FY
2022/23 as compared to 92% in the FY 2021/22.

Sub programme 1.5 Curative services

a) Orthopaedic Trauma

Development of Orthopaedic Trauma Registers (MOH 274) was started in FY 2021/2022 and
completed in FY 2022/23. The Register is a data quality management and collection tool that will assist
managerial decision-making, staff rationalization, and coming up with an indicator such as clubfoot
management in Kenya among others.

b) Clinical Services

Operationalization of the Health and Wellness Center through an expanded range of services was done
in the FY 2021/22 to 2022/23 to offer and cater for emergencies in line with the Health and Wellness
centre at the Ministry of Health, a TWG and draft zero guidelines was developed. Technical assistance
to counties was also done by holding the Annual meeting with county frontline health care workers

32
theme roles in Universal Health Care. This contributed towards the coordination of key health care
personnel that play a major role in primary healthcare in Kenya. All counties were well reached out in
the FY 2021/22 to 2022/23.

c) Radiology and diagnostic imaging

During the period under review (FY 2021/2022/2023), the Radiography bill was signed into law
December 2021 and the current state is to operationalize and implement. The rules and regulations for
radiographers Act was subjected to stakeholders’ engagement and now are in the process of
gazettment.

To improve radiology and diagnostic imaging services and radiation protection safety measures, 40
radiographers were sensitized and trained on radiation monitoring for quality assurance. During the
period under review, a draft ultrasound guideline was developed and awaiting a stakeholder
participation.

d) Rehabilitative Services

In the FY 2021/22, the Rehabilitative services supported the National Council for Persons with
disability in the process of registration of Persons with disability and the KRA in the process of vetting
PWDs who had applied for tax exemption. The Disability Medical Assessment, Categorization
Guidelines and the Rehabilitation and Assistive Technology Strategy 2021-2026 was also done and
the Disability Assessment Committee that was formed was sensitized. Further, Disability Medical
Assessment was decentralized to the counties to ease the process of assessment and registration of
PWDs.

In FY 2021/22, the National Assistive Technology Centre of Excellence was established at JKUAT.
In addition, 7 Disability Classification Tools were developed namely: Physical Disabilities; Visual
Impairment; Hearing, Speech, Language Communication, and Swallowing Disability; Mental Health
Disorders/ Intellectual Disabilities and Autism Spectrum Disorders; Progressive Chronic Disorders
and Oral and Dental Disabilities.

e) Oral Health

In the FY 2021/22 Oral Health Services launched the Oral Health Policy 2022 -2030 and Strategic
Plan 2022 -2026 whose aim is to improve oral health through the utilization of existing socioeconomic,
cultural, political, and health systems frameworks in the country. Currently, development of a National
Plan to phase down Amalgam is ongoing.

In order to upscale oral health promotive and preventive programs, The World Health Organization
(WHO) in conjunction with The Ministry of Health Oral Health Services established a digitalized
training system for training community health promoters in aspects of oral health.

33
Programme 2: National Referral and Specialized Services

Sub-Programme 2.1 National Referral Services

a) Kenyatta National Hospital

i. Specialized surgeries
During the period under review, the hospital performed specialized surgeries that include thirty-two
(32) major liver resections, increased kidney transplants from fifteen (15) FY 2021/22 to nineteen (19)
in the FY 2022/23. A total of 30,451, 33,523 and 37,307 specialized surgeries were conducted in FY
2020/21, 2021/22 and 2022/23 respectively. These specialized surgeries include maxillofacial,
obstetrics and gynaecology, paediatrics surgery, cardiothoracic surgery, neurosurgery, plastic surgery,
general surgery, ENT surgery, orthopaedic surgery, ophthalmology. In addition, a total of 16,106
specialized renal services were provided in the FY 2022/23 that included Continuous Renal
Replacement Therapy (CRRT), Tissue Typing, Venesection, Haemodialysis, Peritoneal dialysis,
dialysis Catheter procedures and Renal Biopsy. The hospital established heart surgery, cancer
treatment, diagnostics and imaging, laboratory medicine, tissue and organ transplantation,
gastroenterology, diabetes and endocrinology centres.

ii. Intrauterine transfusion

During the period under review, a team of four
specialist doctors conducted transfusion of
anaemic fetus (hemolytic disease) in mother’s
womb. In the procedure red blood cells from a
donor are injected into the fetus. The procedure
entails transfusing a baby while still in the
mother’s uterus. The hemolytic disease is a blood
disorder that occurs when the blood types of a
mother and baby are incompatible. This is a
situation in pregnancy when the maternal red
blood cells (RBCs) lacking the rhesus antigen are exposed to rhesus-positive red blood cells through
the placenta leading to the activation of the maternal immune system.

34
 iii. Multidisciplinary outreaches
In the FY 2020/21, the Hospital conducted 163
outreaches, 177 in 2021/22 and 391 in the FY
2022/23 to improve management of patients
before referral and conduct general public
awareness. A total of 123 county referring
facilities were visited and the health care workers
sensitized accordingly. In the period under
review, cumulatively a total of 42,209 clients
were reviewed and screened and 2,711 cases
referred for specialized treatment. On the patient care front, KNH established a diagnostic and
reporting centre in the FY 2020/21 which incorporates a medical teleconferencing facility and artificial
intelligence tele-radiology center which enables relay of radiological images from referring hospitals.
The images are then read, interpreted and reported on a timely basis for clinical decision-making.

iv. Uniportal Video Assisted Surgery

During the period under review, KNH continued to offer
specialized services including a uniportal Video Assisted
Surgery, video assisted thoracic surgery, laparoscopic surgery to
remove large polycystic kidneys in a patient who was being
prepared for kidney transplant which is highly delicate and
complicated process.

v. Play therapy
In the FY 2022/23, the Hospital introduced play therapy
sessions for pediatric patients in both inpatient and outpatient
settings. These sessions play a crucial role in fostering the
development of social interaction abilities among children,
providing them with a means to effectively convey their
emotions, and serving as a valuable coping mechanism.
Smiles for the chance engaging children in art therapy.

b) Mwai Kibaki Hospital

Mwai Kibaki Hospital formerly KNH Othaya was handed over to KNH management and was fully
operationalized in FY 2021/22. To date, patients seen increased from 133,216 in the FY 2021/22 to
285,901 in the FY 2022/23. New services introduced increased from 6 in the FY 2021/22 to 13 in the
FY 2022/23.
35
In addition, the Hospital expanded the following services; cardiology, oncology, vaccination, renal,
family planning, physiotherapy, farewell home, plastic & reconstructive surgery and laparoscopic
surgery. In furtherance of UHC aspirations, the hospital increased medical camps and outreaches from
4 in the FY 2021/22 to 6 in the FY 2022/23. Clients reviewed and screened increased from 4,850 in
the FY 2021/22 to 6,293 in the FY 2022/23.

The hospital further renovated the Critical Care Unit (CCU) and expanded its capacity from 6 in the
FY 2021/22 to 21 beds in the FY 2022/23. The Hospital renovated the New-Born Unit that culminated
to an increase bed capacity from 6 in the FY 2021/22 to 16 in the FY 2022/23.

Oxygen Plant
To meet the rising demand for CCU, Mwai Kibaki Hospital
constructed and operationalized an Oxygen plant with a capacity to
produce 1,500 litres of oxygen per minute, 2,160,000 in 24 hours,
and has 18 ports filling station with an ability to fill in 72 oxygen
cylinders in 24 hours. The Hospital also acquired a 3000-litres bulk
liquid oxygen tank in the FY 2021/22. The facility is supporting the
provision of oxygen to other health facilities within the region.

c) Mama Margaret Uhuru Hospital (MMUH)

During the period under review, KNH was handed over

the management of the former Mathare North Level IV
Hospital, to be an annex of the Hospital. Today, MMUH
is offering a wide range of services and specialized care
including Paediatric Outpatient Clinic (POPC), General
Paediatric Emergency and Outpatient Clinic (GOPC),
Dermatology, Ophthalmology, Comprehensive care
services, Ear, Nose & Throat (ENT), Rehabilitative
services; orthopaedic trauma, physiotherapy and
occupational therapy. A total of 7,894 inpatients and
36,641 out-patients have received treatment in the facility. Cumulatively 14 outreaches targeting
Mathare North and its environs have been undertaken across various sub specialties.

d) Moi Teaching and Referral Hospital

36
 i. Chandaria Cancer and Chronic Diseases
Centre (CCCDC) - This is a One-Stop-Shop
Point of Care for Cancer and other Chronic
Diseases. Two (2) Linear Accelerator
(LINAC) Equipment and Brachytherapy
Machines were installed and operationalized
to increase access to highly specialized
cancer services in the Country. During FY
nd
2022/2023, 19,622 Oncology Consultations ection of the 2 Bunker
were conducted against 16,395 in FY
2020/2021, representing 19.68%. 15,091 Radiotherapy Sessions were conducted in FY 2022/2023.
MTRH invested approximately Kshs. 1.393 billion towards infrastructure and equipment. A 2nd
bunker was constructed and completed in January 2023 and installed with a new True Beam
LINAC machine that was operationalized in February 2023.

ii. Laboratory & Pathology Services: MTRH prides itself in providing highly specialized Laboratory
investigations in Biochemistry, Haematology, Parasitology, Immunology, Microbiology, Histology
and Gene Expert. In FY 2022/2023, MTRH Laboratory performed 1,426,746 tests against
1,119,596 in FY 2020/2021; 27.43% Improvement over the last 3 years. The Laboratory was the
first to hit over 1 million in East & Central Africa. This was made possible through the construction
of a modern laboratory.

iii. Radiology/Diagnostic Services: Radiology Services

provided include Interventional Radiology through MTRH’s
massive investment in Specialized Equipment: CT Scans (32
Slice, 64 Slice and Advanced 128 Slice CT Scans), Magnetic
Resonance & Imaging Equipment (MRIs), Dental
OPG/CBCT/Lateral Cephalogram Machine, Digital X-rays,
Ultrasound Equipment and Mammogram. In FY 2022/2023,
100,288 radiology examinations were conducted against
82,528 in FY 2020/2021; 21.52% Improvement over the last
3 years. During 2022-23FY, a new diagnostic center to
accommodate two (2)1.5 Tesla MRI and two (2) cardiac
catheterization laboratory equipment was constructed and is
90% complete. One 1.5T MRI and one cathlab have already
been procured pending delivery and installation on completion of the building.

iv. Maternal Health: During FY 2022/2023, 13,309 deliveries are conducted and 12,379 in FY
2020/2021; representing 7% improvement. Other specialized Reproductive Health Care Services
provided include Maternal Fetal Medicine, Reproductive Endocrinology & Infertility,
Urogynaecology, Adolescent Gynaecology, Minimally Invasive Surgeries etc.

37
 v. The Renal Dialysis/ Transplant Centre: MTRH provides haemodialysis and haemofiltration to
both adults and paediatrics as well as performing Kidney Transplants as part of the management of
Chronic Disease since 2006. In FY 2022/2023, 18 Kidney Transplants were conducted against 8 in
FY 2020/2021. Further, 2,502 Haemodialysis for children were carried out against 2,083 in FY
2020/2021, 20.11% Improvement.

vi. Highly Specialized Surgical Services:

a) Corneal Transplants: MTRH is the only Public Hospital offering Corneal Transplants in
Kenya. Fifteen (15) Corneal Transplants conducted in FY 2022/2023 against 7 in FY
2020/2021; 118.28% Improvement over the last 3 years.

b) Cochlear Implantation: MTRH performed the first Cochlear Transplant Surgery in June
2023, being the first public Hospital to undertake specialized Surgery in East and Central
Africa.

c) Open Heart Surgeries: 92 Open Heart Surgeries were conducted in FY 2022/2023 against
8 in FY 2020/2021; 1,050% Improvement over the last 3 years.

d) Minimally Invasive Surgeries: During FY 2022/2023, 3,202 Minimally Invasive

Surgeries were conducted against 2,226 in FY 2020/2021; 43.84% Improvement over the
last 3 years.

e) Cardiothoracic Surgeries: During FY 2022/2023, 453 Cardiothoracic Surgeries were

conducted against 297 in FY 2020/2021; 52.52% Improvement over the last 3 years.

vii. Intensive Care Services: MTRH ICU capacity increased from 6 in 2018 to the current 63 beds for
better outcomes in the provision of critical and highly specialized healthcare services. 859
admissions were done in FY 2022/23 and 356 in FY 2020/2021; 41.29% Improvement over the last
3 years.
viii. Medical Oxygen Investments: MTRH invested in
2,000 Litres per Minute (LPM) Oxygen Generating
Plant to ensure consistent availability of oxygen to
patients at the Points of Care. This is the biggest
Hospital Based Oxygen Generating Plant in Eastern
and Central Africa. The average number of inpatients
at MTRH is 1,200 on any given day, for a 1,020-bed
capacity Hospital. Out of these inpatients, about 120-
150 or 10.0%-12.5% are on oxygen support as part of
the treatment mainly referred patients from the wide
region covered by MTRH and most are admitted to
Adult Medicine Wards, Intensive Care Unit (ICU),
Neonatal Intensive Care Unit (NICU), New Born Unit
(NBU), Shoe4Africa Children’s Hospital and
Theatres.
38
 ix. Data Centre, ICT network upgrade and high-definition CCTV: To support digitalization in
Financial Management, Human Resource Management, Asset Management, End-to-End
Procurement, Electronic Medical Records System (EMRS) and other operations, MTRH is fully
equipped with a state-of-the-art Data Centre with an advanced firewall for Big Data security,
intelligent switches, high-capacity backup infrastructure as well as a high availability setup of
servers.
x. Nawiri Recovery and Skills Centre: This is a transition home for mental health patients that
integrates healthcare provision and economic empowerment; a solution to the missing link between
the transition of mental health and community integration. It is one of its kind in a public hospital
in East and Central Africa. Mental illnesses are a significant cause of ill health, with an estimated
25% of outpatients and up to 40% of in-patient health facility visits having diagnosable mental
health conditions among them: Schizophrenia, Bipolar Disorder, Alcohol & Drug Abuse and
Depression. The facility was commissioned on 26th August 2021 by Cabinet Secretary, Health.
Thirteen (13) clients are admitted at any given point at Nawiri Recovery and Skills Centre. One
Hundred and Thirteen (113) patients admitted since inception and 98 discharges.
xi. Alcohol and Drug Abuse Rehabilitation Centre: MTRH recognizes the negative impact of
Alcohol and Drug Abuse in the workplace and Society. To address this, the Hospital established a
41-Bed Capacity Facility to provide rehabilitation services to staff and society to promote well-
being and a productive nation. Extension of the facility with additional 23 beds was done in 2023
at Kshs 9.5 Million. In FY 2022/2023, 95 admissions and 1,684 Outpatients were attended. In FY
2020/2021, 76 admissions and 1,239 Outpatients were attended; representing 25% and 35.91%
improvement in Admissions and Outpatients respectively.
xii. Healthcare, Training and Research: MTRH contributes to strengthening Human Resource for
Health (HRH) capacity in Kenya and beyond through its accredited College of Medicine (CoM) and
Collegiate Postgraduate Training in General Surgery, Orthopaedic Surgery, Paediatric Surgery and
Neurosurgery under College of Surgeons of East, Central and Southern Africa (COSECSA), Other
Programmes are East and Central Africa College of Physicians (ECSACOP) for Physicians, College
of Anaesthesiologists of East, Central and Southern Africa (CANECSA) for Anaesthesiologists and
College of Ophthalmology of Eastern Central and Southern Africa (COECSA) for
Ophthalmologists. During FY 2022/2023, 120 Research Projects were undertaken against 12 in FY
2020/2021; 100% improvement over the last 3 years. Similarly, 3,602 Internship/Attachment
Opportunities were provided in FY 2022/2023 against 2,822 in FY 2020/2021, representing 27.63
improvement.
xiii. Multidisciplinary Outreaches and Inreaches: MTRH continues to undertake specialized multi-
disciplinary outreaches to build Counties’ Human Resource Capacity and streamline patient referral
mechanisms. During FY 2022/2023, 93 multi-disciplinary Outreaches were undertaken against 57
in FY 2020/2021; 63.16% improvement over the last 3 years.
xiv. 150Kg/Hr Medical Waste Incinerator: The new 150Kg/Hr medical Waste incinerator was
procured in 2022/23FY to ensure proper and efficient management of medical waste. This was to
address demand for disposal of medical waste that the 250Kg AMB Microwave Plant and 74KG
World Bank Incinerator was destroyed by a fire accident. The project was tendered in June 2022
and evaluated and awarded in September 2022.

39
 The construction of the new Plant house to house the new machine commenced in October 2022
and it was completed and handed over on 20th February 2023 and operationalized after installation
of the new incinerator. The challenge of disposal of medical waste initially occasioned by the
breakdown of the Microwave medical waste treatment plant World Bank 75Kg/hr waste incinerator
was addressed and currently all daily waste generated are incinerated without any backlog.
xv. Core Beam Computer Tomography (CBCT) Machine: This new machine, an advanced system
of OPG machine was procured to modernize the provision of dental services. A vital machine is
able to rotate round the patient giving the dental professionals a 3D view of the dental structure. It
has enable advanced restructuring of oral and maxillofacial surgeries and other oral treatment
planning. The machine was procured in 2022/23FY.
xvi. Endoscopic Tower: The Hospital successfully procured and operationalized a new endoscopic
tower to provide advanced non-invasive endoscopic examination and treatment procedure.

e) Kenyatta University Teaching Referral and Research Hospital (KUTRRH)

i. Integrated Molecular Imaging Services

The Integrated Molecular Imaging Center (IMIC) and

IMIC Hospitality Centre at KUTRRH were Officially
Commissioned on 16th October, 2021. The centre is the
first of its kind in a public hospital in the Eastern African
Region with a Cyclotron that is capable of producing
FDGs to supply the country and the region. The centre is
also equipped with 2 PET/CTs and SPECT/CT, 3T MRI
and 256 Slice CT. Previously, PET/CT services were not
available in any public hospital and hence were
unaffordable for most Kenyans.

The center started operations on 10th January 2022 and since then, the facility has been able to perform
1,169 successful FDG PET/CT scans in the year 2021/22 and 3685 in the year 2022/23 and 592 PSMAs
in the year 2022/23.

40
 ii. Cyberknife for Advanced Stereotactic Radiosurgeries

On 24th April 2023, KUTRRH hosted His

Excellency President William Ruto who visited the
Hospital to commission the CyberKnife machine.
The CyberKnife is the latest generation of non-
invasive precision treatment that treats cancerous
and noncancerous tumors in areas of the body
previously thought to be untreatable. The
Cyberknife S7 delivers painless treatment by use
of high doses of precise targeted robotic radiation
therapy and is an alternative to surgery. It is the
second of its kind in Sub-Saharan Africa. Cancer
patients can now breathe a sigh of relief after installation of the Cyberknife as the treatment requires
three to five sessions with minimal risk of complications or damage to healthy tissues. The operations
will start in the FY 2023/24.

iii. Brachytherapy, radiotherapy and Chemotherapy

KUTRRH has established a center of excellence in cancer care and has managed to install a
Brachytherapy machine for treatment of cancer patients in addition to the LINAC Machine.
Brachytherapy, also known as internal radiation, is a form of radiotherapy treatment where the source
of radiation is placed on or inside the diseased area. A total of 395 Brachytherapy sessions were carried
out in the year 2021/22 and 851 in the year 2022/23. The number of patients seeking services has
increased as a result of increased demand and improved efficiency in service delivery. A total of 55,296
Sessions of Radiotherapy and Chemotherapy were carried out in the year 2021/22 which increased to
62,134 in the year 2022/23.

The hospital is in the process of expanding the cancer center to ease congestion as well as offer services
to more patients. Construction of the cancer center expansion is at 85% completion.

iv. Critical Care Services

KUTRRH Operationalized the 15 bed Neonatal Intensive Care Unit during the year 2021/22. This is
in addition to the ICU & HDU beds operationalized in the previous years thus increasing the beds from
72 to 87. The number of admissions have increased from 917 in FY 2020/21 to 1525 in FY 2022/23
with a total admission of 3763. This has made KUTRRH one of the largest critical care units in the
country.

v. Increased Capacity for Medical Gases

KUTRRH and MOH officially commissioned a 20,000-litre liquid oxygen tank that was donated
through the Ministry of Health by the World Bank. Currently, KUTRRH has four (4) oxygen plants

41
 which produce 2400 litres per minute cumulatively. With this increased capacity, KUTRRH has
enough oxygen and other medical gases and is supporting five other hospitals.

vi. Operationalizing Heart Surgeries

Kenyatta University Teaching Research and Referral Hospital (KUTTRH) undertook the first case of
Open-Heart Surgery on 26th April 2022 with the first surgeries conducted on two patients. The hospital
conducted 13 open heart surgeries during the year 2021/22 and 35 in the year 2022/23. The hospital
also invested in a state-of-the-art cardiovascular diagnosis and treatment facility. The heart unit has an
automated Catheterization Laboratory, commonly known as a Cath lab. The Cath lab is equipped with
state-of-the-art imaging technology used to view the arteries and check how well blood is flowing to
and from the heart. The number of procedures performed in the period under review is as follows:

Figure: Heart Surgeries and Cath Lab Procedures

vii. Other Specialized Surgeries

KUTRRH performed the first total laryngectomy, which is an operation to remove the entire voice box
for advanced cancers of the voice box. The second such operation was done in April 2023 on a 70-
year-old male patient with stage three cancer. Both patients presented with hoarseness of the voice and
had a history of smoking. They had visited different hospitals where their condition was managed as
an inflammation of the throat, so they did not improve. The number of specialized surgeries carried
out were 736, 1,615 and 4,379 in FY 2020/21, 2021/22 and FY 2022/23 respectively

viii. KUTRRH Comprehensive Breast Care Centre

During the period under review, the hospital operationalized a Comprehensive Breast Care Centre in
October 2022. This is a one stop shop for screening, diagnostics, and treatment for breast care
conditions, including breast cancer. A total of 1756 people accessed the service in the year 2022/23.

42
ix. Research & Clinical Trials

KUTRRH’s Research and Clinical Trials Department works towards building research capacity by
coordinating the Hospital’s research studies. 46 research proposals were received for evaluation and
18 were approved with most being at various regulatory approvals (IRBs, PPB & NACOSTI) and
funds sourcing. Of the approved studies, six have commenced implementation. These studies are in
areas of Cancer, Covid-19 and Renal. During the period under review, the Hospital was awarded a
grant of Ksh. 290 million from University of Manchester to carry out Esophageal Cancer research to
be implemented in the next 3 years.

x. Medical Outreach

KUTRRH conducted 10 medical outreaches during the year 2021/22 and 14 in the FY 2022/23. These
included a free ear surgical medical camp in collaboration with Operation Ear Drop, free Cleft palate
surgical camp in collaboration with Love without Reason, free renal checkup during the World Kidney
Day and a free medical checkup for residents of Kirigiti in Kiambu County and Kahawa West among
others. The total number of people screened in the FY 2021/22 was 4576 and 7657 in FY 2022/23.

xi. Medical Education and Training

a) Specialized Nursing Training

The Training Institute of Specialized Nursing (TISN) in KUTRRH held its first graduation on 2nd
June 2023 at the Hospital’s auditorium for the class that completed in 2022 with a total of 37 students
graduating. The college offers Specialized Nursing Programs namely: Higher Diploma in Critical
Care nursing, Higher Diploma in Oncology Nursing, Higher Diploma in Nephrology and Higher
Diploma in Peri-operative Nursing.

b) Clinical Fellowships

During the period under review, KUTRRH was accredited by the College of Surgeons for East,
Southern and Central Africa, as a training centre for Surgeon Fellows. Additionally, the East, Central
and Sothern Africa College of Physicians and the College of Anaesthesiologists for East, Central
&Southern Africa accredited KUTRRH as a training centre.

Number of students in the various medical training programs

Program 2020/2021 2021/2022 2022/2023

Students Placement for Clinical Rotations 84 301 732

Training Institute of Specialised Nursing 0 39 66

Collegiate/Fellowship Training

COSECSA/CANECSA/ECSACOP 0 2 6

43
f) Mathari National Teaching and Referral Hospital (MNTRH)

During the period under review, the hospital established a research unit which is now registered by
NACOSTI, and trained 20 staff on institutional scientific and ethical review. Subsequently, the hospital
has embarked on various research projects in collaboration with various partners, the most significant
one being a study on Cost Benefit Analysis on the use of Long Acting Antipsychotic Injectable for
treatment of Schizophrenia.

The hospital also acquired specialized diagnostic and therapeutic equipment that include a digital Xray,
CT Scan, Electroconvulsive Therapy (ECT) machine, EEG, a mammogram machine, fully automated
chemistry analyzer, fully automated hematology Olympus, CX23 MICROSCOPE, water bath
machine, hot-air oven, electrolyte machine, hand tally counter and a total of 186,886 tests were
conducted in the period under review.

The number of patients served during the period increased by 120% compared to the previous year
from 296,652 in 2020/22 to 355,515 in 2022/23. The average length of stay (ALOS) reduced by 37.5%
from 48 days in 2021/22 to 30 days in 2022/23. This is attributed to availability of second line drug
for treatment of various disorders and an increase in the number of patients reintegrated back to their
families through the hospital repatriation program from 280 in 2021/22 to 312 in 2022/23.

During the period under review, the hospital expanded the inpatient drug rehabilitation services
capacity by 208% from 48 beds in FY 2021/22 to 100 beds in FY 2022/23. Additionally, the hospital
rehabilitated a 30-bed capacity child and adolescent ward, the only one available in the country for
inpatient care of mentally ill children and adolescents.

The hospital was able to improve the comfort of its customers by constructing toilets and bathrooms
in the outpatient block.

g) Spinal Injury Hospital

The National Spinal Injury Referral Hospital was founded in 1944 as a specialized facility to support
patients with spinal cord injuries. It has both an inpatient and outpatient service portfolio supporting
immediate spine treatment, rehabilitation and reintegration services to its clients.

In the last financial year, the hospital was funded to support renovations for inpatients, built a new
outpatient block and increased its storage capacity to accommodate its regular supplies by procuring
and installing 5 storage containers. More so, the hospital strengthened the hospital health information
management system to monitor and improve patient and service provision. This has remarkably
improved our turnaround time and improved accountability in all service points.

The establishment and strengthening of the quality assurance unit has enabled the facility to closely
monitor quality Hospital Processes. This included creation and strengthening of infection prevention

44
control measures. The hospital also reinforced its emergency responses preparations by acquiring more
fire extinguishers and easy access to all parts of the hospital through decluttering.

Though the facility has a small bed capacity, sufficient measures have been initiated to allow both long
and short stay patients. A clear admissions committee with an established standard procedure has been
instituted and a clear waiting list for patients reassessed. The patients receiving Physiotherapy services
increased to 4377 in FY 2022/2023 from 3441 in FY 2021/2022 and 2810 in FY 2020/2021.

h) Forensic and Pathology Services

In the financial years 2021/22 - 2022/23, the State Department managed to perform 780 autopsies, 235
court expert opinions have been done, and interpreted 10% of the pathology results for clinical
decisions against a target of 40%. The variation is because linkage with clinical teams in the counties
is weak in that some counties do not have pathologists such as Elgeyo market, Kilifi, Garissa, and
Narok among others. In line with supporting administration of justice because of court orders, 25
exhumations were performed.

In the financial year 2022/23, the State Department managed to perform 1705 autopsies, 249 court
expert opinions, 20 exhumations and interpreted 60% of the pathology results, an improvement from
10%. 20 Exhumations were performed. At the National Cancer Reference Laboratory, a cancer
diagnosis was made for 156 patients using histology slides and 200,000 using cytology slides. in
addition, a total of 428 exhumations were carried in Shakahola Kilifi county.

Sub-Programme 2.2 Health Infrastructure and Equipment

i. Managed Equipment Services

Managed Equipment Services (MES) is a seven-year term project and had provision for three (3) years
extension. It involved five (5) contracts for equipment supply, installation & and commissioning,
maintenance, replacement, and disposal, including training and reporting throughout the contract
period in level 4 and level 5 County hospitals and National Hospitals. The contracts were signed in the
year 2015 on various dates except for Philips, which was signed in April 2016. The thematic areas
covered by the MES contracts are the theatres, CSSD units, Dialysis units, ICU/HDU, and radiology
services.
The objective was to improve quality of
healthcare through increased access and
availability of specialized health services. The
project estimated cost was USD 663 Million.
MES equipment results realized that there was
demonstrable benefit of MES equipment in the
supported hospitals and that the availability of
appropriate medical equipment in 121 hospitals A premium ultrasound in
across all the 47 counties has enhanced equity Coast general hospital
of health care especially in availability of
surgical operation, dialysis therapy, critical care , screening of cancers, and radiological diagnoses.

45
With the lesson learnt during the implementation of MES, the Ministry is rolling out National
Equipment Service Program (NESP) that will equip all health facilities from level 2s to Level 5s to
ensure quality and accessible health care services.

In the period under review 2022/2023, the major activity was contract management, including
monitoring equipment functionality In the same period, the equipment supported services and
Utilization as displayed in the table below:

Utilization of MES equipment as of 2020/2021-2022/2023

Key Actual Actual Actual
Infrastructure Performance Achievement Achievement Achievement
Indicators 2020/21 2021/22 2022/23
Number of 162,272 188,030
175,451
surgeries
Managed Number of 264,819 229,354
143,672
Equipment dialysis sessions
Services Number of 3,592 5,508
equipment patients utilizing 2,694
utilized ICU
Number of 1,996,308 1,963,430
1,196,578
radiological tests

Source: MOH

Achievements and Successes of MES Project

The achievements of MES include access to;

1. More reliable and uninterrupted critical service delivery by the medical equipment, which is
maintained to a high standard. This translates to reduced downtime of equipment. All
equipment has to meet the minimum contractual uptime guarantee of more than 95%; hence,
service is not interrupted.
2. Enhanced efficiency in the health system due to reduced time spent in the referral process and
distances travelled while seeking health services,
3. Reduced patients' wait times for the provided services. There used to be a long queue of patients
waiting to access services such as dialysis at KNH, however, with the availability of equipment
in the county, the time taken to access services is greatly improved.
4. Specialized training for health workers was also sustained to optimize the utilization of the
equipment. The contractually guaranteed equipment uptime was consistently achieved at
between 90% - 98%.

i). MRI AND CT-SCAN

46
The Ministry procured the 20 MRI and 37 CT-
Scans in various counties. The equipment has
revolutionized the health care in these facilities.

CT-Scan installed in Mandera

county referral hospital

ii) Kisii level 5 cancer center

Kisii Level 5 Hospital Cancer Centre was conceptualized by the Kisii County Government in 2014.
The project proposal was forwarded to the National Treasury through the Ministry of Health for
funding consideration. The National Treasury secured funding from Arab Bank for Economic
Development in Africa (BADEA) and the Saudi Fund.

Consultancy contract signed in November 2019. The tender was advertised and closed in December
2021. Tender evaluation and award was done in February 2021. The progress was occasioned by delay
in signing of the loan agreement by Saudi Fund for Development (SFFD) in April 2017 whereas
BADEA had signed on June 2015. Unprecedented long period for preparation of project designs,
tender documents preparation and equipment specifications; COVID-19 restrictions that delayed
project tender document preparations and cancellation of 1st tender advertisement done which was
declined. Re advertisement for the contract was done.

iii).East African Centre of excellence for skills & Tertiary Education

The East Africa Centre of Excellence for Skills and Tertiary Education (EACE) was conceived for the
East African Community and financed by the African Development Bank. The East Africa Kidney
Institute (EAKI) is a proposed centre of excellence in renal care, training, and research to be set up in
Kenya as part of the East African Community's objective of developing of relevant and highly skilled
workforce in biomedical sciences to meet the EAC immediate labour market needs and support EAC's
free labour market protocols. It is envisioned that EAKI will attract medical tourism from the region
and beyond. EAKI is part of the EAC COEs focusing on Nephrology and Urology.

EAKI project has 3 components in Urology and Nephrology, and the component deliverables under
this include:
 Establish a regional centre of excellence in urology and nephrology in Kenya:
Construction of the Institute, equipping the Institute, training personnel, research. (UA
24.28million).
 Support EAC regional integration agenda in higher education to respond to labour
market needs (UA 1.32million).
 Project Management and coordination (UA 1.93million).

47
The building construction progress moved from 63% FY 2021/2022 to 84% completion as of 30th June
2023 and the project’s component of
equipping the complex is ongoing. Now
awaiting the delivery of some of Batch II
equipment.

On the training component, the project has

trained health workers in various cadres:
Preceptorship (177), Diploma (65), Masters in
renal nursing (5), Fellowship in Nephrology
(8) and Ph.D. (3). In addition, the project
supported Annual Scientific conferences in
regard to urology and nephrology
professionals (Kenya Association of Urology
Surgeons and Africa Nephrology Nurses
Association) where research papers were presented.

iv).Health Sector Equalization Fund Projects

Following the Court ruling, the National Treasury developed new Equalization Fund Regulations
which were gazetted in April 2021 and subsequently approved by Parliament. The regulations provided
for establishment of a new board to oversee implementation of projects. The Board has since been
constituted and inaugurated and on 27th June 2022, the National Treasury formally wrote to the
Ministry of Health advising that implementation of the stalled projects should commence. Completion
of the stalled projects will commence once the fund board advise.

The total budget appropriated for the 84

projects was KES 1, 964,219,396 while the
total of contract sums was KES
1,892,777,228. The total amount paid to the
contractors by 30/06/2023 was KES
1,469,458,900.4 leaving a sum of KES
423,318,327.60 being the total part of
contract sums not disbursed.

The Ministry through collaboration with

Ministry of defence has able to construct
the following health facilities:

v). Sports Funded Projects in Healtth

The Ministry through collaboration with Ministry of defence has able to construct the following
health facilities:

48
 a) Githunguri Sub County hospital

The project was to upgrade the facility from

a level 3 to a modern level 4 health facility.
It’s a 360 bed capacity hospital. The project
includes 6 storey building that will house
outpatient department, wards, theatres,
radiology and maternity. The construction is
complete and awaiting equipping.

b) Tumu tumu Mission hospital

The ministry has supported Tumu tumu
mission hospital with construction of a
modern outpatient, Accident &emergency
and pharmacy block. The project is at 95%
completion.

c) Upgrade of Engineer health centre

The project aimed at upgrading Engineer

health centre to a modern level 4 hospital.
The construction is complete and fully
equipped with modern medical equipment.

d) Busia County Referral Hospital

The project includes construction of

inpatient block that has 4 wards. The
construction was completed as at 30th June
2023 and was commissioned by the President
on 26th August 2023.

49
 e) Sura Adoru level 2 health facility

The project include construction of Sura

Adoru level 2 health facility in Samburu
county. The area had no health facility. The
construction is complete and awaiting
commissioning

f) Keroka level 4 hospital

The project targeted improving the

infrastructure in the facility. Construction
of Accident & Emergency block,
Maternity, Mortuary has already been
done.

Sub-Programme 2.3: National Blood Transfusion Services (KNBTS)

i. Kenya National Blood Transfusion Services

Kenya National Blood Transfusion Services currently operates six (6) regional and 43 satellite centres.
During the period under review (FY 2019/20), 3 satellites were set up in Homabay, Makueni, and
Kwale while one satellite was set up in Kajiado in FY 2020/21. In FY 2021/22, 14 County Satellite
Blood Transfusion Centres were set up in the country, making a 46% increase from 29 in FY 2020/21
to 43 currently. The satellites were established in; Baringo, Elgeyo Marakwet, Samburu, Isiolo,
Laikipia, Nyandarua, Marsabit, Tharaka Nithi, Nyamira, Mandera, Tana River, Muranga, Kirinyaga
and Mama Lucy counties.

ii. Blood collection and trends

In FY2020/21, 178,249 units were collected against the minimum WHO 1% blood donors target from
500,000 non-remunerated voluntary blood donors, translating to 37.7% of the country’s minimum
blood needs target met as per the 2019 Kenya Population and Housing Census. Blood components
conversion rate target was set at 80% in the financial FY 2021/22 up from 60% in the previous year.
In the FY 2021/22, an increase of 53% was realized with 273,349 blood units collected and processed.
In FY 2020/21 the proportion of the blood collected and converted to components increased to 75% as
compared to 60% in FY 2019/20. Out of the 273,349 units collected in FY2021/22, 57% were

50
 converted into various components. Cumulatively, 348,566 blood and blood components were made
available, translating to 69% of the country’s annual minimum blood needs. In FY 2022/23, a total of
412,868 blood units were collected in the country with a components preparation rate of 67%.

Source: KNBTS Annual Reports

iii. Blood and blood components donation, preparation, and Storage Capacity

Storage and freezing capacity was expanded by 80% from

approximately 35,000-unit storage capacity in FY 2020/21 to 70,000-
unit capacity across 43 Satellite Blood Transfusion Centres and six (6)
RBTCs in FY2022/23. In FY2020/21, the Ministry also acquired
specialized blood component preparation equipment which was placed
in satellites across 8 counties including 1 blood grouping machine. This
investment increased national Blood Safety testing capacity from 1,500
to 2,500 daily tests (or 650,000 annual tests capacity over 260 working
days); Blood grouping capacity increased from 1,500 to 2,600 daily tests
in FY2021/22. A 90% drop in turn-around time from blood donation to
results confirmation relaying was experienced across transfusing
hospitals in Kenya thus ensuring timely access to safe blood and
products. 8 blood bank refrigerators and 8 blood freezers; 8 refrigerated
centrifuges, 4 platelet apheresis machines, and 8 platelet agitators were
acquired in FY 2020/21.

During the FY2021/22, 6 hematology analyzers; 5 refrigerated centrifuges for blood products
preparation; 10 sample centrifuges, 10 platelet agitators; 18 automated plasma extractors, and 12
vehicles were acquired and distributed to different counties across the country. In the FY 2022/23, five
(5) more apheresis machines were acquired bringing the total to 9 machines.

iv. Quality Management and Hemovigilance Systems

51
 The KNBTTS initiated a strengthened Quality Assurance and Hemovigilance system for blood safety
and efficacy and Transplant of Human Derived medical products. Two regional testing laboratories
were accredited under ISO 15189 making a total of five (5) in FY 2021/22. The number of registered
transfusing facilities in the KNBTS database stood at 498 in FY2021/22 up from 450 in FY 20220/21.
In the FY 2022/23 the number of transfusing facilities submitting Hemovigillance and in the KNBTS
database increased to 600.

v. Blood Transfusion Policies and Guidelines.

In FY 2021/22, one policy was developed, and six regulations and standards were approved and
launched to be applied across the country. These included the Policy on donation and transplant of
Human human-derived medicinal products, appropriate use of blood and blood products, standards for
setting up blood establishment, Intergovernmental framework, Cold Chain manual and National
standards for blood transfusion services.

vi. Leveraging ICT to increase efficiency and accountability.

A track and trace system (Damu-KE) for blood and blood components was
developed in collaboration with the Ministry of Health and ICT and securely hosts
all Kenyan blood biodata in line with the Kenya Data Protection Act, 2019. The
system manages blood as a national resource thereby increasing equitable access
to all Kenyans. In FY 2021/22, the system was launched and deployed in 6
Regional Blood Transfusion Centers, two satellite centres, and three transfusing
facilities. The system has a client-facing module where Kenyans can self-register
as blood donors. The system also has a communication module to ensure
interaction with blood donors and increase notification. At the end of FY 2021/22,
the system had already registered a total of 25,240 blood donors. Training of 27 County ICT officers
and 30 Blood Establishment staff has been conducted. Last mile trainings are scheduled to enable
deployment in remaining County 20 County Blood Transfusion satellites

The KNBTS Organized the first Blood Transfusion and Transplant Conference for Africa attended by
over 700 people from Kenya and the region. In FY 2022/23, the KNBTS has scaled up the rollout of
the Damu-KE Blood Banking Management System to 33 Blood Establishments up from 6
establishments achieved in the FY 2021/22. The total number of Blood Establishments for the country
is 49.

In FY 2022/23 end-user equipment was provided to all the 49 Blood Establishments (6 Regional Blood
Transfusion Centers and 43 County Blood Transfusion Centers), and broadband internet installed in
40 out of the 49 blood establishments.

Sub-Programme 2.4: Health Products and Technologies

i. Kenya Medical Supplies Authority (KEMSA)

52
KEMSA takes pride in its pivotal role and significant milestone in Last Mile Delivery of (HPTs), which
positively impacts the lives of every Kenyan. In FY 2022/23, KEMSA served over 9,129 health
facilities, representing 99% of last mile deliveries dispatched to all 290 constituencies and all 47
counties across the Country.

In the FY 2022/23, KEMSA successfully acquired health products and technologies (HPTs) valued at
Kshs. 29.37 billion. Consequently, the organization efficiently delivered essential health products and
technologies worth Kshs. 27.153 billion to 9,129 healthcare facilities spanning all 47 counties in the
country.

Challenges in Stock Availability: It is worth noting that stock availability for essential health products
and technologies was lower than in previous years due to difficulties in maintaining an adequate cash
flow for supplier payments.

Procurement and Distribution Trends: Nevertheless, KEMSA has consistently managed the
procurement and distribution of HPTs over the last three years, as demonstrated in the following table:

Financial Procurement HPTs Value in Last Mile HPTs Distribution Value

Year Kshs. in Kshs.
2020-21 38,946,261,160.53 29,581,890,329.29
2021-22 27,073,132,792.39 28,757,887,972.43
2022-23 29,373,321,550.78 27,153,799,994.00

Order Processing and Fulfillment: KEMSA has implemented and improved the County health
facilities' use of KEMSA-LMIS 3, an online, self-service, computerized Medical Commodities
ordering system. This platform enables counties to place, track, and assess their orders, streamlining
the ordering process and enhancing data quality for informed decision-making. It has also significantly
improved Medical Commodities management at the County level.

Order Fill Rates Over the last three years:

FY 2020- FY 2021- FY 2022-
2021 22 2023
Order fill rate for KEMSA Capital -Essential 54% 50% 51%
HPTs
Target for KEMSA EMMS 90% 90% 90%
Order fill rate for Programmes EMMS (HIV, TB, 94% 85% 80%
FP, Malaria)
Target for Programmes EMMS (HIV, TB, FP, 98% 98% 98%
Malaria)

Several factors contributed to this sub-optimal outcome which include;

● Financial Constraints of essential products-This hampered the ability to procure health products
53
 and vital technologies required to meet the needs of the various counties it serves.
● Supplier delays in deliveries-Poor turnaround time of suppliers in delivering HPTs to KEMSA
added to the complications. These delays hindered the ability to promptly fulfill its
commitments to its customers.
● Uncertainty due to organizational reforms-The ongoing organizational reforms introduced an
element of uncertainty. This uncertainty had a noticeable impact on the morale of the staff,
resulting in reduced productivity and engagement
The order turnaround for Hospitals in the FY 2020/21, 2021/22 and FY 2022/23 stood at 12.6
day,14.7days, and 14.4days respectively against a target of 7 days, while that of Primary Health
Facilities (PHFs) stood at 18.1 days, 19.8 days and 16.9 days respectively against a target of 10 days
during the periods. In FY 2020/21, there was slight improvement in performance of hospital and PHFs
orders compared to previous years that was attributed to business process re-engineering efforts that
were supported by the KAIZEN institute.
Several factors contributed to the below target outcome which include;
● Disjointed Warehouses Impacting Efficiency- The presence of disconnected warehouses
throughout Nairobi had a detrimental effect on route integration and resulted in prolonged order
processing times. Consequently, this issue led to extended order turnaround times.
● Insecurity in Remote Areas- Insecurity in hard-to-reach regions further exacerbated the
challenges. This posed difficulties in serving certain areas efficiently, affecting both operations
and customer satisfaction

Warehousing Construction of the National Commodities Storage Centre (KEMSA Supply Chain
center)
KEMSA embarked on the construction of a
National Commodity storage center which is
aimed at improving access to essential medicines,
by ensuring regular, shorter supply chains and
continuous availability of medicines in the public
health facilities, improving responsiveness
during diseases outbreaks and disasters or
emergencies due increased space and reducing
shortages e.g. COVID-19 pandemic. The completion rate as at the end of FY 2022/23 is 88%.
At the end of FY 2022/23 the authority has developed a turnaround strategy which is geared towards
business process re-engineering. This is to reduce the efficiencies in the organization and improve
UHC outcomes. Expected results include reduced turnaround time and increased Order fill rate.

ii. Directorate of Health Products and Technology (DHPT)

HPT Policies to provide requisite oversight for the sector.

54
During the period 2020/21 to 2022/23, the directorate prioritized policy guidelines including the review
of the National Pharmaceutical Policy 2012 following its expiry period. By June 2023, the situation
analysis report with recommendations were completed and development of the HPT policy is
prioritized in 2023/2024 FY.

All essential HPT lists were reviewed to increase the scope and depth of coverage by increasing the
number of products available as well as decentralizing the level of care they can be accessed to support
UHC delivery. These include.

a) Review of the Kenya Essential Medicines Supplies Lists (KEMSL) that also incorporated the
Assistive Technologies
b) Review of the Kenya Essential Diagnostics List (KEDL)
c) Development of the Specifications for the KEDL
d) Review of the Kenya Essential Medicines List (KEML)
e) Development of the first Kenya National Medicines Formulary (KNMF) 2022 edition and
update of the KNMF aligned to KEML 2023

The National Medicines and Therapeutics Committee was operationalized to enhance rational use of
Medicines in the Country. Subsequently, 47 counties also formed and operationalized their County
MTCs.
Several guidelines were developed in support of the health supply chain
http://guidelines.health.go.ke/#/category/28 and converted to online content under MOH virtual
academy https://elearning.health.go.ke/. Some include the HPT Management Guidelines, Guidelines
for establishment of Medicines and Therapeutic Committees, the HPT Quantification Handbook, and
the Commodity Management Supportive Supervision Checklist.

A digital donations portal under development is 70% complete and a draft donations policy was
developed to enhance efficiency and transparency in donations management. For example, by the end
of FY 2022/23, a total of 260 donation import permits and 55 customs clearance endorsement letters
applied for under the USAID HPT funded projects were facilitated manually by DHPT. With
completion of the portal, these and all other donations will be facilitated online.

A Traditional and Alternative Health Practitioners Bill and a TAM Policy was also developed, and
stakeholder engagement completed. Cumulatively, seventy-seven (77) TAM practitioners were
registered and or licenses renewed in the review period. Additionally, MOH trained at least twenty
(20) herbalists on Intellectual Property (IP) Rights and in December 2023, a further thirty (30) were
trained on Good Manufacturing Practices (GMP)

HPTs Governance at the national and county levels

Following the creation of the Division of Health Products and Technologies (HPT) in April 2019, an
inaugural Health Products and Technologies Supply Chain Strategy 2020-2025 was developed.

In line with the strategy, DHPT supported County Governments to establish equivalent
multidisciplinary Health Products and Technologies (HPT) Units to strengthen efficient management
55
of HPT. By May 2022, all 47 Counties had established the Units and (5) counties have anchored their
HPT Units in their County Health Act/legislations namely Vihiga, Machakos, Makueni, Kilifi, and
Taita Taveta. A guidance for the establishment of HPT Units was also developed.

Increased availability of health products & Technology

Quantification of HPT was done for each of the 47 county governments, all 6 national referral facilities,
and the strategic programs forming the first scientific establishment of national HPT needs, and a
critical resource mobilization tool for HPT in Kenya. The national HPT need for the FY 2022/23 was
established as KSh 98,088,330,559.00.

The capacity to deliver oxygen in health facilities was enhanced with health facilities capacitated
through various strategies where by June 2023, the progress was as follows:
Piping of oxygen in health facilities - A total of 324 facilities were targeted for piping. Tenders were
awarded for all the 14 lots, vendors introduced to counties through the Council of Governors in 2023.
Vendors have completed piping of facilities in two counties (Vihiga and Bungoma) while work is
ongoing in all other counties.

Installation of PSAs in health facilities – Twenty-seven (27) Pressure Swing Adsorption (PSA)
technology oxygen plants were to be installed in the counties. By end June 2023, training was done,
and five PSAs installed. Twenty-two 22 PSAs had procurement tenders awarded, vendors introduced
to counties through COG and installation work is ongoing.

Handover of Liquid Oxygen Tank to Deputy Governor,

West Pokot County

Installation of liquid oxygen tanks in health facilities-

Thirty-two (32) health facilities were targeted to receive
liquid oxygen tanks, and ten (10) of them have already
been installed. Others are awaiting delivery and
installation.

Ensuring availability of oxygen cylinders in health facilities A total of twenty thousand six hundred
(20,620) cylinders were procured and delivered to the 47 counties with a county receiving a minimum
of 300 cylinders each.

Inspection of cylinders before dispatch to counties

To improve HPT consumption reporting and data

visibility, the first essential HPT reporting tool was
developed where the overall reporting rate grew from 0%
in March 2021 to 91.2% as of end June 2023 with a timely
reporting rate of 83%. MOH further supported the revision and printing of the 7,000 copies of the
MOH 647 tool in December 2022 to uphold reporting. The revision saw the number of Tracer HPT
reported monthly increased from 61 to 85 in consultation with counties. Digitization of the health
56
supply chain will go a long way in replacing the manual reporting systems and helping to capture
thousands of HPT used in the health facilities.

The Directorate actively supported successful roll of COVID-19 vaccines supply chain following the
establishment of the COVID-19 vaccines procurement and logistics committee in March 2021 a micro
planning tool was developed to support COVID-19 deployment that facilitated planning by the
healthcare facilities in the 47 counties.

Regulatory capacity enhancement in support of local production initiatives

The collaboration across sectors in the implementation of the Big 4 Agenda saw the Ministry of Trade
and the Ministry of Health develop a preferential Master Roll 1 of 2022 for use by all MOH SAGAS
and MDAs in local procurement of HPT.

Taxation reports were developed and submitted under the Medicines Affordability and Pricing
Advisory Committee to inform HPT tax incentives in the Finance Bill towards HPT affordability and
enhancement of local manufacturing of HPT. This led to exemption of taxes for various HPT and
manufacturing equipment under the Finance Act 2022 in support of local manufacturing for HPT and
vaccines. The regulator, Pharmacy and Poisons Board embarked on Level 3 maturity level capacity
building and assessment under the WHO Global Benchmarking Tool (GBT).

Programme 3: Health Research and Innovations

Sub-Programme 3.1 Health Innovations

Kenya Biovax Institute

The Institute achieved the following in the review period:

i. Corporate Governance structure developed and being operationalized.

ii. Refurbished Embakasi site for office space and ongoing works for installation of equipment.
iii. Received NEMA license to enable establishment of the fill and finish facility at Embakasi.

57
 Proposed 3D impressions of the refurbished KBI Embakasi
warehouse

iv. Established Strategic partnerships engagements for technology and knowledge transfers for
drug substances and drug products; 1 agreement(MOU) signed with Kenya Medical Research
Insitute and Kenya Institute of Primate Research on collaboration in research initiatives,
product development and commercialization of specialized health products and technologies.
Partnership agreements with International Vaccine Institute (S. Korea) and Biofarma
(Indonesia) at advanced levels of negotiation for implementation .

KBI Chairman M. Kibati, EBS, CEO Dr. M.

KBI CEO Dr. M. Lusiola exchanges
Lusiola and Dr. R. Kenyanya attend a high-
signed MOU with KIPRE CEO Dr.
level meeting between IVI Director General
P. Mwethera as members of both
and HE President William Ruto, Health CS,
teams look on.
S. Nakhumicha and PS H. Kimtai
v. Technology Transfer Agreement with the WHO mRNA technology transfer program
submitted to Office of the Attorney General for review.
vi. Non Disclosure Agreements with two (2) potential global vaccine manufactures signed
vii. KBI is actively engaged with AU and Africa CDC in discussions on Vaccinde Market
Shaping

58
 KBI CEO, Dr, M. Lusiola signs
MOU with Biofarma, Indonesia

viii. Two (2) staff members have been trained in Biomaufacturing at International Vaccine
Institute, S.Korea and capacity building for staff is ongoing.

Digital Health Emmanuel to provide more information

The Directorate of Digital Health, Informatics, Policy and Research has developed a final draft of the
Digital Health Bill, 2023. The bill seeks for An ACT of Parliament to provide for a framework for
provision of digital health services; to establish a comprehensive integrated digital health information
system, data governance and protection of personal health information, service delivery through digital
health interventions, e-waste disposal, health tourism, and for connected purposes.

Sub-Programme 3.2 Medical Research

Kenya Medical Research Institute (KEMRI)

During the period under review (FY2020/21-2022/23) Kenya Medical Research Institute (KEMRI)
undertook a number of strategic initiatives, reforms and policy measures to address issues of health
research and development which included:
Research: KEMRI developed and implemented 191 new research proposals in the FY 2022/23, 162
in FY 2021/23 and 143 in FY 2021/21, covering national health research priority areas with the aim of
providing evidence-based research data to inform policy formulation, practice and product
development.
In the period under review, KEMRI presented 209, 174 and 92 scientific abstracts in FY 2022/23, FY
2021/22 and FY 2020/21 respectively in national and international conferences and scientific forums
with 525 publications done in peer-reviewed journals. These contributed to increased scientific
knowledge in addition to providing a repository of scientific reference material for formulation of
evidence-based policies out of which 12 policy /evidence briefs were developed and submitted to MoH

59
in FY 2022/23. The policy briefs have in turn informed the development and review of disease
management guidelines and health systems interventions.
In FY 2021/22 KEMRI conducted a Rapid situation analysis on population needs for Universal Health
Coverage in Government selected Pilot Counties. Subsequently KEMRI scaled up and completed UHC
studies in twelve (12) counties namely Bungoma, Homabay, Bomet, Nyandarua, Nyeri, Isiolo, Meru,
Machakos, Kitui, Taita-Taveta, Kisumu and West Pokot. During the same period and within the wider
institutional framework for UHC, KEMRI conducted research on human food security and nutrition
and Health Systems, and developed Foods and Recipe lists to be used in development of retention and
yield factors for standard recipes during the food consumption survey.
In FY 2022/23 environmental AMR studies have been completed showing high level of drug resistance
to commonly used antibiotics from pathogen isolates collected from effluents and rivers that mirror
the levels of resistance documented from pathogens isolates collected from health facilities. Based on
this KEMRI scientists are working on alternative ways to mitigate AMR by development of
bacteriophages. The Institute continues to maintain a robust AMR surveillance platform across several
counties to continue informing the status of AMR in Kenya. This is being conducted in collaboration
with MoH (National Inter-agency Stewardship Committee).
Surveillance: KEMRI continues to run the Health and Demographic Surveillance Systems (HDSS)
targeting population dynamics, validating National census/demographic Health Surveys, health facility
utilization, evaluation of new health interventions and priority diseases monitoring within Kisumu,
Siaya, Nairobi, Homabay and Kilifi Counties. This robust platform has been used to achieve some of
the key health systems interventions evaluations such as;
 Successful pilot deployment of malaria vaccine in Kenya and now adopted as one of the
vaccines to be taken up by KEPI.
 Continued mapping out disease dynamics within communities.
 Continued mapping of health facilities and their utilization to inform the functioning of UHC.
This information is regularly shared with the County and National Government for planning.
 Continued monitoring the COVID 19 transmission dynamics and impact of control measures
deployed and other disease outbreaks.
Climate change and health: KEMRI continues to monitor the trends in disease causing organisms
and their vectors in relation to climate change. KEMRI has developed models to predict and monitor
malaria outbreaks, allowing the identification of possible epidemics. In FY 2022/23 KEMRI
established a Clean Air Africa (CAA) programme for capacity building that led to the launch of the
Centre of excellence in air pollution. This is a culmination of work on the forecasting on the potential
effects of climate change on Malaria in the lake Victoria Basin by KEMRI.

Neglected Tropical Diseases (NTDs): In FY 2021/22 KEMRI supported the Ministry of Health in
undertaking the public Health Initiatives such as National school-based deworming programme,
Malaria Survey in school children, National Trachoma impact assessment survey, capacity building
for school health and nutrition and capacity building and technical support for NTDs control and

60
 elimination by providing technical support and field operations. Additionally, KEMRI participated in
the development of strategies and guidelines such as NTDs strategic plan (2022-26), Advocacy,
communication and social mobilization (ACSM) strategy (2022-26). KEMRI also participated, chaired
technical meetings including Lymphatic Filariasis Technical Advisory Group (TAG), Schistosomiasis
and STH TAG and Trachoma TAG, and continues to support the NTD Regional Reference Lab
Health Products and Technologies (HPT): Discovery, Development and Clinical trials of Medicines,
Vaccines, biotherapeutics and Diagnostics:
Vaccines: Control of diarrhoeal diseases – in FY 2020/21 The Institute was involved in evaluation of
several vaccine candidates for cholera, salmonella, shigella. KEMRI currently establishing a shigella
human challenge model platform to support early vaccine and drug development studies.
In FY 2022/23 KEMRI Successfully completed phase three evaluation of the childhood Hexavalent
(SHAN6). This vaccine is to reduce the number of injections children receive in the first year of life to
achieve full immunization.
In FY 2021/22 KEMRI Completed evaluation on Injectable polio vaccine which is currently being
deployed in many countries as a replacement of oral polio vaccine.
Prevention of Cervical cancer - HPV Vaccine – Single-dose HPV vaccine completed and adopted by
WHO in FY 2022/22. KEMRI technical team is working with MoH on the revision of HPV vaccine
guidelines for single dose use.

In FY2022/23 KEMRI completed evaluation of several COVID 19 vaccine candidates and currently
there are new candidates being evaluated targeting new variants. A number of KEMRI Centres are
involved in the understanding of the TB epidemiology and evaluation of new TB vaccine candidates.

Medicines:
The Malaria drug discovery research programs using platforms such as; chemical library mining,
nanotechnology, phytochemistry, and computer aided drug design (CADD) KEMRI in FY 2022/23
KEMRI has drug candidates going into pre-clinical development. In the same period the institute
initiated late stage of evaluation of new anti-malarial such as KAF, KAE and monoclonal antibodies.
Since FY 2006/07KEMRI did set up of a real-time robust anti-malarial drug resistance surveillance
and monitoring.
In FY 2022/23 KEMRI was involved in the development and evaluation of antiretroviral and
optimization of existing ARVs combinations.

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Since FY 2021/22, KEMRI has been involved in the development of new TB drugs and optimization
of the existing ones.
In FY 2022/23 KEMRI completed clinical trials on the new anti-Leishmania combination therapy.
This new therapy is the basis of the current review of the Leishmania treatment guidelines of Kenya.
For Schistosomiasis (bilharzia), in FY 2022/23 KEMRI completed the final evaluation of the pediatric
formulation of praziquantel. The product is currently under review by the European Medical Agency
for registration.
KEMRI is involved in the National Mental Health taskforce and is undertaking several studies on
understanding the epidemiology of mental health conditions, Alcohol, drug and substance use
disorders to inform policy and mental health management programs.
KEMRI was involved in COVID-19 (ANTI-COV) study platform that showed that all the potential
anti-Covid treatment non-was found to be effective, especially the treatment of mild to moderate
disease. KEMRI was involved in several sickle cell disease drug candidates.
Diagnostics: The first locally manufactured new rapid diagnostic test (RDT) for malaria was
developed in FY 2022/23. Samples were shared with neighboring countries (Uganda and Rwanda) for
quality testing and currently WHO pre-qualification is planned. KEMRI hosts the only regional
Malaria Diagnosis training Centre in Kisumu that is providing training for health workers, researchers
and supports external quality control for clinical trials in Malaria.
Diarrhoeal diseases being a major public health problem, KEMRI has a diarrhoeal disease research
program that has finalized the evaluation of 12 RDTs for typhoid.
KEMRI is currently involved in evaluation of new RDTs for diagnosis of leishmaniasis and at the same
time, a new program has been established for in house development of identifying new targets to
inform the development of better diagnostic tools. Viruses remain a major driver of morbidity and
mortality especially arborvirus and
have been associated with epidemics and pandemics. In response to this in FY 2021/22 KEMRI
developed a program on identification and characterization of known and emerging viral pathogens to
inform the development of RDTs for ease of diagnosis such as yellow fever, Rift valley fever, dengue,
chikungunya e.t.c.
COVID-19 KEMRI Response: In FY 2022/23 KEMRI conducted 151,353 COVID-19 diagnosis tests
across the country, conducted 55,637 EID tests and 3,326 COVID-19 genome sequencing. In FY
2022/23 the Phases 2 and 3 clinical trials on AstraZeneca (Chadox) was completed.
Capacity building: In FY 2022/23 KEMRI trained (4) participants on Molecular Diagnostic Tools in
clinical genomics and Human Identification. 4 staff from Gertrudes Hospital were trained for two
months on Molecular Diagnostic Tools in clinical genomics and Human Identification, 24 officers
from 17 countries on Scientific Writing for Public Health Practitioners, 54 officers on global training
hub for biomanufacturing (GHT-B) and 24 officers on Laboratory accreditation mentorship and
internal auditors cohort 1 & 11. The Institute also trained 36 graduate attaches, 78 postgraduate
Diploma students, 34 Masters Students and 42 PhD students to completion, with 26 Masters and 51
PhD students. In FY 2021/22 KEMRI sensitized 46 county laboratory managers on biosafety and
sample collection on onset, traind 51 personnel on entomology, trainees were drawn from (Kenya,
Tanzania, Burundi, Rwanda, Sudan, Nigeria, South Sudan and Ghana), trained 47 staff from Embu
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County, Mandera County, Institute of Primate Research and Gertrudes Childrens’ Hospital on COVID-
19 testing. Additionally, KEMRI trained 25 IPR staff on understanding of COVID 19 disease and
infection prevention and control (IPC) and 120 laboratory staff from 47 counties on emergency
laboratory preparedness and response.

Innovations and HPT Development

In FY 2022/23 KEMRI registered the COVID-19 PCR kit with the Pharmacy and Poisons Board.
KEMRI also manufactured Malaria diagnostic kits, Plasmocheck and validated PCR testing kits. These
were launched during 12th KASH Conference, in FY2022/23.
During FY2021/22 KEMRI produced some of the developed innovations such as; 32,788 pieces of
Viral transport media, 244,927 units of bleach (TBCide) and 335,862 units of Sanitizers (KEMRUB).
The products were supplied to KEMSA and distributed to other health facilities.

In FY2022/23KEMRI won the adjudicators award

for diagnostic Innovation, PlasmoCheck-Malaria
rapid test kit, Virus Transport Media (VTM) and
KEMCov -19 COVID -19 PCR test kit at the Africa
Public Service Day, 10 years and Beyond event.

In FY 2021/22 KEMRI developed a cloud-based technology to support Maternal and child healthcare
in Kenya and the region. The product, developed in partnership with Kwale County piloted a digital
version of the mother-child booklet that nurses and clinicians can now use to enter medical records
instead of the
traditional paper
booklets and will be used
for neonatal
vaccination tracking in
Kenya.

KEMRI Kenya Vision 2030 Flagship Projects

a) Center of Excellence for Stem cells Research, Synthetic Biology and Regenerative medicine:
The Center of excellence in stem cell research was established, fully equipped commissioned in FY
2022/23,

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b) Natural Products:
Manufacture of pharmaceuticals through Public Private Partnership Initiative
Development of indigenous technologies for manufacture of niche products
● In FY 2022/23, the formulation of authenticated herbal remedies for management of cancer
and jigger eradication was completed. The product (Tungicide) is available for final clinical
evaluation for Tungiasis (jigger infection).
● In FY 2021/22, the Pre-clinical studies for herbal medicines for cancer treatment- One hundred
and forty-seven (147) samples collected in Nairobi and Uasin Gishu. Microbial contamination
and drug sensitivity studies have been completed for 117 samples; data analysis completed in
FY 2022/23. Cytotoxicity studies are also continuing. Data compilation for 5 samples tested
against prostate and cervical cancer cell lines on going.
● Formulation of a remedy for management of COVID 19 from Zedupex was completed in
FY2022/23.
● In FY 2021/22 KEMRI completed the development of therapeutic and supplemental foodstuffs
to prevent and treat malnutrition; Ujiplus – A third clinical trial of Ujiplus, a fortified herbal
formulation among children infected with Schistosomiasis in Mbita, Homabay county was
initiated in effort to boost the elimination of roundworms and hookworms in children.

Innovations
During FY2021/22 KEMRI developed and produced some of the innovations such as;
32,788 pieces of Viral transport media developed,
produced 244,927 units of bleach (TBCide) and 335,862
units of Sanitizers (KEMRUB). The products were supplied
to KEMSA and distributed to other health facilities.

KEMRI also obtained accreditation by KENAS

(ISO17043) for COVID-19 Proficiency Testing and so far, 16 laboratories have been registered in FY
2022/23.

Capacity Development
Infrastructural
In FY 2022/23 KEMRI maintained the following accreditations; WHO accreditation (CVR-EPI LABS
polio/measles), Microbiology & Clinical Research Labs (CAP) (KEMRI/WRP Kericho), ISO
9001:2015 (QMS Requirements KEMRI, Certified Clinical, Microbiology & Immunology labs
(GCLP), CGMRC Kilifi, CGHR Kisumu, CCR Kombewa/Kondele/Kericho, ISO/IEC17043:2010

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General Requirements for Proficiency Testing (Production), Fully fledged laboratory for Human
Identification & Training for paternity and for disaster and crime scene investigation.
In FY 2022/23 KEMRI Installed CCTV, barrier access control at KEMRI HQ, in FY 2021/22,
rehabilitated/replaced water pipping system at HQ, repaired/renovation of staff quarters at Mbagathi
& rehabilitation of access roads and in FY 2020/21 constructed and upgraded BSL2 and other
laboratories supported by USA Defense Threat Reduction Agency (DTRA), upgraded ICT
infrastructure and automation.

Human Resource
KEMRI Graduate School enrolled PhD and Master’s
students in FY 2022/23, whereas 28 & 60 were enrolled
in FY 2021/22 and 16 & 43 in FY 2020/21 respectively.
KEMRI and Japan International Corporation Agency
(JICA) launched a project in FY 2022/23 that will
enhance research capabilities in Kenya and on the
African Continent. The KEMRI JICA Technical
Corporation Project (TCP) aims at strengthening
institutional research capacity for the improvement of human research capabilities in the region.
KEMRI partnered with Smile Train to offer a one-of-a-kind research methodology training for medical
professionals drawn from 6 Central and Eastern African countries in FY 2022/23 In FY 2021/22 trained
Thirty -four (34) personnel on Evidence based decision, 24 on Research Methodology where trainees
were drawn from Kenya, Ethiopia, Uganda, Democratic Republic of Congo and Rwanda.

Professional development
In FY 2022/23 KEMRI trained seven (7) officers in Air Pollution, Energy, Climate Change and Health
curriculum, Seven (7) trained on Health Journalism and Public Health Communication Curriculum:
Certificate in Health Reporting, Fifteen (15) trained on Research Administration & Management
Program, in FY 2021/22 one officer was trained on the fungal exposome and health issues, 7 on
methods in epidemiological clinical and operation research, 35 on TB prevalence survey, 18 on
COVID rist perception study, 60 on pediatrics TB diagnostic study implementation, 520 on biosafety
and biosecurity, 1 officer on Introduction to Biotechnology & Bioinformatics, 2 officers on ISO
15189:2012- Medical Laboratories requirements for quality and competence, 180 officers through
Africa Genomic Medicine Training Initiative Course were also trained virtually, 12 trained on Malaria

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Microscopy Competency offered by HuQAS, 12 staff trained on performance evaluation of a prototype
rapid diagnostic test for the diagnostic of schistosomiasis, 10 on Miseq FGS Sequencing, and 16 on
environmental methodologies.

Service delivery
● Technical assistance
KEMRI continues to offer technical assistance to the Ministry of Health through; Secondment of
personnel (NPHLS, NQL, BioVax, participating in the Technical working groups and Committees to
MoH departments, divisions and programmes (Kenya Medical Laboratory Technicians &
Technologists Act, Micronutrient Forum, Infant and young child feeding, Tobacco control Board,
National Public Health Laboratory, COVID-19 task force, COVID-19 vaccine deployment, National
Immunization Technical Advisory Group (NITAG), National Laboratory Technical Advisory
Committee (NLTAC), Kenya Coordinating Mechanism for Global Fund)., Other National
Governments (Environment, Education, Defense, Agriculture, Interior, Judiciary)
KEMRI has also Dedicated a Unit to County Governments for research support. i.e., UHC piloting and
evaluation and Knowledge management to county health departments.

Outbreak detection of Viral Hemorrhagic Fever (VHF)

In FY 2021/22 KEMRI assisted MoH with early detection of outbreaks of dengue, Rift Valley fever,
yellow fever, Chikungunya among other suspected outbreaks like Ebola. In the period between July
2021 to June 2022, the laboratory received and tested 293 suspect arbovirus samples from 12 counties
During this period, the Institute was in the forefront of prompt detection of Dengue (coast),
Chikungunya (coast), Rift valley Fever (Rift valley region) and yellow fever (Isiolo) outbreaks in
various parts of the country that informed prompt response including instituting vaccination campaigns
against yellow fever by the Kenya Ministry of Health.
KEMRI operationalized One Health Research approach programme in AMR, and surveillance of key
zoonotic infections in FY 2021/22.
● Laboratory services
KEMRI offered 971,376 specialized laboratory services in FY 2022/23, 636,427 in FY 2021/22
and 1,335,872 in FY 2021/12 respectively. These specialised services included; Viral Load testing
which covers 75% of all National tests, PCR- Early Infant Diagnosis of HIV, HIV/Rapid Test and
DNA tests during the period under review.
● Products KEMRI developed and commercialized 162,213 diagnostic kits and other products
in FY 2022/23, 286,664 in FY 2021/22 and 698,613 in FY 2020/21 respectively. The products
included, Culture Media (plates), Culture Media (Tubes), KEM-rub, TBcide, Safi Kem (Hand
wash), Sheep blood and Distilled Water
● Regional, Continental and International responsibilities
In FY 2022/23 KEMRI continues to hosts the following reference centers; East African Community:
East African Health Research Commission focal point, African CDC: East African Region
Coordination Center (RCC) laboratory support, WHO regional reference laboratory for polio,
Arbovirus regional reference laboratory, Global reference center for Malaria diagnosis, Regional

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trainer for COVID 19 genomics, and KEMRI supported establishment of Malaria Diagnostics Centers
of excellence in Tanzania, Ghana and Nigeria.

Recognition
In FY 2020/21 KEMRI was awarded the 16th (2020) JICA President award for its contribution to
diagnostics and research in human health especially during the COVID-19 pandemic, KEMRI was
also ranked the top health research Institution in Africa in terms of health research output, according
to the authoritative Global Information Analytics Giant, Scimago Laboratory from 2019 – 2021 and
was also ranked number eight in all research institutions in Africa and number one in health research
innovation in Africa.

Programme 4: General Administration

Sub-Programme 4.1 General Administration & Human resource Management & Development

General administration supported technical directorates as follows: -

 Development of tools to enhance efficiency in service delivery.

 Coordination of digitalization process
 Facilitate acquisition of medical equipment and infrastructure development.
 Alignment of laws and development of Bills to enhance health services.
 Security and maintenance of buildings and health facilities supported by National Government.

Human resource management & development

The Subsector has undertaken Workload Analysis that will strengthen the institutional frameworks for
its different State Corporations to address duplication, overlap and harmonize the reporting
relationships. Additionally, the restructuring will address staffing gaps arising from devolution and
new & emerging health technologies.

The HR instruments for the following State Corporation below were developed and approved by Public
Service Commission: -

● Mathari National Teaching and Referral Hospital;

● Kenya National Radiation Authority (KNRA);
● Kenya Biovax Institute; and
● The Kenya Medical Research Institute (KEMRI).

Industrial Relations

During the reporting period the Subsector faced industrial unrests which disrupted service delivery.
An alternative dispute resolution mechanism was deployed to improve the industrial relationship thus

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averting pending strikes. Currently as a Sector is experiencing unprecedented industrial peace and
harmony.

Training and Development

In the period under review, training was emphasized on increasing the pool of specialized health
workforce. The Sector enrolled healthcare workers in various universities to undertake different
specialized courses that is, psychiatric (8) Orthopaedic Surgery (14), Neurology(1), Paediatric
Surgery(4), Anesthesiology (3), Diagnostic Radiology(6), Nephrology, Urology(9), Plastic &
Reconstructive surgery(6), Ophthalmology(26), Family Medicine(7), Thoracic & Cardiovascular
surgery(3), Internal Medicine(40), Human Pathology(5) and various courses at the Kenya School of
Government (KSG). The sector trained a total of 327 and 302 officers in 2020/21 and 2021/22
respectively. In the year under review, no new training approvals were made and the allocation was
used to clear pending fee payment for officers who were already in school pursuing different
programmes.

Internship programme

Internship in health sector is a compulsory experiential learning, where graduates build upon
previously acquired technical knowledge by working within a professional work setting. The
programme is designed to allow graduates to enhance their professionalism and gain career knowledge
through hands-on – training for a prescribed period of one (1) year.

The Subsector has an authorized establishment of 9500 interns. In the year 2022/23, a total of 4934
interns were placed in various health facilities to undertake their mandatory internship programme.
This was an increase from 4165 and 3876 in 2021/22 and 2020/21 respectively. However, during the
implementation of the programme, the sector faced a challenge of inadequate funds to place the
approved numbers and lack of enough placement facilities to cater for the increased number of
graduates.

In order to streamline the Internship Programme, the Subsector developed an internship guideline
which are expected to solve challenges facing management of the internship programme in the health
sector.

Sub-Programme 4.2 Finance and Planning

The Directorate/Department led the State Department of Medical Services in the articulation of the
BETA priorities as reflected in the Medium Term Plan IV. The Department further provided support
and capacity development on planning, priority petting and costing to SAGAs and programs.
In addition, it collaborated with the County Department of Health in the development of County Health
Strategic Frameworks. At the National level, the department of Planning developed concept notes for
the Kenya Health Sector Strategic Plan, Ministerial Strategic Plan as well as for Returns on Investment.

68
National health Accounts (NHA) report was finalized and disseminated together with County Health
Financing Facts Sheets. As part of the NHA, 15 policy briefs were developed and shared with MOH,
CoG and County departments of health.

In the year under review, the Division of Monitoring and Evaluation spearheaded a joint integrated
support supervision with counties (JHFA) that involved an extensive data collection process from
sampled 90 hospital and 172 primary healthcare facilities with an aim of evaluating the quality-of-
service delivery and ultimately make recommendations towards improving access and outcomes for
the entire population.

In addition, the Division, in collaboration with the KNBS and other stakeholders conducted the Kenya
Demographic Health Survey (KDHS) 2022 to assess the prevalence of key health indicators like
maternal and child health, family planning, HIV/AIDS, and nutrition to inform health policies and
guide program planning.

To track key performance indicators for the Primary Health Care systems, in the year under review,
the Division led the development of both the National and County PHC progression models that
includes both qualitative and quantitative data measuring key aspects related to inputs of PHC;
identification of priority areas and trend improvements in the implementation of PHC over time.

The Division also conducted a post evaluation of the COVID-19 roll out in the country with a draft
M/E framework developed and visualization of the framework linking the Chanjo system to the KHIS.

Sub-Programme 4.3 Social Protection in Health

Health Financing

In the period under review, the State Department of Medical Services together with NHIF, finalized
the Harmonized UHC Essential Benefits Package (EBP). The essence of the Essential Benefit Package
is mainly to support strategic purchasing decisions and clearly outline the scope of benefits, and from
where the benefits can be accessed. In the same reporting period, the Health Financing strategy was
finalized and launched. Other achievements towards the realization of the UHC goal included approval
of the finalized Social Health Insurance Sessional Paper. Identification and registration of over one
million indigents across the forty-seven (47) counties was done by the State Department for Social
protection and National Health Insurance Fund. Finally, the State Department of Medical Services in
the period finalized the development of Facility Improvement Fund (FIF) Guidelines to outline the
process of retention of user fees and NHIF reimbursements among other sources of revenue for the
health facility and initiated the process of development of Donor Transitioning Road map.

During the review period, the State Department of Medical Services together with EAC held the first
National Health Financing Dialogue as a recommendation from the African Leadership Meeting that
advocated for increased domestic resources for health.

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The State Department in collaboration with other stakeholders have initiated processes that serve as
facilitators for UHC. This has contributed to significant milestones such as provision of SMART cards
to cover 200,000 boda boda riders, achieved through a partnership involving the Ministry of Interior,
National Transport Safety Authority (NTSA), National Registration Bureau (NRB), National Youth
Service (NYS), Huduma Centres, and the National Health Insurance Fund (NHIF). In the same breadth
there have been efforts to enroll a big segment of informal sector through collaboration between the
Ministry of Health, NHIF has partnered with USAID & Health Partners to pursue the Cooperative
Health Financial Model to leverage and increase member enrolment through structured Sacco/Welfare
and cooperatives in the country.

Universal Health Coverage

The sector paid premiums for one million poor households, who are currently on a social health
insurance nested in NHIF, to the tune of six billion Kenyan shillings. The contracts of 8,571 healthcare
workers employed under the UHC was renewed in the last financial year.
More than 20 primary health care networks (PCNs) have been established, bolstering the national
vision of primary health care agreed from Astana in 2018 and institutionalized through the national
PHC strategic framework. The PCNs are in varying levels of implementation, with the main challenge
being the modes of financing of the PCNs. Currently there are a total of 7,476 fully functional
community health units (CHUs) with close to 80, 000 community health promoters offering services
at the household level. In FY 2022/23, referrals from the community level to the facilities were 7 times
more than the target (6, 108, 097 out of a target of 850,000).
Through collaboration with health enabler ministries, to date, of the 5,945 public health facilities, three
quarters are connected to electricity while more than two thirds have access to a reliable water source
and are accessible by road as in the chart below;

These investments have improved service delivery and coverage leading to an attainment of an overall
UHC service coverage index of 79%, which is good progress in the journey towards universal health
coverage for all.

National Health Insurance Fund (NHIF)

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Linda Mama Program
The Government of Kenya through the Ministry of Health introduced Free Maternity Services in 2013
to address the high maternal morbidity and mortality which at the time was 362 deaths per 100,000
live births. Further, 62% of births in Kenya are delivered under the supervision of a skilled birth
attendant, which is still below the international target of 90%. Traditional birth attendants continue to
assist with 28% of births, relatives, and friends with 21%, and in 7% of births, mothers receive no
assistance at all.

The Ministry of Health transitioned the program to NHIF

in 2016 and rebranded it to “Linda Mama Program”.
NHIF provides access to maternal services including
skilled delivery, antenatal and post-natal care services as
well as complications arising from pregnancy.

Key Performance for Financial Year 2022/2023

1. Over 1.2million expectant mothers registered for Linda Mama
2. 927,102 deliveries recorded in the period under review.
3. 84% of births attended by skilled health in 2022/23 compared to FY 2021/22 with 65% of
skilled births.
4. 65% of Linda Mama beneficiaries attended at least four (4) ANC visits.
5. Increase in the antenatal care (ANC) coverage is positively associated with increase in use
of skilled care during birth where use of skilled care during birth.

The Linda Mama Program received KES 4.098 Billion program funds during the FY 2022/23. The
utilization of the Linda Mama funds since inception is summarized in the table on Funds utilization
for Linda Mama Program.

Funds utilization for Linda Mama Program

2017/18 2018/19 2019/20 2020/21 2021/22 2022/23 Cumulative

-
Balance B/fwd. 373,747,692 1,698,019,343 527,046,256 2,564,562,271 2,383,577,090 2,019,486,726
Funds transferred
to NHIF 2,961,525,853 2,000,000,000 6,079,570,000 - 8,196,000,000 4,098,000,000 23,735,095,853
Total funds
available 3,335,273,545 3,698,019,343 6,606,616,256 2,564,562,271 5,812,422,910 6,117,486,726

Benefits

Inpatient 291,600 409,350,835 916,033,053 1,312,328,570 747,279,078 1,417,035,192 4,802,318,328

Caesarean Section 198,695,425 416,724,020 482,602,251 711,534,353 598,954,101 763,288,833 3,177,324,983

Normal Delivery 1,402,218,705 2,046,261,027 2,196,770,409 2,332,660,545 1,978,327,987 2,538,580,959 12,497,714,132

Ante-Natal 14,817,275 229,297,566 381,686,463 528,633,291 426,515,462 571,707,974 2,152,658,031

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 2017/18 2018/19 2019/20 2020/21 2021/22 2022/23 Cumulative

Post-Natal 1,494,997 22,942,330 41,397,009 62,982,602 41,859,556 84,363,929 255,040,423

Admin costs 19,736,200 46,397,309 23,564,800 - - - 107,530,117

Sub-total 1,637,254,202 3,170,973,087 4,042,053,985 4,948,139,361 3,792,936,184 5,374,976,887 22,992,586,014

(2,383,577,090
Balance C/fwd. 1,698,019,343 527,046,256 2,564,562,271 ) 2,019,486,726 742,509,839 742,509,839

Health Insurance Subsidy Program (HISP)

The Health Insurance Subsidy Programme (HISP) is a demand financing health intervention that
intends to enhance utilization of health services and at the same time reduce out of pocket spending by
the indigent population.

NHIF rolled out HISP in 2014 targeting beneficiaries of the Orphans and Vulnerable Children Cash
Transfer Program implemented by the State Department for Social Protection. Currently, there are
181,968 households registered and covered by NHIF. HISP members are entitled to a similar cover
enjoyed by the National Health Scheme members. This includes inpatient, outpatient, and special
packages & products.

The State Department for Social Protection through the Ministry of Health shared the data file of
72,400 HHs with NHIF which were subjected to IPRS verification and subsequently registered. The
number of households covered stands at 254,368 OVC households as at 30th June 2023.

There is a marked improvement in utilization of benefits among HISP beneficiaries because of the
system and operational improvements such as biometric identification. In addition, the sensitization
that was also conducted while biometric registration was taking place empowered beneficiaries with
the right information relating to access to benefits.

A total of KSh. 510 million has been paid out as benefits for members of the program for the FY
2022/23 ended 30th June 2023 which is represents a 53% increase compared to KSh. 290 million in FY
2021/22.

Older Persons & Persons with Severe Disability (OPSD) Program

Recent discussions in the past five (5) periods have centred on increasing health coverage to the poor
and vulnerable persons in society. Currently, approximately 36% of the population lives below the
poverty line while 9% live in extreme poverty. A large proportion of the population is vulnerable to
poverty because of a wide range of factors are unable to deal with livelihood shocks such as sickness,
old age, unemployment, and disability.

Government of Kenya through the Ministry of Health subsidizes the premiums of the beneficiaries of
the Older Persons and Persons with Severe Disability Cash Transfer Programme. NHIF has been
implementing the OPSD program since 2014 and currently covers 58,800 households.
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The OPWD target group constitutes the households under the Older Persons and Persons with Severe
Disability Cash Transfer Programme. The targeting and identification was carried out by the Ministry
of Labour and Social Protection (ML&SP) through proxy means testing and community verification.

The 58,800 households were ranked by the Ministry of Labour and Department of Social Protection
as the poorest in the database of beneficiaries in the Older Persons and Persons with Severe Disability
cash transfer program. The households have access to benefits as prescribed under the National Scheme
guidelines including inpatient, diagnostic testing, chronic care management and outpatient services
among others to all NHIF members including HISP beneficiaries.

OPSD members are entitled to a similar cover enjoyed by the National Health Scheme members. This
includes inpatient, outpatient, and special packages & products. A total of KES 142 million has been
paid out as benefits for members of the program for the FY 2022/23 ended 30th June 2023. This
represents a 56 per cent increase compared to the KSh.91 million paid out in FY 2021/22.

Inua Jamii 70+ Program (IJP)

Inua Jamii 70+Program is a government flagship program that rolled out in April 2018 and aims to
extend coverage to older persons as part of its commitment to achieving Universal Health Coverage as
underscored in the BETA Agenda. The Ministry of Labour and Social Protection expanded the Older
Persons Cash Transfer Program to cover all poor and vulnerable persons aged 70 years and above.
Therefore, this group of beneficiaries are set to access health insurance cover through the National
Hospital Insurance Fund (NHIF).

Currently, the beneficiaries of Inua Jamii 70+ program are not accessing benefits due to the fact NHIF
is yet to receive the premiums for the beneficiaries. However, the beneficiaries are eligible to access
to benefits as prescribed by under the National Scheme guidelines including inpatient, diagnostic
testing, chronic care management and outpatient services.

Government Sponsored Indigents (UHC)

The Government of Kenya under the ‘BETA’ agenda is committed to the provision of quality
healthcare to all, including the vulnerable members of society. The Government seeks to expand health
insurance coverage for poor and vulnerable groups under a cover nested in NHIF. Towards this, H.E
the President launched the UHC Scale-up on 7th February 2022. The cover took effect from 1st January
2022 and intends to offer equitable access to quality health services and financial risk protection for
all Kenyans through health insurance coverage.

Data of 1,509,037 indigents was submitted to NHIF for registration. This was subjected to IPRS
validation and other internal checks before registration. Out of these, 882,291 qualified for sponsorship
and were registered to access benefits. Consequently, the Ministry directed that the balance of the funds
that were paid for the UHC vulnerable households who had not yet been identified be utilized to
provide a medical cover for 200,000 Boda Boda riders.

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As of June 2023, a total of 456,354 out of the 882,291 validated beneficiaries have been biometrically
registered. This is an increase of 90,835 beneficiaries compared to 369,519 households registered
biometrically as of June 2022. Currently, 1,000,000 households are covered under this program due to
the premium paid of KSh. 6 billion annually. NHIF is fast-tracking the biometric registration of the
members for seamless access of services. A total of KSh. 3.3 billion of benefits were paid out during
the FY 2022/23 compared to KSh.1.3 billion paid in FY 2021/22. This represents an increase of 154
per cent.

2. STATE DEPARTMENT FOR PUBLIC HEALTH AND PROFESSIONAL STANDARDS

Programme 1: Preventive and Promotive Services

The objective of this programme is to prevent occurrence of diseases by increasing access to quality
promotive and preventive health care services. It has six sub programmes as shown below.

Sub-Programme 1.1: Communicable Disease Control

i. Malaria
The mass insecticide-treated bed nets (ITN) campaign is implemented every three years in malaria-
risk areas. Currently, this is deployed in 28 counties. During the 2021 mass net campaign, Pyrethrin-
Piperonyl Butoxide (PBO) nets were distributed in three malaria-endemic Counties (Kakamega, Busia
and Bungoma).

Figure 1: Malaria Interventions - Country Context

The number of confirmed malaria cases per 1,000 population depicts an increase in malaria incidence
in the last two financial years from 82 cases per 1,000 in FY 2021/22 to 105 cases per 1,000 in FY
2022/23. The increase is because of enhanced diagnosis (testing) and, therefore, not a real increase.
The malaria blood examination rate, i.e., number of tests done per 100 population, has increased from
25.8 in the fiscal year 2019-2020 to 29.1 in the fiscal year 2022-2023. This enhanced testing of
suspected cases follows the “Test and Treat” policy for suspected malaria cases.

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Figure 2: Confirmed Malaria Per 1,000 Population And Tests Done Per 100 Population

The proportion of pregnant women receiving SP during ANC visits has been gradually increasing i.e.,
45% for IPTp3, while IPTp2 was at 57% and IPTp1 indicated An increase to 70% in the fiscal year
2022-2023.

Figure 3: ANC Clients Receiving IPTP In Malaria Endemic Areas in Kenya FY 2019/20–2023

ii. Tuberculosis
Tuberculosis (TB) remains a global epidemic of public health concern being one of the leading causes
of death from a single infectious agent. Kenya is among 30 high TB and TB/HIV high burden countries
that contribute over 85% of the global TB burden. According to the TB prevalence survey carried out
in 2017, TB prevalence was 426 per 100,000 population. In 2021, WHO estimated that about 133,000
people fell ill due to TB in Kenya (WHO report 2022). The drug-resistant strain of tuberculosis poses
a major public health challenge and an economic burden to the country especially the household
affected by the disease due to the high intervention cost. During the financial year 2022/2023, Kenya
diagnosed 98,97582,302 people with drug-susceptible tuberculosis and started them on treatment.
There were 609 702 people diagnosed with drug resistant strain of TB and all of them were started on
second line treatment.
The country has achieved significant progress in TB control and prevention resulting in notable
decrease in new cases and mortality due to TB. The figure below shows trends of TB incidence and
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mortality since 2015. The trends show that Kenya is on track on achieving the End TB milestones of
reducing incidence and mortality.

Figure 4: Trends of TB Incidence and Mortality,

Source: KHIS

• While TB case finding has improved from 73,777 in FY21/22 to 82,302 in the reporting
period, a significant proportion (32%) of people with TB are still missed. DR TB case
identification declined during the period from 804 in FY21/22 to 702 in FY22/23. The
Ministry of Health has put in place strategies to accelerate TB case finding and improve
treatment outcomes. Some of the interventions carried out during the year were;
• Active case finding in health facilities; This requires that all persons visiting the health
facilities are screened for TB and those with symptoms tested for TB using molecular
testing such as gene expert and Trunat. Community outreaches were also done in hard-to-
reach areas using mobile X rays assisted in increasing case finding. TB contacts screening
was also strengthened using community health volunteers
• Strengthening of TB diagnosis; by continuously supporting procurement and distribution
of testing reagents and gene expert cartridges across all the 47 counties. Adoption of new
testing technologies as recommended by WHO such as Trunat and gene Xpert ultra also
has contributed to TB diagnosis
• Strengthening of initiation of TB preventive therapy (TPT) among TB contacts; this is
expected to contribute to a significant reduction in new TB cases
• The Ministry continued to ensure availability of first-line and second-line treatment in order
to improve and sustain treatment success rates
• Engagement of all care providers including private sector both formal and informal in TB
control activities
• The Ministry had the following achievements in the period under review:
• The TB program and its stakeholder’s success fully developed TB strategic plan
FY2023/24- 2027/28
• Roll out of public-private mix (PPM) dashboard assisted by WHO to improve private sector
visibility in TB reporting

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 • Expansion of molecular testing including introduction of Trunat to complement gene Xpert
in order to improve access of drug susceptibility testing (DST) by all TB patients. Digital
adherence technologies were also introduced in the country.
• Improvement in TB case finding which could be attributed to strengthening of active case
finding and quality improvement
• Notable gradual TB incidence and mortality decline
• In order to contribute to the government agenda, facility-based app t-bu lite app was rolled
out to ease reporting in facilities in both private and public sector.

i. Primary Healthcare
As follow up of the Government’s directive, the State Department of health has outlined new
arrangements in terms of service delivery through the formation of Primary Care Networks as stated
in the primary health care strategic framework. To strengthen the agenda, reorganization of service
delivery through the establishment of primary care networks (PCNs) was prioritized. To establish the
PCNs guidelines were developed to outline the steps which envisioned that all the community Units in
each sub-county are linked to the primary health care facilities (Level 2 & 3) and the sub-county
hospitals. Over the period in review 10 counties have established PCNs translating to 21% as per the
target of 47 counties during the financial year in review. The country has established 30 primary health
care networks spread across ten counties since 2020, with the bulk having been established in 2022/23.
To strengthen community reporting, the Sector developed a e-community health information system
for roll out to all the counties in 2022/23. It also collaborated with the county governments to set up
seven (7) primary care networks in seven counties, namely Makueni, Kisumu, Garissa, Mombasa,
Nakuru, Kakamega and Marsabit.
The Primary Health Care Act 2023, Digital Health Act 2023, Facility Improvement Financing Act
2023, and the Social Health Insurance Act 2023 (all aimed at providing an enabling environment to
sustain PCNs) were assented into law. The electronic community health information system (eCHIS)
has been scaled up to 7 counties from one in the previous year.
Community health units are deemed functional if they meet the following requirements: submitting
the MOH 514 every month, conducting four dialogue days, 12 action days and 12 monthly feedback
meetings in a year as well as doing home visits. Operationalization of existing Community Health
Units gradually increased from 81 per cent in 2021/2021 to 86% in 2022/2023.Dialogue days
conducted in the community increased from 32,260 to 43,212. However, this is still below the expected
number as one community health unit is expected to conduct 4 dialogues in a year.

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Figure 5: A Primary Health Care Network

Sub-Programme 1.2: Non-Communicable Diseases Prevention & Control

ii. Diabetes and Cardiovascular Disease Control
Non-communicable diseases are increasingly imposing a major public health and economic burden in
the country, accounting for 44% of hospital deaths. This group of diseases is estimated to reduce
household incomes by on average 29% due to reduced productivity, premature mortality and direct
health related expenditure. There has been a 30% and 45% increase in the incidence of outpatient visits
attributed to hypertension and diabetes respectively between 2017/18 and 2020/21.
In response to the increasing burden of cardiovascular diseases, the Ministry reviewed management
and treatment guidelines in the fourth quarter FY 2022/23.

Sub - Programme 1.3: Radiation Safety and Nuclear Security

i. Kenya Nuclear Regulatory Authority
During the year under review, the authority made a successful bid to host an international Postgraduate
Education Certificate (PGEC) program. Focused on the critical domains of radiation protection and
safety of radiation sources, this program is poised to welcome its inaugural cohort on the 2nd of
October 2023. Notably, this inaugural cohort comprises students from approximately twenty-five
diverse countries within the African region, exemplifying the program's broad regional appeal and
impact.
Prior to this milestone, the program had exclusively been available in South Africa and Ghana within
the African continent. However, we are delighted to announce a significant expansion. Kenya is now
positioned to emerge as a prominent regional hub for chemical, biological, radiological, and nuclear
training, solidifying its leadership in this crucial field.
Furthermore, it is noteworthy to highlight that we have successfully established a counterpart funding
model for this program. Notably, the International Atomic Energy Agency has committed a substantial
contribution of Kshs 100 million to support this endeavour. In light of this, we humbly request the
Government of Kenya to consider providing a matching contribution of Kshs 100 million towards this
program, reinforcing our collective commitment to its success.

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During the year under review the authority processed one license applications for Positron Emitted
Tomography Computed Tomography (PET/CT). The PET/CT detects residual or recurrent disease and
is an excellent diagnostic procedure to differentiate tumour recurrences and as such the approach
allows for the development of a more rational treatment plan for the patient.
The Authority also considered five license applications for installations of linear accelerators. Linear
accelerators are a best alternative to radiotherapy centres which were using radioactive materials for
treatment of cancer. In addition, a big advantage of the replacement is that linear accelerators don’t
pose nuclear security challenges as compared to radiotherapy centres. Risk-based radiation
contamination monitoring of consumer products imported to our country was also conducted during
the year under review.
In the realm of nuclear security and non-proliferation of weapons of mass destruction, the authority
conducted Chemical Biological Radiological and Nuclear (CBRN) explosives training for fifty officers
from the National Police Service. In addition, during the period under review conducted in conjunction
with development partners the physical security planning and enhancement of high radiation risk
facilities.

Sub-Programme 1.4: Reproductive Maternal Neonatal Child and Adolescent Health

(RMNCAH)
ii. Family Wellness, Nutrition and Dietetics
Family Wellness: The rising burden of lifestyle diseases in Kenya is a critical health challenge that
demands urgent attention and action. Non-communicable diseases (NCDs), also known as lifestyle
diseases, have emerged as the leading cause of morbidity and mortality in the country. These diseases,
which include hypertension, diabetes, cardiovascular diseases and obesity-related ailments, are largely
preventable and heavily influenced by lifestyle factors such as physical inactivity and unhealthy eating
habits.
Kenya's healthcare system is grappling with the overwhelming burden of lifestyle diseases. As more
and more people suffer from NCDs, the demand for healthcare services increases, leading to higher
healthcare costs and stretched resources. Moreover, the treatment of lifestyle diseases often involves
long-term care, leading to a chronic burden on the healthcare system. As the prevalence of NCDs rises,
there is a risk of depleting health resources, hindering the healthcare system's ability to provide
adequate and quality care to all citizens.
In addition to the impact on healthcare, lifestyle diseases also take a toll on individuals' well-being and
productivity. People suffering from NCDs experience reduced quality of life, decreased productivity
and higher rates of disability. This not only affects individuals but also has repercussions on their
families and communities. The loss of productivity due to NCDs can have adverse effects on economic
growth and development, hindering the country's progress towards achieving its socio-economic goals.
To counteract this growing crisis, there is a pressing need for innovative approaches that emphasize
prevention and health promotion. One such promising approach is the establishment of wellness
centres that focus on preventive measures and lifestyle modifications to mitigate the impact of NCDs.
Goal and objective is to enhance participants' physical health by providing access to fitness services,
nutrition training and expert guidance. The purpose of the programme is to enhance the holistic well-
being of individuals and communities by providing accessible wellness centres and comprehensive

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resources. It aims to prevent non-communicable diseases, improve physical and mental health, foster
community support and promote eco-friendly living, creating a lasting positive impact on health and
wellness.
Nutrition and Dietetics: Kenya is experiencing the triple burden of malnutrition, where undernutrition
(underweight, stunting and wasting), overweight and obesity and micronutrient deficiencies in addition
to the burden of Non-Communicable Diseases (NCDs). Out of 6,301,316 children under five years,
nearly 1,109,032 are stunted (18%); 308,764 are wasted (5%); 636,433(10 per cent) are underweight;
and 3% are overweight or obese. Slightly over a quarter (28%) of adults aged 18–69 years are either
overweight or obese. Currently, with the prevalence in women at 38.5% and men 17.5% (Kenya 2015
STEPwise Survey). Micronutrient deficiencies of iron, folate, iodine and vitamin A are also
widespread, with 42% of pregnant women and 26% children 6–59 months are anaemic (KNMS, 2011).
Although Kenya has made improvement in some of the nutrition indicators, malnutrition remains a
significant public health problem, a hindrance to achieving the country’s developmental agenda with
huge economic losses estimated at KSh 374 billion annually. Additionally, the Human Capital Index
(HCI) for Kenya stands at 0.55 meaning that a child born today in Kenya (provided all indicators stay
at the level they are today) is only 55% productive of what he/she could be with complete education
and full health. Among the factors contributing to the present HCI for Kenya are the high stunting
rates. Notwithstanding these significant economic losses or costs due to poor nutrition, further evidence
shows that the return on investment for nutrition in Kenya stands at USD 22 for every USD 1 invested
towards nutrition, making nutrition a worthwhile investment.

Figure 6: Economic Losses due to Malnutrition

The Ministry is implementing several nutrition interventions in addressing malnutrition in all its forms.
The recurrent budgetary allocation for nutrition increased from KSh 80 million in 2021/22 to KES
204,746,905 under capital projects for procurement of therapeutic and supplementary food for
treatment of acute malnutrition in FY 2022/23. Cognizant of the declining donor funding for nutrition
programs, nutrition is one of the components included in the Health Sector Financing Transitioning
Roadmap 2022-2030.
During the report period the following achievements were realized. VAS coverage has improved
82.1% in 2020 to 86.3% in 2021, and 83.7 in 2022 thereby realizing the global and national target of
80%. The improved coverage of Vitamin A supplementation was due to accelerated Malezi Bora. This
is normally done through routine health facility visits and integrated community outreaches. Successful

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Malezi Bora events require that stakeholders work collaboratively in microplanning, pooling
resources, leveraging on each partner’s comparative strengths, and coming together to review progress
achievement.
Other important achievements include capacity building of Health Care workers on Baby Friendly
Community Initiative (BFCI), Integrated management for acute malnutrition, the Kenya Nutrition
Scorecard and training on Healthy Diets and Physical Activity. A total of 52 TOTs were trained and
3,670 Health Care workers trained. Kenya Nutrient Profile Model (KNPM) was finalized, the draft
Front of Pack Nutrition labelling (FOPNL) standard is near finalization. FOPNL is one of the diet-
based interventions in prevention, control and management of NCDs.
Under the ending drought emergencies flagship project, the Ministry is promoting integrated
management of acute malnutrition in the 23 ASAL counties: Every year, 2 nutrition situation
assessments have been conducted providing the caseloads for treatment of acute malnutrition.

Sub - Programme 1.5: Environmental Health

i. Water, Sanitation and Hygiene (WASH)
WASH in the health sector addresses Global commitments, like the sustainable development goal 6.2
which states; “By 2030, achieve access to adequate and equitable sanitation and hygiene for all and
end open defecation, paying special attention to the needs of women and girls and those in vulnerable
situations. During the period the State Department prioritized to increase the proportion of villages
certified as open defecation free by 2% from 29 in 2021/2022 to 31 in 2022/2023 however, we managed
30%. The 1% coverage was lost to weak structures which were not resilient to climate change(floods)
in flood prone areas.
ii. Vector & Vermin Control
Ministry conducted awareness on Jiggers infestation during the commemoration of the National Jigger
Awareness Day in three Counties of Kakamega, Embu and Homa Bay with Kakamega hosting the
National celebration in March. Over 500 persons were treated for jigger infestation in the 3 Counties.
The Ministry also distributed Vector control Commodities to 9 Counties with High burden of Vector
infestation. The counties include Kisumu, Busia, Kakamega, Mombasa, Taita Taveta, Migori, Trans
Nzoia, Homa Bay and Embu. A total of 20 Public Health, 10 Community Health Officers and 30
Community Health Volunteers were sensitized on Jigger Control in Kakamega County.
iii. Healthcare Waste Management & Climate Change
With regards to Healthcare Waste management the State Department installed a total of 10 microwaves
and commissioned Nine (9) in the project counties.
iv. Food Safety & Quality Control
Under food safety, 85% of foods meeting food safety standards was targeted and 80% was achieved
by the time surveillance was taking place, there was transition of the premix standard with new
micronutrient levels. Most industries were using the old standard. Secondly, Contamination levels vary
significantly between branded flour and informally milled posho flour. There was no funding to carry
out a third surveillance which would have informed further on the achievement.
v. Occupational Health & Safety
During the period under review, the Ministry had prioritized to establish Occupational Health and
Safety Committees in 10 level 4 and 5 health facilities, this was achieved with support from partners
however the project supporting this came to an end.

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The need to save lives requires the urgent implementation of the health sector strategic priority 5 on
minimization of exposure to health risk factors. During the period under review the Ministry prioritized
to train a total of 2500 community health volunteers and managed to train 2668 CHV with support
from GIZ and the 47 counties.
vi. Port Health Services
The International Health Regulations (2005) requires countries to develop and strengthen capacities at
ports, airports and ground crossings based on routine activities and emergency situations of both local
and international concern, in a bid to safeguard the country’s borders against the introduction and
exportation of infectious diseases and other public health risks. In order to achieve this objective four
(4) key indicators were developed to assess performance. These include:
i). Screening of travellers for notifiable diseases; 1% achieved
ii). Issuance of vaccination certificates as per health requirements; 77% achieved
iii). Cargo clearance and; 151% achieved
iv). Inspection and certification of conveyances. 159% achieved

The descalation of COVID-19 travel requirements had an impact of the set targets to include reduction
of enhanced screening of travellers and issuance of COVID-19 vaccination while a marked increase
was noted in the number of conveyances arriving into the country as well as cargo.
In terms of preparedness for an emergency of international concern, Port Health services embarked on
a joint core capacity assessment with Tanzania at the Kenya/Tanzania borders, developed draft
simulation manual for points of entry, draft operational point of entry operational guidelines and draft
five-year port health strategic plan, the first of its kind. Further 38 thermal cameras were installed and
commissioned at the points of entry through funding support from the AFD project.
vii. Tobacco Control Board
Tobacco Control Board is established under Section 5 of Tobacco Control Act 2007 Cap 245A and
continues to discharge its mandates within the Confines of the WHO-FCTC, Tobacco Control Act and
Regulations including the relevant laws with the view of guiding Tobacco Control in Kenya. During
the period under review, the planned activities included training of Tobacco Control enforcement
officers in the 47 counties and full implementation of new graphic health warnings. The Board
prioritized formation and sensitization of multisectoral tobacco control and enforcement committees
in all the 47 counties.

On establishment and training of enforcement officers, the Board initiated the process of establishing
county multisectoral tobacco control and enforcement committees. A total of two meetings were held
virtually between the board and the county commissioners across all the 47 counties. Tobacco control
enforcement training manual was developed and a total of 200 county enforcement officials were
trained in two workshops conducted in Eldoret.

Sub - Programme 1.6 Disease Surveillance and Response

i. Disease Surveillance and Response
The Division of Disease Surveillance and Response is mandated to oversee implementation and
response to events of public health importance in line with the strategic focus of the Kenya Health

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policy 2014 to 2030 and the Kenya vision 2030 to transform the country into a globally competitive
and prosperous nation with a high quality of life by 2030.
In the FY 2022/23, the Division of Disease Surveillance and Response developed the third edition
Integrated Disease Surveillance and Response (IDSR) technical Guideline. The Division, through the
support from partners, conducted sensitization on the guidelines to the county management team in all
47 counties. The Division plans to scale up the training to all sub-counties, health facilities, and the
community by 2026 as stipulated in the DDSR strategic plan 2022-2026. There is a need therefore to
rally support from the national and county governments for roll out to all counties and ensure
sustainability. The Division also finalized the Cholera Elimination Plan 2022-2026 and the Cholera
Treatment Guidelines 2023.
AFP Surveillance: The detection rate of non-polio Acute Flaccid Paralysis (AFP) declined from 4.06
to 3.14 per 100,000. As Per international norms, a rate below 2 per 100,000 indicates that the
surveillance system is not effective. This performance was a result of system-strengthening approaches
like performance-based reimbursements, supportive supervisory activities, and guidance from Polio
expert committee members. There is significant support from partners both at the National and county
levels. Globally, there is a reduction in donor support for Polio activities and there is a need to transition
to Government funding to ensure a polio-free status.

Figure 7: National Non-Acute Flaccid Paralysis Rate 2018-2023

Event Based Surveillance (EBS): Event based surveillance (EBS) is premised on the fact that
occurrence of some events may precede disease outbreaks. Undertaking surveillance on such events
provides good lead time to either prevent or significantly reduce the associated unfavourable outcomes.
It involves collection and notification of information on events that present known and unknown public
health threats thus complimenting the routine integrated disease surveillance (IDSR) on priority
diseases and conditions. The Ministry through the Division of Disease Surveillance and Response
established Community Events Based surveillance system in five selected counties of Kajiado,
Marsabit, Mombasa, Nakuru and Siaya. Commitments for the FY 2022/23 was to scale up the number
Counties implementing EBS from 8 to 20.
Division of Zoonotic Diseases: Staff trained on Rabies and Brucellosis. The Zoonotic Disease Unit
(Now Division of Zoonosis) was established in 2011 jointly by the Ministry of Health and Ministry of
Livestock Development with a mission to establish and maintain active collaboration at the animal-
human ecosystem interface towards better prevention and control of zoonoses. The ZDU serves as
Kenya's One Health office and secretariat to the Zoonoses Technical Working Group (ZTWG). In
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2012, the ZDU launched its first strategic plan (2012-2017) whose main objectives were to strengthen
One Health implementation and national and county levels, to strengthen zoonotic disease surveillance
and to promote applied research using the One Health approach. During the FY 2022/23 the Division
planned to support investigation of rabies deaths by use of post-mortems biopsy. So far 5 rabies
diagnosis were confirmed as opposed to the targeted 10. There were challenges related to difficulties
in sample collection that hampered the desired achievements.
Public Health emergency Operations Centre: The Kenya Public Health Emergency Operation
Centre (PHEOC) is a hub for coordinating preparedness and response to public health emergencies
and diverse public health threats, such as disease outbreaks. The country continues to implement the
National Action Plan for Health Security (NAPHS) 2019-2023.
During the financial year 2022/2023, through the support of WHO, AFRO and Africa Centres for
Disease Control and Prevention, 118 Africa Volunteer Health Corps (AVoHC) surge personnel were
trained as rapid responders. The participants were drawn from all 47 counties, Ministries of Health,
Water and Sanitation, Education, Agriculture and Livestock, Tourism, Wildlife and Heritage and
Interior. The surge capacity is ready for deployment in the event of an emergency in the continent.
There is a need to review the NAPHS as a priority for the next financial year.
The Kenya Public Health Emergency Operation Centre (KPHEOC) was activated and supported
response for various outbreaks in the country and continues to coordinate response measures as well
as provide daily situation reports to inform planning for five outbreaks, namely, COVID-19, Visceral
Leishmaniasis, Measles, Cholera, and preparedness for Ebola outbreak. In addition, it coordinated the
first mass vaccination of the oral cholera vaccine in response to an outbreak. Further, the Centre
conducted three simulation exercises: A World Health Organization Africa Regional functional
exercise on Ebola, tabletop exercise on Rift Valley fever, and Ebola outbreak.
Field Epidemiology and Laboratory Training (FELTP): The Field Epidemiology and Laboratory
Training (FELTP) programme started in 2004. The mandate of the programme is based on the need to
develop a skilled public health workforce that supports the surveillance systems, respond to public
health emergencies and use data for decision making respond to outbreaks in a timely manner to avoid
morbidity and mortality. In the FY 2022/23 the program has been able to train and graduate total of
200 grandaunts thirty (30) from Advanced Level, sixty (60) from Intermediate level and one hundred
and twenty (120) Front line.
ii. Department of Laboratory Services
The Department of Laboratory Services (Now Division of National Laboratory Services, DNLS) in
the Ministry of Health is tasked with formulation of laboratory policies and guidelines, provision of
specialized testing for priority infectious and non-communicable disease, laboratory-based disease
surveillance, provision of quality assurance for the public health laboratories and referral services
linking national, international, and county laboratories.
Within the period under review, the Department worked closely with key partners, international
organizations, and technical agencies to establish and expand molecular testing capacity for High-risk
HPV, improve laboratory network for referral services, conduct food fortification monitoring and
surveillance of contaminants in drinking water and foods.
In 2021/2022, 2022/2023 the Department targeted to expand and maintain the proportion of national
and county reference laboratories able to conduct molecular testing for emerging and re-emerging

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diseases to 31%. This was maintained in 2021/2022 and 2022/2023. This was due to the scale-up of
molecular testing platforms in level IV and V laboratories.
The Department also targeted to increase and maintain the number of medical laboratories with
capacity to detect and report on Antimicrobial Resistance (AMR) at 17. This was achieved through
sensitization and activation of targeted laboratories in AMR surveillance.
The target was to conduct 3,000 and 4,200 tests in 2021/2022 and 2022/2023 respectively. These
testing targets were surpassed to 4,822 and 24,310 respectively. The proportion of laboratories with
capacity to conduct molecular testing of High-risk HPV was also increased from 9.1% to 10.6% in
2022/2023. These increases were due to effective sensitization for testing by the National Cancer
Control Program.

The targets for COVID-19 testing for 2021/2022 and 2022/2023 were 1.9 and 1.2 million respectively.
The testing dropped to 174,308 tests in 2022/2023 due to the de-escalation of COVID-19 as a global
health emergency requiring testing for only targeted cohorts.
The targeted proportion of mycotoxin tests on foods and feeds as well as Fluoride, Nitrates and
Sulphates on water for compliance with food safety standards of 86% and 80% respectively in
2022/2023 was achieved due to the Public Health Officers (PHO) initiative for sampling of food, water
and feeds for compliance with food safety standards.

The proportion of tests on maize and wheat flour complying with food fortification standards also
increased from 38% to 72.6% owing to the increased surveillance and sensitization of the flour milling
industry. This followed the Ministry’s development of a Guideline on Surveillance and Enforcement
for Food Fortification in Kenya with the aim of strengthening enforcement of mandatory required food
as per CAP 254 and Kenyan Standards.

Programme 2: Health Research and Development and Innovation

Sub – Programme 2.1: Capacity Building and Training

i. Kenya Medical Training College
In order to develop a workforce while prioritizing the implementation of Primary Health Care
objectives, the Kenya Medical Training College (KMTC) aligned its strategies to those of the Health
Sector, Bottom-Up Economic Transformation Agenda (BETA) through realignment of some curricula
and introduced new courses to address emerging health needs. These include a course in Speech
language therapy, Point of care ultrasound in obstetrics for Nurse Midwives, Community Health
Assistant (CHAs).
The College equated its programmes and did registration of graduates with the Kenya National
Qualifications Authority. This was aimed at protecting data, ensuring authenticity of certificates and
enabling graduates to compete globally.
The College has embarked on harnessing innovation and creativity, leveraging on E-learning, setting
up an E-library system and digital repositories, to ensure continuity of teaching and learning. The
college increased the availability of ICT resources across all the Campuses. The college ensured
implementation of an e-learning platform. A total of 71 Campus representatives were trained on the

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use of the platforms. Part of content theory in every module was covered via e-learning. In addition, at
least one continuous assessment test in each module per semester was undertaken on an e-learning
platform. These interventions made the college to be named among the top 100 best institutions in ICT
innovation in Africa at the 13th edition of the Africa CIO100 Awards. The College retained its position
as the preferred medical institution- Webometrics ranking of 2021 and 2022.
Further the College launched a state-of-the-art simulation laboratory. The Laboratory provides quality
simulation inter-professional experience training for critical care health workers and trainees. The
Laboratory includes a mock Intensive Care Unit (ICU) and operating theatre in which routine and
complex clinical cases can be performed under the guidance of our faculty. It is fitted with a
Comprehensive Care Ventilator (CCV) as well as Universal Anaesthesia Machine (UAM), several
mannequins, an ICU bed, patient monitors, oxygen cylinders and accessories, machines to simulate
different types of breathing, airway kits, and other devices, accessories, and consumables that help
simulate a real clinical environment.
In the FY2022/23, the student enrolment grew from 21,700 in 2021 to 25,889 in 2023 this led to
increase in student population from 59,000 to 62,807 from 2021 to 2023 respectively. This was due to
an increase in infrastructural development which introduced more training opportunities in Teso,
Transmara, Chemolingot, Shianda Mumias ,Ndhiwa while Kangema ,Othaya and Navakholo
campuses which w ere opened. Further, to this there was a 95% transition rate from admission to
graduation.
ii. Kenya Health Professions Oversight Authority (KHPOA)
During the period under review the Authority developed Human resource instruments which were
approved, and the Authority was categorized as an Oversight/Regulatory state corporation category
PC6B.
A total of 13,996 health facilities were inspected for compliance to standards in service delivery and
17 level 5 hospitals assessed for emergency care preparedness. In addition, 176 County Health
inspectors were trained across all the 47 counties on inspections for quality-of-care improvement.
The Authority processed 70 complaints from patients and aggrieved parties; and facilitated resolution
of 5 disputes from regulatory boards and councils.

iii. Kenya Health Human Resource Advisory Council (KHHRAC)

KHHRAC has realized gradual progression in its operationalization. The Council now has all the
members as provided for in the Health Act 2017. The Board was gazetted in May 2023 and inaugurated
by His Excellency the President in June 2023.

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Figure 8: The President presiding over the inauguration of Kenya Health Human Resource Advisory Council

During the period under review with technical support from the State Department for Public Service
KHHRAC, developed human resource (HR) instruments which include the Organizational Structure,
Career Progression Guidelines, Human Resource Policy and Procedure Manual, and job descriptions
and are awaiting presentation to the Public Service Commission for approval. With support from
partners KHHRAC has been carrying out national health workforce accounts (NHWA) and workload
indicators for staffing needs (WISN).

The National Health Workforce Accounts (NHWA) is a system by which countries progressively
improve the availability, quality, and use of data on the health workforce to support the achievement
of UHC and Sustainable Development Goals (SDGs). KHHRAC received technical and financial
support from the WHO to implement the third round of NHWA in the Country in 2022. The Council
strengthened the governance structures with technical working groups and stakeholders’ forums
towards progressive improvement. Training for County Human Resource Management Officers for
Health (HRM), County Health Records Information Officers (CHRIOs), and officers from National
Referral Facilities on NHWA and Integrated Human Resource Information system (iHRIS) was
conducted. The progressive update and improvements of iHRIS for NHWA have enabled Kenya to
report on the WHO platform for the last three years since 2020. KHHRAC held a Chief Officers Forum
and a Multi-Agency stakeholder forum to disseminate the findings.

Integrated Human Resource Information System (iHRIS), through the support of partners USAID,
Global Fund, and PFMR undertook the training of the 47 County Human Resource and Health Records
Information Officers on the Integrated Human Resource Information System tool to capacity-build
them on in-depth data analytics which has enabled counties to update the system and develop County
health workforce data profiles and dashboards for improved data for decision making.

Workload Indicators for Staffing Needs (WISN) is a human resource planning and management tool
that gives health managers a systematic way of making staffing decisions. During the period under
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review KHHRAC made major steps towards the implementation of WISN. KHHRAC steered the
development of the WISN Implementation roadmap; training of two Expert Working Groups;
identification of the Workload Components and development of Activity Standards of each of the
health professional cadres which were prioritized. Sampling of the Health facilities in which the Data
Collection will be done was also done as was the development of the Data Collection Tools. Piloting
of WISN was done in Mombasa County. Further, KHHRAC undertook training of human resource
officers from all 47 counties on WISN.

KHHRAC planned to have a centralized database that records captures and manages information about
healthcare professionals. The goal is to uniquely identify all health care workers providing health care
services in Kenya thus enhancing the quality of care and efficient use of resources to support the
development of a skilled workforce and accelerate UHC.

iv. Kenya Medical Practitioners and Dentists’ Council (KMPDC)

The Kenya Medical Practitioners and Dentists Council (KMPDC) is a body corporate established under
Section 3 of the Medical Practitioners and Dentists Act (CAP 253 Laws of Kenya) with the mandate
to regulate the training and practice of medicine, dentistry and community oral health within the
Republic of Kenya. The Council is also mandated to regulate all health facilities within the country.
Further, the Council is categorized by the State Corporations Advisory Committee (SCAC) as a
‘Regulatory State Corporation’, under Category PC 6A.

Kenya Medical Practitioners and Dentists Council (KMPDC) has been able to achieve most of its set
targets and has made significant progress in various areas. The digitization of the practitioner's license
renewal process and increased awareness are undoubtedly positive developments. This not only
streamline the process but also offers greater convenience to practitioners.
The success in routine inspections and the determination of malpractice cases is also a positive sign.
This is attributed to increase in Disciplinary and Ethics Committee hearings and ensuring ethical and
professional standards in the medical and dental fields are adhered to.
However, the underachievement in the number of new health facilities registered and licensed
highlights some challenges that needs to be addressed. These challenges include lack of personnel,
logistic challenges and dependence of other Government agencies for joint inspections.

v. Nursing Council of Kenya (NCK)

The Nursing Council of Kenya (“NCK”) is a regulatory body under the Ministry of Health established
under Section 3 of the Nurses and Midwives Act Cap 257, Laws of Kenya.
The Council’s mandate is to make provision for the training, registration, enrolment and licensing of
nurses and midwives: to regulate their conduct and to ensure their maximum participation in the health
care of the community and for connected purposes.
Nursing Council of Kenya was categorized by State Corporation Advisory Committee (SCAC) as a
State Corporation PC 6B. This was achieved in the last F/Y 2020/2021 and the preparation of the
Human Resource instruments as advised by SCAC has been finalized and approved.
The functions of the Council are:

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 • To establish and improve standards of all branches of the nursing profession in all their
aspects and to safeguard the interests of all nurses;
• To establish and improve the standards of professional nursing and of health care within
the community;
• With the approval of the Cabinet Secretary, to make provision for the training and
instruction for persons seeking registration or enrolment under this Act;
• With the approval of the Cabinet Secretary, to prescribe and regulate syllabuses of
instruction and courses of training for persons seeking registration or enrolment under this
Act;
• To recommend to the Cabinet Secretary institutions to be approved institutions for training
of persons seeking registration or enrolment under this Act;
• With the approval of the Cabinet Secretary, to prescribe and conduct examinations for
persons seeking registration or enrolment under this Act;
• To prescribe badges, insignia or uniforms to be worn by persons registered, enrolled or
licensed under this Act;
• To have regard to the conduct of persons registered, enrolled or licensed under this Act,
and to take such disciplinary measures as may be necessary to maintain a proper standard
of conduct among such persons;
• To have regard to the standards of nursing care, qualified staff, facilities, conditions and
environment of health institutions, and to take such disciplinary or appropriate measures as
may be necessary to maintain a proper standard of nursing care in health institutions
• To direct and supervise the compilation and maintenance of registers, rolls and records
required to be kept under sections 12, 14 and 16;
• To advise the Cabinet Secretary on matters concerning all aspects of nursing
• To advise the Cabinet Secretary on any matter falling within the scope of this Act.

The main objective of the Performance Review Report (PRR) is to inform the budget process by
reviewing budget implementation progress in previous periods and using the lessons learnt for future
expenditure decisions. The Council PPR will be used to determine MTEF budgetary allocations by
assessing whether value for money has been obtained in previous allocations, which programmes are
to be given priority. This is expected to contribute towards an efficient and effective way of allocating
resources towards realization of the objectives and UHC.
Delivery of outputs during the period under review
• The Council achieved the targets set in the following core mandate activities in
collaboration with the Ministry of Health, State Corporation Advisory Committee, other
health regulatory bodies and the state Department for Public service among other key
stakeholders:
• Education and Examination: During the three years under review the council was able to
conduct nine (9) Nurses & midwives licensure examinations, where a total of 30,560
undertook in the exams with a percentage pass rate of 75% and indexed a total of 29,403
nurses and midwives. The council reviewed all training Curricula which were due for
review during the same period.

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 • Standards and Compliance: The Number of nurses and midwives privately practicing rose
to 744. The current streamlining of regulation of private practice in the health sector is
expected to further increase the number of new applicants as well as renewals. The Council
inspected one hundred and forty-four (144) Health facilities for nurses and midwives’
clinical placements.
• Registration and Licensure: During period under review, the Council registered 19,022
nurses and midwives who applied for registration. Under the same period the council
licensed 143,801 nurses and midwives who applied for registration. In addition, the council
achieved 100% of BSNs presented by Ministry of Health for attachment placements.
• Technological Integration: Digitization and digitization of all services, which has improved
service delivery, 95% of all NCK services and operations are done online. This has
improved efficiency and reduced turnaround time in service delivery.
• Policies, regulation and guidelines: Over the last three (3) years the Council has been able
to develop various policies, regulations and guidelines to support Universal Health
Coverage (UHC) agenda. The policies, regulatory tools, developed and being implemented
are:
 Developed and reviewed regulatory tools and guidelines to ensure standards of
nursing and midwifery practice are maintained. Scopes of Practice (Developed 13
for both general and specialty areas); Revised Code of Conduct and Ethics and
Procedure Manuals
 Developed and operationalising the Nurses and Midwives (Fitness to Practice)
Regulations, 2022;
 Data Protection; Alcohol and Drug Abuse; Business Continuity Management and
Disaster Recovery; Gender Mainstreaming; Gender Based Violence; Corruption
Prevention; Whistle Blowers’; Road Safety Mainstreaming; and Continuing
Professional Development (CPD) Guidelines.
 Developed the Nurses and Midwives (Private practice) Regulations, 2022 that is at
approval stage before publication.

To ensure services have been devolved the Council has operationalized four (4) regional offices, thus
making its services easily accessible in Coast, Nyanza, Central and Rift valley regions. The Council
achieved ISO 9001: 2015 Quality Management Systems Certification (2022).
Bilateral Agreements on Immigration of Nurses and midwives: During the period through the Kenya-
UK BLA, the Council was able to take 128 nurses and midwives in UK, who are currently employed.

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Figure 9:Cabinet Secretary, MOH Flagging-off of Nurses to the United Kingdom

vi. Public Health Officers and Technicians’ Council (PHOTC)

The Public Health Officers and Technicians Council is a statutory body established by the Public
Health Officers (Training, Registration, and Licensing) Act No. 12 of 2013 to regulate the training,
practice, and employment of Public Health Officers and Technicians and to advise the Government in
relation to all aspects thereof PHOTC specific mandate is to exercise general supervision and control
over the training, practice, and employment of public health officers and technicians in Kenya and to
advisory to the Government.

The Council achieved the targets set in the following core mandate activities in the business process
as follows:
• Standards and Compliance: During the period under review the council Inspected 12 new
training institutions and re-inspected 4 universities and 5 middle-level colleges. In addition,
the council collaborated with other regulations and conducted joint health facility
inspections across the county for approximately 224 health facilities.
• Registration and Licensure: The council gazetted a total of licensed public Health
officers/Technicians total of 7114. During the period under review, the total number of
professionals registered rose with a total of 2,678 professionals. This was 40% growth for
the period under review.
• Online service provider Integration: The council improved its services by ensuring
Digitization and digitization of all services. This increased the service provision by 60% to
the professionals.
• Education and Examination: During the period under review the council was able to
conduct 2 examination cycles per year. For the three years, the total examined were 2345
candidates with total indexed students of 3123 students. The council accredited 5 internship
centres for maximum exposure of interns during the internship.
• Professional Development and Growth: for the period under review the council was able to
sensitize, create awareness, appoint regional CPD Focal persons to implement CPD uptake,
and increase the number of CPD providers. Additionally, conducted 1st International Public
Health Conference.

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Critical Challenges
• During the period under review to implement the core, mandate the council was
incapacitated due to a lack of resources to execute the business processes.
• Having Insufficient Human resources at the council, the current staff is incapacitated to
meet the mandate and the tasks in accordance with the performance contract.
• The council's relevant pending approval for policies, regulations, and legal instruments to
formalize and legalize business processes of the council such as regulations for public
health inspection of health institutions regulations, 2020.
• Dependence on the government institutions' subsidy on the rent for the office workspace
among other infrastructure related to public health professional assessment.
• Insufficient enforcement task force leads to extremely low renewal rates among registered
professionals, with insufficient enforcement mechanisms.

Sub – Programme 2.2: Research and Innovation

Kenya Institute of Primate Research (KIPRE)

Kenya Institute of Primate Research (KIPRE) has achieved significant milestones, contributing to the
advancement of healthcare and research. In the area of preclinical evaluations, KIPRE conducted
assessments of 29 candidate drugs and vaccines for major infectious diseases, focusing on efficacy and
safety. Additionally, the institute played a crucial role in early warning for emerging infections by
testing 10,240 zoonotic samples, supporting preventive and promotive health efforts.

KIPRE's snakebite intervention program made a substantial impact through 128 field snakebite rescue
missions. These missions resulted in the successful rescue of 356 snakebite victims across various
Counties, including Kitui, Samburu, Turkana, Baringo, West Pokot, and Narok. The institute's
commitment to infrastructure development is evident in the completion of the Archives, Ablution
block, and Resource centre. Furthermore, an ongoing initiative involves the construction of a perimeter
fence.

Programme 3: General Administration, Planning and Support Services

Sub-Programme 3.1: Health Standards and Quality Assurance

Antimicrobial resistance threatens the effective prevention and treatment of an ever-increasing range
of infections caused by all disease-causing organisms including bacteria, parasites, viruses and fungi.
The WHO has declared AMR as one of the top 10 global public health threats facing humanity. During
the period under review (FY 2020/21-2022/23), the Ministry put several measures and interventions
in place to prevent and contain AMR. Key policy documents were developed including the National
Action Plan for containment and prevention of antimicrobial resistance (2021), National
antimicrobial stewardship guidelines for health care settings in Kenya (2021) and the Patient and
healthcare worker and quality of care policy (2022). The Ministry strengthened the capacity of 17
public health laboratories to detect and report on antimicrobial resistance from 2020/21-2022/23
FYs. Within the period under review, Multisectoral AMR coordination structures have also been
established at both 92
national (National Stewardship Inter-Agency Committee-NASIC) and in 24 county levels to oversee
the implementation of the AMR National Action Plan and Policy with an aim to reduce morbidity and
mortality due to resistant microorganisms.

The Ministry, through the Infection Prevention and Control Program-IPC, is implementing has
prioritized implementation of interventions aimed at preventing harm caused by infections to patients
and health care workers. Within the period FY 2020/21-2022/2023, Key policy documents on IPC
were developed including the National Infection Prevention and Control Policy (2021), the National
Infection Prevention and Control Strategic Plan (2021-2025) and the National Infection Prevention
and Control in the context of COVID-19, (2021). The Ministry, in collaboration with implementing
partners, also strengthened the management, leadership, and governance of IPC services through
establishment and strengthening Infection Prevention and Control (IPC) Committees both at the
National and county levels. County IPC coordinators were also appointed in all 47 counties to provide
leadership and coordination of IPC measures.

The Ministry is implementing the Quality-of-Care Certification Framework that defines the process of
ensuring delivery of quality health services to the Kenyan population. This has been achieved through
implementation of the Kenya Quality Model for Health (KQMH) which is designed to guide and
facilitate quality improvement through regular assessment for quality of health services delivery.
Within the period under review, all 47 County Health Management Teams (CHMT) and hospital
management teams were trained on Kenya Quality Model for Health (KQMH) and are able to assess
quality of care using KQMH tool. In the FY 2022/23, a total of 109 health facilities were assessed
using KQMH standards compared to 50 health facilities assessed in the previous financial year. To
ensure institutionalization of quality improvement initiatives in provision of health services within the
counties, three quality of care coaches in each county have been identified and capacity built. Quality
Improvement Teams have been set up in the counties and health facilities and are continuously
mentored in continuously improving the quality of health care. One hundred and forty (140) county
health inspectors from all counties were also trained to assess health facilities on compliance to quality
and patient safety standards using Joint Health Inspection Checklist. The county health inspectors
conduct routine inspection of health facilities in their respective counties under the coordination of
Kenya Health Professions Oversight Authority and also other regulatory agencies.

Sub-Programme 3.2: Human Resource Management and Development

Health workforce is a critical building block in every health system and is key to achieving universal
health coverage. Within the period under review, the State Department of Public Health and
Professional Standards recruited 8,580 health care workers who were deployed to the counties to
strengthen quality service delivery for universal health coverage. In 2021/2022 FY, the Ministry of
Health in collaboration with its key stakeholders, conducted the Health Labour Market Analysis
(HLMA) whose findings informed significant policy shift that being utilized to improve health service
delivery. The report will also guide investments in Kenya’s health workforce. Within the same period,
the National Health Workforce Account (NHWA), A World Health Organization (WHO) supported
human resource for health information system for decision making, was updated. To mitigate the

93
negative effects of health worker migration to foreign countries, the Sector developed a draft health
worker migration policy which was later incorporated into the National Labour Migration Policy. In
the FY 2022/2023 the MOH On-boarded 6, 248 Interns of various cadres as shown in the table below
for a one-year program.

Table: Programme Deployments FY 2022-2023, State Department of Public Health and

Professional Standards

S/No. Cadre Number

1 Clinical Officer Interns (Dip.) 2207
2 Clinical Officers (BSC & OPTH) 794
3 Nurses 995
4 Nursing BSCN 879
5 Dental officer interns 56
6 Pharmacist Intern 431
7 Medical Officer Intern 886
TOTAL 6248

Sub-Programme 3.3. Health Administration

To support evidence generation for resource mobilization, the Sector undertook the Kenya National
Health Accounts (NHA) to track the flow of funds in the health sector for the FY 2016/17-2018/19.
National Health Accounts (NHA) is an important tool for understanding the financing of a country’s
health sector, providing a framework for measuring the total public and private health expenditures.

Programme 4: Health Policy, Standards and Regulations

Sub-Programme 4.1: Health Policy, Planning and Financing

The Ministry is in the process of developing an end-to-end digital health platform. Local developers
were identified, and a landscape assessment of the digital health platform was conducted, and a report
is available. The business requirement framework, business logic/intelligence and workflows were
developed. The out-patient modules and one vaccination module (Chanjo System) were also
developed. Inpatient and specialized clinics modules are yet to be developed.

Sub-Programme 4.2: Health Standards and Regulations

The Ministry takes lead in setting norms and standards for the health sector. Within the period under
review, The Norms and Standard for health Service delivery were developed. Clinical Guidelines for
management and referral of common health conditions were also developed (2022/23 FY). Review of
the Kenya Essential Package for Health guideline was done and awaits finalization. Clinical Guidelines
and the Kenya Essential Package for Health.

The Ministry has continued to strengthen the legislative and regulatory framework for the health sector.
Within the period under review, key legislation was developed including the National Health Insurance
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Fund (Amendment) Act, 2022 and the Mental Health (Amendment) Act, 2022. Within the same period,
key legislation was also developed and assented into law, including the Digital Health Act 2023, the
Primary Health Care Services Act 2023, the Social Health Insurance Act 2023 and the Facility
Improvement Fund Act 2023. The Ministry also reviewed several proposed legislations from
Parliament e.g., the Kenya Drugs Authority Bill, 2022, Health (Amendment) Bill, 2022 and cancer
prevention and control (Amendment) Bill, 2022.

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 Table 2. 1: Analysis of Programme Planned Targets and Achieved Targets

STATE DEPARTMENT OF MEDICAL SERVICES

Programme Delivery Unit Key Outputs KPI Planned Target Achieved Target Remarks
2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
PROGRAMME NAME: Curative and RMNCAH
OUTCOME: Increased access to quality promotive and preventive health care
SP 1.1 National AIDS HIV Prevention and Number of adolescents and young people 1,200,000 350,000 1,250,000 294,058 723,755 10,479,542.00 The ongoing 'End the Triple Threat among adolescents,
Communicable Control Council Management reached with HIV prevention and SRH World's AIDs Day and Condom Day campaign increased
disease control (NACC) Services information through peer-to-peer approach message reach to adolescents and young people
Number of men reached with information on 605,000 300,000 610,000 226,021 361,176 805,569 Leveraging Community of Practice (CP) under LISTEN
HIV prevention and SRH and UHC Program lead by male champions more men were reached with
information HIV and AIDS information
Number of PLHIV networks sensitized on 35 150 38 135 205 168 Integrated discussions on NCDs and HIV during sensitization
Non-Communicable Diseases of PLHIV on their rights in Meru and Mombasa. Discussions
also highlighted on integration of services especially for those
with co-morbidities
Number of condom dispensers installed in 610 1,000 630 921 3,800 352 Installation of condom dispensers in FY 2022/23 was not
non-health settings achieved due to reduction in distribution of user free condoms
Number of condoms distributed in non-health 13,000,000 20,000,000 15,000,000 40,393,996 6,451,258 5,871,526 Target not achieved due to national and global supply chain
settings challenges of essential commodities including condoms.
Number of people reached with HIV 10,000,000 26,000,000 11,000,000 25,000,000 51,175,630 82,433,925 Target was surpassed due to Townhall meetings in Counties,
prevention and UHC messages via different during World's AIDs Day and Condom Day targeting to reach
platforms. people with information on HIV, Sexual and gender based
violence (SGBV) and reproductive health. Media coordination
and extensive coverage of Triple Threat stories in the
mainstream media in four counties.
No of counties reached through Beyond Zero 7 3 10 3 9 6 A medical safari was conducted at Tudor Sub County Hospital
medical safaris clinics in Mombasa, lower Kabete in Nairobi, Marsabit, Isiolo,
Mandera and Turkana
Number of MDA s reporting on Maisha 320 320 323 303 305 297 Inconsistent and late reporting by MDAs affected the reporting
Certification system average for all the 4 quarters
Number of Infrastructure projects 50 50 90 83 59 36 The 9 HIV Programme were implemented during the quarter.
implementing Health and HIV prevention This will repeat in every quarter throughout the financial year
Programmes (Road, Energy, Water and
Irrigation, Housing)
Number of thematic modules introduced into 4 4 5 4 4 2 The recent upgrade of the Kenya Health Information System
the Situation Room (KHIS) caused misalignment of the Application Programming
Interfaces (APIs) that export data to the Situation Room
system. As a result, some of the modules in the Situation
Room were affected and the data displayed in its dashboards
was inaccurate. The team is currently working to rectify this
issue and further modules will be added to the Situation Room
once it is resolved.
Number of organizations reporting through 1,700 1,700 1,000 1,290 1,247 136 Due to insufficient funding, there are discrepancies in how data
the CAPR system is reported, leading to a lack of uniformity. These issues can
cause problems for those relying on the accuracy of the
information. To ensure accuracy and consistency, additional
resources must be put in place
No of mathematical modelling projects 2 3 0 1 3 2 The annual HIV Estimates for 2023 have been completed.
conducted Epidemic appraisal to support development of Kenya Modes of
Transmission is still ongoing.
Number of Counties supported to develop HIV 13 1 0 13 10 47 Mid term review of county plans has been completed in all the
related policies counties. The over achievement was due to the timely
evaluation of the CAIPs midway
NASCOP Number of people Currently on ART 1,254,800 1,254,840 1,287,890 1,255,598 1,299,152 1,330,565 The target surpassed due to implementation of test and treat
strategy for clients who test HIV Positive, MOH and partners

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Programme Delivery Unit Key Outputs KPI Planned Target Achieved Target Remarks
2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
HIV Prevention and efforts in minimizing likelihood of loss to follow up, (Loosing
Management clients initiated to ART due to various reasons) and deaths.
Services Number of targeted HIV tests amongst high- 8,686,470 8,234,360 7,632,170 4,969,514 4,012,492 4,241,677 Delayed procurement and distribution of HIV rapid test kits to
risk populations the service delivery points.
Number of HIV Positive Identified 182,410 190,800 125,854 103,099 91,093 Delayed procurement and distribution of HIV rapid test kits to
189,390 the service delivery points.
Estimated percentage of children newly N/A N/A 8.4 8.3 8.9 8.6 The variance is attributed to ANC Coverage testing rates,
infected with HIV from mother-to-child enrolment to HAART, Adherence and EID Testing for
transmission among women living with HIV children. There was a shortage of commodities as well
delivering in the past 12 months
Percentage of HIV pregnant women who 94 95 98 95% 93% 94% The variance is due to women opting out of treatment for
received HAART in ANC, PNC and Labor and various reasons. A lot of effort in both public and private
Delivery sector in Behavior Change.
SP 1.2 Non- Cancer Cancer Prevention Number of women of reproductive age 369,380 400,000 500,000 328,852 670,109 344,576 The drop in screening attributed to change in reporting tool
Communicable Programme Services screened MOH 711 to MOH 745, lack of adequate human resources at
diseases NCCP to support program activities.
Number of Primary health care workers trained 500 2800 3,000 2,600 6,300 6,805 The target was surpassed due to Global Fund supported
trainings and sensitization through webinars.
Comprehensive Number of regional cancer centres 3 3 4 3 3 2 In the FY 2022/23 under review, two centers in Nakuru and
regional cancer Garissa were launched and are operational. Two other centers
centers established were at procurement stage.
National Cancer Public education in Number of people reached with cancer 5,000,000 8,000,000 15,000,000 5,810,591 14,000,000 19,800,000 Target was achieved. The Institute held various forums that
Institute Kenya cancer prevention Prevention & Control messages acted as platforms to reach Kenyans with messages on cancer.
and control The initiatives included: - The Cancer Summit; The World
Cancer Day; and Cancer Survivors Day. Further, NCI-K
enhanced messaging on mainstream media and social media
including vernacular FM Stations and HUDUMA Mashinani
Caravans to educate the public.
Partnerships in Proportion of counties with county specific N/A N/A 10% N/A N/A 10% Target was achieved. Five Counties namely Kakamega;
cancer prevention cancer control frameworks Mombasa, Nakuru, Machakos and Nyeri were supported to
and control develop County-Specific Cancer Action Plans
Number of MDAs trained to implement 8 9 22 9 12 44 Target was surpassed as MDAs including Teachers Service
Workplace Cancer Prevention and Control Commission and Ministry of Interior and Coordination of
Programs National Government, State Department for gender; Children
department; MOH; MOE; HUDUMA Kenya; NACC and
NCPD were sensitized and trained on Workplace Cancer
Prevention and Control Programs.
Number of Cancer Care Centers certified N/A 20 30 N/A 58 78 The target was surpassed due to an increase in demand for
designation by the cancer treatment facilities. Major Facilities
including Avenue hospital Kisumu; Bosongo Medical Centre;
Garissa County Referral; Tawfiq Hospital; Fairfield Medical,
Cancer Centre of Excellency Limited and Salama care were
certified. Two facilities namely Cancer Care International and
Ladnan hospital were inspected but awaiting certification after
they put in the minimum requirements.
Quality assurance Proportion of cancer treatment facilities that 15 19 5 19 57 5 Target was achieved. Five facilities were inspected and were
in cancer care have met the minimum standards of care confirmed to have met the minimum standards of care they are
services awaiting official certification by NCI-K.
Cancer data and Number of policy briefs generated from cancer N/A N/A 3 N/A N/A 0 Target not achieved. However, the policy briefs are still being
research to inform data and research generated in consultation with relevant stakeholders for
policy and practice finalization. This will be finalized in the FY2023/24.
Cancer information Number of cancer registry hubs established 12 17 8 13 21 8 Target was achieved.
platforms
established in
national and county
levels

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Programme Delivery Unit Key Outputs KPI Planned Target Achieved Target Remarks
2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
Mental Health Health Care Number of Health Care Workers trained 10,000 10000 1,000 1,195 786 1,591 We were able to exceed our target in FY 2021 & 22/23, due to
Unit Workers Trained on integration of mental health in Covid 19 and Ebola
Mental Health and Preparedness and response.
Psychosocial
support
Community Health Number of community health workers trained N/A 500 700 N/A 120 75
Workers trained on
mental health Targets not achieved due to insufficient Funds
Interventions
Kenya Board Of Inspection of Number of inspections done. N/A N/A 1 N/A N/A 0 The board was not in place in FY 20/21 & 21/22.
Mental Health Mental health units Unable to achieve target for FY 22/23 due to lack of funds.
and facilities
offering mental
health services
Report on status of Quarterly report on state of mental health in N/A N/A 1 N/A N/A 0 The board was not in place in FY 20/21 & 21/22.
Mental health in the the Country. Unable to achieve target for FY 22/23 due to lack of funds.
Country
Non- TOTs trained on Number of TOTs trained 500 1500 500 498 87 0 The target was not achieved due to inadequate funds.
Communicable Diabetes and
Diseases Cardiovascular
(NCD)Prevention Diseases prevention
and Control Unit and management
Nation NCDs STEPWISE survey report 1 1 0 1 0 0 There was lack of funds. Plans underway to undertake the
STEPWISE Survey STEPWISE Survey.
conducted
Diabetes and Number of diabetes patients receiving 100,000 150,000 226,310 113,099 142,223 179,028 The target not achieved due to incomplete reporting secondary
hypertension treatment to Hypertension and Diabetes tools and inadequate capacity
curative services among Health Care Workers (HCW) to utilize the revised
reporting tools, financing for NCD's (out of pocket expenditure
limiting access), inadequate human resources to support the
unit.
Number of hypertensive patients receiving 150,000 250,000 1,100,000 186,000 240,000 513,805 The target not achieved due to incomplete reporting secondary
treatment in Millions to Hypertension and Diabetes tools and inadequate capacity
among Health Care Workers (HCW) to utilize the revised
reporting tools, financing for NCD's (out of pocket expenditure
limiting access), inadequate human resources to support the
unit.
Community Health Number of Community Health Volunteers 285 400 1500 232 1151 1191 Inadequate Financial resources to train more community health
Volunteers trained trained promoters
on Diabetes and
CVDs prevention
and control
Violence and TOTs trained on Number of TOTs trained 75 100 200 50 50 202 The target was surpassed to training of TOTs in the following
Injuries trauma prevention counties: Makueni, Machakos, Kajiado, Nairobi and Nakuru
Prevention and and care counties
Control Division Community Health Number of CHVs trained 0 1500 3500 500 0 200 Inadequate Funding
Volunteers trained
on prevention and
control of violence
and injury
Geriatrics Functional Number of functional workplace wellness 1 1 1 0 0 0 The wellness centre established; however, it is currently
Medicine workplace wellness programs operating sub-optimally (Weight, height and BMI readings
programme taken for members at MOH) Plans are ongoing to incorporate
established at more services.
Ministry of Health
Guidelines on Guideline on Physical Activity, Healthy Aging 1 0 1 0 1 0 The guideline was developed in FY 2021/22
Physical Activity, and Older Persons developed and available
Healthy Ageing and

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Programme Delivery Unit Key Outputs KPI Planned Target Achieved Target Remarks
2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
Older Persons
developed and
disseminated
Rapid geriatric Number of RGAs conducted 200 1000 1300 0 1200 0 Target not met due to inadequate resources
assessment (RGA)
conducted on
Geriatric patients
SP 1.3 Department of Family Planning Proportion of Women of reproductive age 50 50 55 43 52.4 74 Source DHIS2: Coverage increased due to availability of
Reproductive Family Health Services receiving FP commodities stocks and the introduction of the integrated LMIS which
Maternal improved the supply chain efficiency. GOK procurement of FP
Neonatal Child commodities happened in FY 22/23.This is expected to result
and Adolescent in decline in coverage.
Health Maternal Neonatal Proportion of pregnant women attending at 60 57 57 52.1 52.8 51.9 The adoption of the 8 ANC contacts to be rolled out.
and Child Health least 4 ANC visits
Services Proportion of women receiving post-natal care 52 50 50 12 12 37.9 Data quality issues have been identified. Clarity on period for
within 2-3 days of delivery required data in the indicator description to be within 48hours.
Number of MCH books distributed in Millions 2.2 0 2.2 0 0 0 Process for procuring for 2.2m books 2022-2023 on-going
printed by MOH
Facility based maternal mortality rate per 100 103 100 103 110.3 86 Samburu County was exempted due to data quality issue.
100,000 deliveries However, there’s need to carry out an audit and
recommendations from the audit to be implemented.
Number of facilities based neonatal deaths per 12 23 11 23 9.3 10 A slight improvement noted due to scaling-up of high impact
1000 live births interventions, supplies and equipment, capacity building of
essential newborn care, development and rolling out of quality-
of-care standards, data reviews meetings, improved technical
assistance to counties
Proportion of Vitamin A Supplementation 62 80 80 82 86 83.3 The target achieved due availability of commodities, partner
(VAS)coverage support, community mobilization during Malezi Bora activities
(May & November) covering all ECDs
Number of Pre-school and school going 6 6 6 2.6 5.4 4.5 In 2023 there was change in strategy in which some of the
children de-wormed in Millions counties with low prevalence of Soil transmitted Helminthes
and Schistosomiasis were not covered
SP 1.4 Division of Vaccines Proportion of fully immunized children (Proxy 84 84 86 84 88 84.7 There has been a decrease in Fully Vaccinated Children due to
Immunization National and Penta 3) vaccine shortage.
Management. Vaccines and Immunization Proportion of Health Facilities with Functional 90 92 94 88 88 85 The cold chain spare parts are expensive and not readily
Immunization Services Cold Chain Equipment available in the country. The last time the parts wee procured
program was in 2018, and National level have been assisting county in
repairs. World bank has provided funding for maintenance of
the equipment.
Number of Covid 19 vaccines doses 9 37.6 9 370,465 18,841,001 24,699,468 The figures represent total Covid 19 Vaccines (Dose 1)
administered(millions) administered, dose 2 and boosters to both adults and teenagers.
The numbers have been slightly increasing.
Proportion of fully immunized adults 17 100 100 1.4 32 38.4 Kenya has fully planned to vaccinate 19 million adults (70%
of the adult population by end of June 2022 and the entire
population of 27million people by the end of December
2022.Since WHO declared the end to Covid 19 as a global
health emergency.
SP 1.5 Primary Division of Functional Number of Functional CHU's 9513 9513 8663 8663 8772 9867
Health Care Community Community Health >100% achieved Counties opened up more CHU's towards
health services Units UHC roll out. As at end of June 2023, there was 9,967
(CHU's)established functional CHU's in the Country.
Collection and Number of Counties using e-CHIS to collect 0 5 5 0 2 5 10.6% Five Counties have (100%) achievement namely:
reporting of and report data on KHIS Kisumu, Kakamega, Siaya, Vihiga and Migori Counties.
community health
data strengthened

99
Programme Delivery Unit Key Output Key Performance Indicators Planned Target Achieved Target Remarks
2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
Programme 2: National Referral Facilities and Specialized services
Programme Outcome: Increased access and range of quality specialized health care services
S.P 2.1 National Kenyatta Specialized health Number of Heart surgeries done 326 Target surpassed due to acquisition and installation of heart
Referral Health National care services 150 359 395 465 627 lung machine, allocation of additional dedicated theatre as well
Services Hospital as training of specialized personnel. Conducted 3 heart surgery
projects in collaboration with international partners
Number of Other Cardiothoracic surgeries 931 Target surpassed due to acquisition of additional specialised
conducted 567 1,024 1,127 1,142 1,238 equipment and introduction of extended theatre operations as
well as operationalization of Ward 4B Critical Care Unit
Number of Kidney Transplants conducted 7 Screening, identification and preparation of patients for Kidney
25 15 20 16 19 transplant was conducted and a total of 19 Kidney transplants
have been undertaken and 304 patients were screened and
prepared for transplantation.
Number of minimally invasive surgeries done 5,232 Target achieved. Key activities undertaken including training
4,849 5,756 5,956 6,044 6,113 thirty (30) personnel on use of equipment for minimal invasive
surgeries, procured and operationalized three laparoscopic
towers at general surgery, Urology and orthopedics
Number of patients undergoing specialized 534 Target not achieved. The target was not met hence the hospital
Burns treatment (OBD) 575 544 589 553 524 has initiated RRI for reduction of ALOS and allocation of
additional specialised dedicated theatre
Number of cancer patients on (Chemotherapy 39,971 Target not met due to the decommissioning of two
and radiotherapy 48,113 41,970 44,068 38,639 37,772 radiotherapy machines (Equinox and Cobalt 60). The
Implementation of the Equipment Replacement Plan is
ongoing whereby a brachytherapy machine has been installed
and operationalized. Installation of a new Linac machine and
two (2) bunkers is ongoing.
Health Research Number of new Research Projects 16 Target surpassed. The hospital has expanded the knowledge
disseminated disseminated 16 17 18 18 34 repository and provided a platform for research mentorship
program.
Average waiting ALOS for trauma patient’s (days) 39 Target not met due to the nature of our patients. The hospital
time for specialized 32 36 36 40 38 has initiated RRI for reduction of ALOS and allocation of
diagnostic and additional specialized dedicated theatre
treatment services Average waiting time (days) for radiotherapy 21 Target not met due to the decommissioning of two
reduced 20 20 19 18 22 radiotherapy machines (Equinox and Cobalt 60). The
Implementation of the Equipment Replacement Plan is
ongoing whereby a brachytherapy machine has been installed
and operationalized. Installation of a new Linac machine and
two (2) bunkers is ongoing
Average waiting time (days) for chemotherapy 27 21 17.5 Target met. The hospital Introduced 24-hour in-patient
21 19 18 chemotherapy services and Operationalized two (2) satellite
pediatrics chemotherapy centres. In addition, specialised teams
and strict adherence to NHIF booking model established.
Outreaches Number of outreaches conducted 344 Target met. The outreaches were conducted 122 physically and
conducted 70 61 67 381 391 269 webinars to various counties
Mentorship and Number of staff under preceptorship N/A N/A Target not met due to government austerity measures on
preceptorship for 50 32 53 14 training
specialized health Number of Youth Internships/Industrial 1,731 Target met. A virtual conferencing model and creating a
personnel Attachment/ Apprenticeship provided 1,650 1,818 1,999 1,904 2,766 multidisciplinary team of facilitators was established as well as
conducted introduction and expansion of additional specialised services.
Mwai Kibaki Specialized health Number of minimally invasive surgeries done 1,398 Target surpassed due operationalization of the maternity
Hospital care services 1,398 1,468 1,541 1,698 1,907 theatre, engaged specialists in obstetrics, orthopedics and
ophthalmology
Average waiting time for chemotherapy 12 Target surpassed. Implemented sessional consultancy for
services (days) 15 14 12 7 8 oncology unit and introduced framework contracts for
oncology medicines.
Number of dialysis sessions conducted 778 Target met. However, machine breakdown during the year
550 856 3,323 4,025 3,514

100
Programme Delivery Unit Key Output Key Performance Indicators Planned Target Achieved Target Remarks
2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
Average length of stay for orthopedics surgery 12 Target not met. Most of the Orthopedics patients admitted
(days) 15 14 14 18 15 needed multi-disciplinary intervention and inability to pay.
Number of specialized clinics 16 Target not met. The Hospital is in the process of hiring a
9 18 20 21 17 nephrologist, plastic specialist and neurosurgery specialist.
Number of screening sessions for NCDs N/A N/A Target surpassed. NCD sessions were incorporated in the
2 3 7 7 medical outreaches and attended to 2,902 clients.
Health Research Number of research projects on health N/A N/A N/A N/A Target not met. However, the hospital has established, staffed
disseminated disseminated 7 1 and operationalized the research department.
Mentorship and Number of youth internships/industrial N/A N/A N/A N/A Target met due to high demand of students seeking for
preceptorship for attachments/apprenticeship 130 153 attachment and internship. Signed MoUs with training
specialized health institutions.
personnel
conducted
Multi-disciplinary Number of specialized multi-disciplinary N/A N/A N/A N/A Target met. Conducted 15 physical outreaches across the Mt
outreaches to outreaches 15 15 Kenya region.
sensitize facilities
and the public
conducted
Policies and Number of Policies developed N/A N/A Target met. Domesticated policies as per the approved KNH
strategies 5 6 7 6 manuals and guidelines.
developed Number of strategies developed N/A N/A Target met. The hospital domesticated the main hospital
- 2 1 2 culture change strategy and Reviewed KNH Othaya Strategic
Plan
Mama Margaret Specialized health Reduce case fatalities amongst admitted N/A N/A Target achieved. Conducted monthly mortality and morbidity
Uhuru care services Neonates 12.1 11.3 10.9 11.1 audits amongst neonates and implement recommendations
Reduce the case fatalities amongst admitted N/A N/A Target achieved. Conducted monthly CMEs on most prevalent
Infants 13.0 12.7 12.0 12.5 diseases that cause mortality
Number of new services N/A N/A Target surpassed. Introduced ENT, POPC, Maternal Child
11.0 12.0 10.0 13.0 Healthcare, Orthopedic technology, CCC, TB-Clinic, MCHFP,
Occupational Therapy, Physiotherapy and Orthopedic Trauma
services
Average length of stay N/A N/A Target achieved. Introduced three major ward rounds,
8.0 9.0 8.1 8.0 placement of laboratory equipment.
Health Research Number of new Research Projects N/A N/A Target not achieved. Structures to institutionalize research put
disseminated disseminated 1.0 2.0 - 1.0 in place.
Multi-disciplinary Number of specialized multi-disciplinary N/A N/A Conducted six outreaches across various sub-specialties i.e.
outreaches to outreaches 1.0 4.0 1.0 6.0 IPC, World club foot, TB day, diabetes.
sensitize facilities
and the public
conducted
Moi Teaching Average length of Average Length of Stay for Orthopedic 14 12 11.7 12 11.3 11.1 Achievement due to timely specialized diagnostic services,
and Referral stay reduced Surgery (Trauma Patients) Days adoption of 24 hrs. Theatres operations, consistent supply of
Hospital drugs and non-pharmaceuticals.
Average Length of Stay for Paediatric Burns 34.1 34.1 31.23 30.6 28.5 Achievement due to timely interventions to patients
Patients (Consultant’s daily ward rounds), availability of
drugs/supplies, and timely discharges.
No. of Kidney Transplants undertaken 16 17 18 8 18 18 Achievement due to continued screening & recruitment of
patients from the Clinics and Wards as well as investment in
Specialized HRH and Medical Equipment.
Specialized Number of Minimally Invasive Surgeries 1,463 2,500 2,700 2,226 3,118 3,202 Achievement due to continued screening & recruitment of
Healthcare Services patients from the Clinics and Wards as well as investment in
Specialized HRH and Medical Equipment.
Patients receiving oncology services- 16,024 17,120 16,600 16,395 17,536 19,622 Continued availability of Consultants at the Clinics &
Consultations & Treatment adherence to chemotherapy sessions schedules.
Number of Open-Heart Surgeries 39 40 44 8 56 92 Achievement due to continuous investment in specialized
Human Resources for Health (HRH), modern equipment,
drugs, and supplies.

101
Programme Delivery Unit Key Output Key Performance Indicators Planned Target Achieved Target Remarks
2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
Number of Corneal Transplants 9 10 11 9 12 15 Achievement is attributed to highly trained staff, corneal tissue
(imported), modern equipment, adequate drugs, and essential
supplies. MTRH is the only Public Hospital in Kenya doing
Corneal Transplants in Kenya
Number of Hemodialysis Sessions for Children 1,750 1,900 1,930 2,083 2,424 2,502 Achievement is attributed to the availability of highly trained
staff, modern equipment, adequate drugs, and essential
supplies. MTRH is the only Public Hospital in Kenya doing
Children's Hemodialysis.

Number of Cardiothoracic Surgeries 45 410 315 297 436 453 Achievement due to continuous investment in specialized
Human Resources for Health (HRH), modern equipment,
drugs, and supplies.

Health Research Number of Disseminated Research Papers on 12 22 24 12 21 120 Achievement is due to allocation of Research Fund (Intramural
disseminated Health Funds) by MTRH and other Research Grants through
Academic Model Providing Access to Healthcare (AMPATH)
Multidisciplinary Number of Multi-disciplinary Consultations 52 77 81 57 86 93 MTRH continues to undertake specialized multi-disciplinary
Consultations with Counties outreaches in Western Region Counties. This was done in
Conducted partnership with the County Health Services.
Youth internships/ Youth Internships/Industrial Attachment/ 3,380 3,390 3,395 2,822 3,508 3,602 The Hospital has ensured progressive involvement of youths in
Industrial Apprenticeship attachment & apprenticeships.
attachments/Appren
ticeships provided
Kenyatta Specialised health Number of Open-Heart Surgeries done The target was exceeded due to increased demand for the
3 4 18 7 13 35
University care services service
Teaching, Number of Kidney transplant undertaken Capacity building was undertaken for the transplants to start in
0 0 2 0 0 0
Referral and 2023/24
Research Number of minimally invasive surgeries done The target was exceeded due to increased demand for the
Hospital 135 150 750 120 735 1234
service
Number of patients receiving chemotherapy The target was exceeded due to increased demand for the
7500 18000 19,500 7,908 18,950 19,752
and radiotherapy Treatment service
Number of Hemodialysis Sessions conducted The target was exceeded due to increased demand for the
3200 6500 7,200 5400 6845 7840
service
ALOS for orthopedic patients’ (days) The target was exceeded as a result of improvement in service
15 16 14 16 15 11
delivery
ALOS (days) for elective general surgery The target was exceeded as a result of improvement in service
12 9 7 10 7 6
patients delivery
Number of specialized Gynecology procedures The target was exceeded due to increased demand for the
0 500 500 0 384 812
conducted service
Average waiting Average waiting time (days) for radiotherapy The target was not achieved due to the inability to meet the
25 17 18 18 20 28
time for specialized demand for radiotherapy services
diagnostic and Average waiting time (days) for Chemotherapy The target was exceeded due to increase in capacity by
21 21 17 21 18 2
treatment services introducing additional shifts
reduced Average turnaround time for oncology patients The target was exceeded due to increased efficiency
4 3 2 3 2 1
(hours)
Number of PET Scan examinations done The target was exceeded due to increased demand for the
0 0 3,000 0 0 3685
service
Number of SPECT CT-Scan examinations The target was exceeded due to increased demand for the
0 0 800 0 0 1570
done service
Number of Cyber-Knife procedures done 0 0 50 0 0 0 The equipment was installed and services to start in 2023/24
Number of Brachytherapy sessions conducted The target was exceeded due to increased demand for the
0 0 720 0 0 854
service
Studies & Research Number of research conducted & completed
1 2 3 2 2 3
conducted The target was met

102
Programme Delivery Unit Key Output Key Performance Indicators Planned Target Achieved Target Remarks
2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
Medical Number of Medical Outreaches and
Outreached and Mentorships conducted
mentorship 4 5 6 5 6 7 The target was exceeded as a result of successes in the camps
conducted held hence increased demand
Youth internships/ Number of Youth Internships/Industrial
Industrial Attachment/ Apprenticeship
attachments/Appren 30 100 260 85 247 327
The target was exceeded due to increase in number of requests
ticeships provided from universities and colleges
Diagnosis and Percentage of completion of Integrated
Cancer Treatment Molecular Imaging Center (construction and 50 100 N/A 80 100 N/A
Facilities equipping)
Developed Percentage of completion for the expansion of
the Cancer Center (Manu Chandaria 0 40 70 0 50 80 The target was exceeded due to acceleration of the construction
Comprehensive Cancer Care Center) process
Percentage of procurement, installation, and
0 0 100 0 0 100
operationalization of Cyber Knife completed. The target was met
Mathari Policies, Standards Number of policies developed 1 2 SOPs and 5 years Strategic Plan
National and Regulations Number of standards and regulations 1 2 Waivers Manual and Finance Manual
Teaching and developed to developed
Referral operationalize
Hospital MNTRH
Specialized mental Number of patients receiving in-patients 246729 259066 272,000 183262 189182 248,254 Target was not met due to a lot of clients not able to come for
health services specialized mental health services. the services as a result of economic conditions as most of them
are repeat patients
Number of patients receiving out-patient 282,842 296985 312,000 252180 254913 342,100 Due to the elevation of the hospital status to a level 7 Referral
specialized mental health services Hospital hence a bigger coverage and more referrals
ALOS for civil psychiatric in-patients 42 55 50 64 48 44 Most of the patients are from low economic backgrounds,
hence are unable to pay their bills in time and will always seek
to be waived
Number of community mental health N/A 2 2 N/A 16 21 More budget was allocated for the community outreach
outreaches conducted for early detection and
treatment
Number of clients assessed for mental status N/A 600 700 338 407 1372 There is perceived increase in the rate of youth indulgence in
alcohol and substance abuse, causing an influx in mental cases
Number of forensic clinics to prisons N/A 16 22 N/A 30 32 Due to increase of general crime rate in the country hence
conducted having more forensic patients in the prisons
Sub-specialized Number of sub-specialized mental health N/A 4 8 N/A 5 15 Increased budget for training in specialized psychiatry
mental health practitioners trained
practitioners trained
Mentorship and Number of Youth Internships/Industrial N/A 1300 1,450 N/A 3020 3,645 Introduction of mental health courses in medical training
preceptorship for Attachment/ Apprenticeship colleagues caused the influx
specialized mental
health personnel
conducted
Scientific Number of staff facilitated for scientific N/A 100 125 N/A 52 220 Increased emphasis on continuous medical education and
conferences conferences development.
facilitated
Abandoned patients Number of patients waived N/A 180 140 N/A 222 1749 This was due to economic hard times due to high inflationary
waived effects caused by COVID
Patients Re- Number of re-integrated patients into the 96 90 85 103 280 312 Due to the increase in the number of abandoned patients,
integrated into the community causing over admission. The cured patients have to be re-
community integrated back to create more room
Studies and Number of research conducted on. behavioral N/A 1 1 N/A 0 3 3 research ongoing
Research conducted health system needs
Spinal Injury Specialized spinal Number of in-patients receiving spinal services 190 226 240 219 204 150 The inpatients wards were under renovation.
services Number of out-patients receiving spinal 1353 1820 1920 1754 2126 1654 The was renovations going on in the hospital
services

103
Programme Delivery Unit Key Output Key Performance Indicators Planned Target Achieved Target Remarks
2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
Average Length of Stay (days) for Spinal 90 83.7 83.2 84.2 84 83 Due to availability of specialized drugs, spine implants, and
patients diagnostic equipment. MRI, CT SCAN enhanced quality
treatment
Number of orthopedic spine surgeries N/A 156 187 N/A 180 100 The was renovations going on in the hospital, the number of in-
patients admitted was low
Number of Plastic surgeries N/A 152 182 N/A 160 94 The was renovations going on in the hospital, the number of in-
patients admitted was low
Number of Patients re-integrated N/A 190 216 N/A 106 112 112 patients were successfully re-integrated
SP 2.2Health Health Managed No of Public hospitals with MES equipment 118 118 118 118 118 118 The project has been extended for one year.
Infrastructure and Infrastructure Equipment Services
Equipment Management Kisii level 5 cancer Percentage of Completion rate 100 100 100 0 0 0 Re-advertisement for the Contract was done
center constructed
East African Percentage completion rate of construction 100 100 100 51 63 84 Final finishes for the complex is ongoing and the process of
Centres of works procurement of equipment has began
excellence for skills Number of Health Workers trained in renal 287 287 287 287 0 287 The project has trained the targeted number.
& Tertiary specialties
Education
Kigumo Hospital Percentage of Completion rate 60 80 100 52 78 90 The project is on course
upgraded to level 4
status
Regional Cancer Percentage of Completion rate 0 20 40 0 0 0 Budget constraints
Centre in Meru
established
Regional Cancer Percentage of Completion rate 0 20 40 0 0 0 Budget constraints
Centre in
Kakamega
established
SP 2. 3.Health Division of Health Facilities Number of Health facilities with the capacity 20 32 DHPT worked to ensure health facilities were capacitated to
Products & Health Products with the capacity to to deliver oxygen deliver oxygen through (i) piping of oxygen in health facilities
Technologies and deliver oxygen (ii) Installation of PSAs in health facilities (iii) Installation of
Technologies liquid oxygen tanks in health facilities and (iv) Ensuring
availability of oxygen cylinders in health facilities
Pharmacy Proper Percentage of Counties with quantification data 85 100 Quantification was carried out for all 47 counties. Additionally,
Services quantification of for HPTs the 6 national referral hospitals were included while at the
Health Products consolidation level, all strategic programs HPT were also
and Technologies included. The National Quantification Report for Health
conducted Products and Technologies 2021/22 to 2023/24 was officially
signed off in March 2022. Resources were availed by Afya
Ugavi USAID for the countrywide quantification execersise.
Division of Policy guidelines Traditional & Alternative Policy guideline 1 A Traditional and Alternative Health Practitioners Bill has
traditional and and regulatory developed been developed, is at the Attorney General's Office. The TAM
alternative framework for Policy has also been completed stakeholder engagement and is
medicine traditional and at the MOH legal office awaiting forwarding to the Cabinet.
alternative Some resources were mobilized from TICAH and UNESCO
medicine (TAM) who supported the work. The process has taken very long as
established no resources were allocated by GOK to support the completion
On-going of the work.
Number laws/Regulations developed 1 On-going Awaiting the passing of the Bill and the Policy
Traditional and alternative health practitioners 1
council established On-going Awaiting the passing of the Bill and the Policy.
KEMSA Availability of % order refill rate for HPTs 90% 90% 90% 54% 50% 51% The organization's performance during the year fell below
Health Products & expectations due to; Financial Constraints for Essential
technologies Products: The organization faced financial limitations,
hampering its ability to procure essential health products and
vital technologies required to meet the needs of the various
counties it serves.
Supplier Delays in Deliveries: The poor turnaround time of
suppliers in delivering Health Products and Technologies
104
Programme Delivery Unit Key Output Key Performance Indicators Planned Target Achieved Target Remarks
2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
(HPTs) to KEMSA added to the complications. These delays
hindered the organization's ability to promptly fulfil its
commitments to its customers
Uncertainty due to Organizational Reforms: The ongoing
organizational reforms introduced an element of uncertainty.
This uncertainty had a noticeable impact on the morale of the
staff, resulting in reduced productivity and engagement.
% order refill rate for UHC HPTs 100% 100% N/A 69% 55% NA
Order turnaround time(days) PHFs 10 10 days 10 days 18.1 19.8 days 16.9 days The organization's performance during the year fell below
expectations. Several factors contributed to this sub-optimal
outcome:
Disjointed Warehouses Impacting Efficiency: The presence of
disconnected warehouses throughout Nairobi had a detrimental
effect on route integration and resulted in prolonged order
processing times. Consequently, this issue led to extended
order turnaround times.
Insecurity in Remote Areas: Insecurity in hard-to-reach regions
further exacerbated the challenges. This posed difficulties in
serving certain areas efficiently, affecting both operations and
customer satisfaction.
Order turnaround time(days) Hospitals 7 7 days 7 days 12.6 14.7 days 14.4 days
%of orders dispatched to health facilities N/A 100% 100% N/A 99% 99% The Authority takes pride in its pivotal role and significant
milestone in Last Mile Delivery of (HPTs), which positively
impacts the lives of every Kenyan. In FY 2022/23, KEMSA
proudly served over 8,700 health facilities, representing 99%
of last mile deliveries dispatched to all 290 constituencies and
all 47 counties across the Country. As the leading the
Government Authority in distribution of Health Products and
Technologies (HPTs), KEMSA goes above and beyond to
reach patients at their nearest rural hospitals
National % completion rate (Initial Contract) 90% 100% 100% 77% 92% 92% The project completion was delayed due to unavailability of
Commodities funds as per the budget estimates GoK Allocation of KSh. 310
Storage(supply Million which was not disbursed
chain) center
National % completion rate (Remeasured Contracts - 100% 100% 72% 81%
Commodities with new budget needs)
Storage(supply
chain) center
Equipping, %ge of completion 46% N/A NA 7% The balance of funding that had been committed under Project
Warehouse Layout, of Operationalization CODE: 1081101800 by Global Fund was reclassified to
Automation & Operationalization of the New Warehouse and not for main
Operationalization works. Reference is made to the Global fund correspondence
of the New vide letter Ref: GMD/HIA2/KEMSA Construction/Progress
Warehouse Review_4 dated Geneva, 27th January 2022. Global Fund
recognized that there is still pending works which are critical to
the operationalization of the warehouse and granted approval
of usage of the remaining grant funds solely for the
operationalization of the warehouse of US$ 2,839,726.
SP 2.4 National National Blood Blood transfusion Number of blood units Collected 200,000 400,000 400,000 34,187 273,349 412,868 The set target of 400,000 of blood and blood components was
Blood Transfusion services surpassed.
Transfusion Service, Tissue Percentage of whole blood units collected and 80% 70% 70% 75% 57% 67% The variance is due to the increased number of blood units
Services and Human converted to components collected and new blood establishments. KNBTS has equally
Organ increased component preparation capacity in the new blood
Transplant establishment.
Number of transfusing facilities under 350 450 500 262 450 500 The 500 transfusing facilities submit monthly hemovigilance
Hemovigilance surveillance reports to KNBTS. The establishment and strengthening HTCs
is ongoing.

105
Programme Delivery Unit Key Output Key Performance Indicators Planned Target Achieved Target Remarks
2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
Number of Kenya National Blood Transfusion 25 35 47 28 48 49 All the 49 sites including the 6 RBTCs are supplied with
Sites (KNBTS) supplied with specialized specialized commodities and equipment.
commodities and equipment
Number of New blood collection centres 15 14 0 Between FY 2020/21 and FY 2022/23, the number of satellite
established blood transfusion centres increased from 29 to 43 while the
RBTCs remained 6 making a total of 49 Blood establishments
in the Republic.
Forensic and Forensic services Percentage of Clinical forensic autopsies 100% 100% 30 100% 100% 100% All clinical Autopsies requested during this period were done
Pathology performed
services Number of Expert opinions given 100% 100% 250 100% 100% 100% All expert opinion requested during this period were given
Number of exhumations performed for medical 100% 100% 25 100% 100% 100% All exhumations requested during this period by the courts
forensics were executed
Number of Criminal related death scenes 100% 100% 30 100% 100% 100% All criminal scenes that were presented to the Directorate of
viewed. criminal investigations were visited by DCI together with the
Forensic pathologists
Histology and Number of Histo-cytopathology examination 30% 40% 45 40% 60% 60% The number of histocytopathology examination for cancer
Pathology services for cancer diagnosis carried out diagnosis carried out in both years surpassed the target
Percentage of interpreted pathology results for 40% 40% 45 10% 60% 100% Percentage of interpreted pathology results for clinical
clinical decisions decisions in the previous year the target was met in the
following year the target was surpassed.
Nursing services Nursing policy Nursing policy developed N/A N/A 1 N/A 1 (100%) The National Nursing and Midwifery Policy was developed
2021-2030 and launched in July 2022.
developed
Nursing Health Draft Nurses act CAP 257 presentation to N/A N/A 1 N/A N/A 0% Draft presented but returned for further consultations
legislation enacted parliament health committee
Critical care Number of nurses sponsored for critical care N/A 150 200 N/A 20 (30%) 150 (75%) 150 nurses enrolled nursing specialty courses but under self-
services services sponsorship model
Ophthalmic Eye Comprehensive Number of new ophthalmic training Centers N/A 1 N/A 1 Achieved at MTRH
Health Ophthalmic centers Number of New Centers offering Diabetic eye N/A 5 N/A 3 Equipment are in procurement processes for Thika L5, Embu
established care and Meru level5 only.
Number of Centers offering Refractive and N/A 15 N/A 0 Target not met due to inadequate Budgetary allocations
Low Vision Services
Eye health Number of eye Health Facilities Rehabilitated N/A 10 N/A 0 Target not met due to inadequate Budgetary allocations
infrastructure National Eye Drop Production upgraded to N/A 1 N/A 0 Target not met due to recommendation from PPB to drop it as
upgraded Good Manufacturing and Production Standards it’s a regulatory function. However, MOH to work on Contract
(GMPS) manufacturing
Oral health Oral health policy Oral health policy in place N/A 1 1 N/A 1 N/A Ministry of health launched the Oral Health policy which
services developed awaits dissemination
Guidelines and Guidelines for oral health developed N/A 1 1 N/A 1 N/A Guidelines and safety protocols for oral health in place
safety protocols for
oral health services
developed
Amalgam National plan for amalgam phasedown N/A 1 1 0 10% The National plan to phase down dental amalgam is 10% done
phasedown developed with a zero draft in place
Number of Amalgam phasedown tools N/A 9 4 0 4 The target was not achieved due to lack of funding
developed
Rehabilitative Disability Number of disability classification tools N/A N/A 7 N/A N/A 7 1 tool was reviewed and out of the one tool 7 were formed
and classification tools reviewed (Physical disability, visual impairment, maxillofacial, hearing,
Physiotherapy reviewed speech & language and communication, progressive disorders
Services and mental intellectual disabilities
Guidelines for Guideline for disability assessment in place N/A N/A 1 N/A N/A 1 Target was achieved
disability
assessment
developed
Clinical Services Guidelines for the Guideline for operationalization of Wellness N/A 1 1 N/A 1 1 Draft in place and ongoing
Health and Centre developed

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Programme Delivery Unit Key Output Key Performance Indicators Planned Target Achieved Target Remarks
2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
Wellness Centre
developed
Health & wellness Number of Health and wellness clients 400 400 400 400 400 400 Target met
center for staff screened at MoH Health and wellness centre
mainstreamed all
MDAs
Orthopedics and Health Legislation Orthopedics &Trauma Act Developed N/A 1 0 N/A 1 0 Target was not met as a result of no stakeholders' engagement
Trauma Unit on Orthopedics
&Trauma
developed
Radiology & Radiographers Radiographers Act in place N/A N/A 1 N/A N/A 1 Target was achieved
Medical Health legislation
Diagnostic developed
Services Radiographers Number of Radiographers sensitized. N/A N/A 60 N/A N/A 40 Target not met due to inadequate funding
sensitized on safety
and operation of
imaging equipment.

Programme Delivery Unit Key Output Key Performance Indicators Planned Target Achieved Target Remarks
2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
Programme 3: Health Research and Innovations
Health Research and Innovations
SP:3.1 Health Kenya Biovax Human vaccine Fill Percentage completion rate of human vaccine N/A N/A 50% N/A N/A 16.5% (Completion of building including roofing - 25%; GMP
Innovations Institute and Finish facility fill-and-finish facility Consultancy and Turnkey Contractor contracts - 17% and
established NEMA License - 8%) The contractor experienced work
exigencies that led to delays in delivery of the roofing material.
During that period, the Institute undertook a strategic direction
to expand available office space which would accommodate
recruited staff - this led to redesigning the refurbishment works
to incorporate roofing in the second stage for enabling works.
Technology transfer Number of technology transfers agreements N/A N/A 1 N/A N/A 0 Technology Transfer Agreement with the WHO mRNA
of HPTs acquired technology transfer program submitted to Office of the
Attorney General, awaiting feedback
Personnel trained in Proportion of personnel trained in specialised N/A N/A 100% N/A N/A 100% The Institute trained all twenty staff on administrative
specialised HPTs HPTs manufacturing and management (Corruption Prevention, Prevention of Alcohol and Drug
manufacturing and Abuse and in Road Safety Mainstreaming) and technical
management (Three Staff were Trained in Biosecurity (South Africa), One
trained in Introductory Course to GxP (South Korea), One
Trained in Introductory Course for Biologics Development and
Manufacturing (South Korea)).
Staff recruited Number of staff recruited N/A N/A 23 N/A N/A 1 Requisite approval from the National Treasury and Economic
Planning for recruitment made in June 2023
Quality Percentage completion rate of quality N/A N/A 50% N/A N/A 25% ERP Contract signed in June 2023. Implementation ongoing
Management management systems established
Systems established
Partnerships & No of partnerships and collaborations N/A N/A 4 N/A N/A 1 The Institute has signed an MoU with the Kenya Institute of
Collaborations Primate Research. A draft MoU has been prepared with the
established Kenya Medical Research Institute and review meetings held -
MoU awaiting signing
SP 3.2 Medical Kenya Medical Policy briefs Number of policy briefs 10 14 15 48 18 12 The reduction in number of evidence briefs is due to delay in
research Research developed completion of some research projects.
Institute Research protocols Number of New research protocols approved 125 224 178 143 162 191 The positive increase is because of focus on high priority, high
approved impact team driven research initiatives.
Number of ongoing Research Projects 405 200 500 520 522 516 This is the cumulative number of ongoing multi-year projects
including the new ones formulated within the reporting period.

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Programme Delivery Unit Key Output Key Performance Indicators Planned Target Achieved Target Remarks
2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
Research Findings Number of research Papers published 310 350 350 446 432 525 The number of publications is significantly higher than the
Disseminated target maintaining the positive trends over the last three years
medium term.
Number of research Abstracts presented 135 166 191 92 174 209 The positive increase is due to the increased number of
scientific conferences offering a broad range of opportunities
for scientists for dissemination involving regional,
international as well as in country and county platforms for
dissemination.
Number of Scientific & Health Conferences 1 2 4 1 3 2 The Conferences included KASH, and Lung conferences that
held were undertaken during the period under review. Some of the
conferences were co-hosted (KASH & Malaria forum).
Quality diagnostic Number of Diagnostic kits produced 698617 768471 293000 698613 286664 162213 The relative deduction is due reduced demand of our flagship
and specialized products (Kemrub, Tbcide and Transfer where research outputs
laboratory services are developed into commercially viable products. The products
include diagnostic kits that aim to improve quality of diagnosis
and support service delivery within the health sector. Strategies
are underway for demand creation.
Number of Specialized laboratory tests 1223256 1629082 568242 1335872 638427 971376 The positive variance is due to the increased number of
conducted in Millions specialized laboratory and clinical tests that include tests in
(Viral Load, PCR-Early infant diagnosis of HIV, VCT rapid
tests and other molecular diagnosis). This increase was also
due to enhanced community engagements and rise in new and
ongoing research projects.
Health Researchers Number of researchers enrolled for graduate 60 60 88 0 59 90 The positive variance is due to the increased visibility and
enrolled for studies scope of courses offered as we drive towards the attainment of
graduate studies the full charter of a special degree awarding institution.
Completed relevant Project completion rate 100% 100% 100% 77.20% 55% 86% The following capital projects were undertaken during the
projects reporting period.
•Repair, renovations of staff quarters at Mbagathi –Blocks C
&D
•Rehabilitation of access roads and drainage in KEMRI Kisian
station
• ICT infrastructure and automation
• Installation of CCTV, barrier access control
•Rehabilitation/Replacement of water piping system at HQ
• Upgrading of the p3 laboratories CRDR
• Equipping of flu lab and P3 lab at HQ
•construction of Sample Management and Receiving Facility
(SMRF) and renovation of laboratories

Programme Delivery Unit Key Output Key Performance Indicators Planned Target Achieved Target Remarks
2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
Programme 4: General Administration and Medical Policy
Programme Outcome: Strengthen Governance and Leadership in the State Department
SP4.1: General General Information ISMS policy and procedures developed N/A N/A 1 N/A N/A 1 ISMS Policy and procedures were developed
Administration administration Security Number of Information Security Risk N/A N/A 15 N/A N/A 15 Security Risk registers for 6 directorates and 9 division were
Management Registers (Risk Assessment and Treatment) in developed
System (ISMS) place across all directorates
policy and Number of audits conducted to monitor ISMS N/A N/A 2 N/A N/A 0 Audit was not conducted since training of ISMS auditors was
procedures implementation not done
developed and
implemented
ICT Services Staff(officers) Ratio of staff to computers and laptops N/A N/A 1.30ꓽ1 N/A N/A 1.25ꓽ1 There was no funding allocation to procure the computers.
computer ratio
improved

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Programme Delivery Unit Key Output Key Performance Indicators Planned Target Achieved Target Remarks
2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
Records at MOH Percentage of MOH records at Central registry N/A N/A 50% N/A N/A 0 Inadequate funding to procure an Electronic Document and
central registry digitalized Records Management System (EDRMS)
digitalized
ICT Strategy 2022- ICT Strategy Document developed N/A N/A 1 N/A N/A 1 Draft ICT Policy developed
2027 developed
ICT Use 2 and ICT ICT Use Policy and ICT Security Policies N/A N/A 1 N/A N/A 1 Draft use Policy developed within the Division
Security Policies
and Guidelines
developed
Public Relations Communication Communication strategy developed N/A N/A 1 N/A N/A 1 Draft Communication Strategy developed
Division strategy on Health Percentage of Strategy implemented N/A N/A 50 N/A N/A 0 No strategies were implemented
developed and
implemented
Human Capacity building Number of health care workers recruited 9308 1119 0 8706 605 0 The target was achieved in the previous FY
Resource of health care Number of health care workers placed on N/A 9500 9500 3876 4165 4934 Lack of exchequer and placements facilities
Management & workers internship.
Development Percentage of in-post employees trained N/A 6% 15% N/A 10% 0% Priority was given to pending fee balances
division Operational Percentage of state corporations Organization N/A N/A 15% N/A N/A 37% Target was attained
efficiency in state structures reviewed.
corporations under
Ministry of Health
SP4.2: Financing Finance division Absorption of Absorption Rate 100 100 100 100 89 93.7 Lack of exchequer at the closure of the financial year
and planning financial resources
allocated
Collection of public Total AIA collected by the Ministry (KSh. 10.8 10.8 16 10.8 14.8 17.3 Increased reporting rate for donor funded projects.
health sector Billions)
financial resources
increased
Quarterly budget Number of budget reports submitted 4 4 4 4 4 4 Target was achieved in the planned period
performance reports
submitted
Central Planning Policy briefs Number of policy briefs 1 4 4 2 9 1 Policy briefs were prepared in line with the National Health
& Projects developed Accounts finding for (FY 16/17 - 18/19) which prioritized
Monitoring specific programmes and diseases
Unit/ Capital projects Number of capital projects monitoring progress N/A N/A 2 N/A N/A 0 No capital projects were monitored in 2022/23
UHC Secretariat monitored reports
National and Number of National and County Budget 1 1 1 1 1 1 The department carried out a national and county budget
County Budget Analysis analysis and generated a report that was published.
Analysis conducted
UHC Secretariat Population service Service coverage index 92 80.7 85 88 90 92 Need for more resources to achieve this
Coverage Number of Households Covered under UHC 1 1.5 1.5 1 1 1
Scheme (Millions)
Service Access Service Access Index 83 83 85 88 90 92 Target met
increased
SP4.3: Social Directorate of Health Financing Health Financing Communication strategy in N/A N/A 1 N/A N/A 0 Kenya Health Financing Communication Strategy was not
Protection in Health Communication place developed since the financing reforms were not yet completed.
Health Financing strategy developed The strategy will speak on the finalized reforms.
County Health Number of County Health Management teams N/A N/A 23 N/A N/A 8 8 CHMTs sensitized in 4th Quarter of 2021/2023
Management (CHMT) sensitized
teams (CHMT)
sensitized on
the health
financing
strategy
NHIF Reduced financial No. of Deliveries 1,231,200 1,231,200 1,231,200 784,385 821,307 927,102 The target was based on the number of deliveries in a year.
barriers to access to However, we achieved 75% in FY 2022/23 due to the fact that
healthcare some mothers delivered using other insurance covers. There is

109
Programme Delivery Unit Key Output Key Performance Indicators Planned Target Achieved Target Remarks
2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
a growth of 10% in number of deliveries compared to FY
2021/22
Number of indigents accessing healthcare 253,400 253,400 253,400 253,400 253,400 253,400 Planned target achieved 100%
through HISP.
Number of elderly & Persons with severe 58,800 58,800 58,800 58,800 58,800 58,800 Planned target achieved 100%
disabilities registered.
Number of indigents covered 0 1M 1.5M 0 1M 1M Registration of additional indigents not carried out limiting
funding
Number of elderly persons accessing services N/A N/A 0 0 NHIF has registered 484,086 members but
through the Inua Jamii subsidy program 484,086 484,086 their premiums were not received from the exchequer
% Population with social Health Insurance 89% 62% N/A 46% 55% N/A This indicator was dropped in FY 2022/23
Average claims processing period (days) 30 27 N/A 27 23 N/A This indicator was dropped in FY 2022/23

STATE DEPARTMENT OF PUBLIC HEALTH AND PROFESSIONAL STANDARDS

Programme Delivery Unit Key Outputs Key Performance Indicators Planned Targets Achieved Targets Remarks
2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
Programme 1: Preventive, Promotive and RMNCAH
Programme Outcome: Increased access to quality promotive and preventive health care
SP 1.1 TB Programme TB Prevention and Number of TB cases notified (All forms) 112,800 100,617 99,226 73,777 82,517 82,302 Due to insufficient budgetary allocations, there was erratic
Communicable Curative Services supply of TB diagnostic commodities over the period under
Disease Control review
Proportion of successfully treated TB cases (all 90% 90% 90% 85% 84% 84% Concomitant Malnutrition in TB patients led to adverse
forms of TB) treatment outcomes with a high death rate of 6%
Malaria Prompt malaria Number of Artemisinin Combination Therapy 6.8 7.0 6.3 5.8 5.0 6.5 The was improvement in ACTs supply in FY 2022/2023
Programme treatment enhanced (ACTs) doses distributed to public health compared to earlier FYs resulting in surpassing the target for
facilities(millions) 2022/2023
Malaria cases in Proportion of suspected cases tested 95% 100% 100% 67% 89% Improvement in the performance from previous period was as
public health (microscopy or Rapid Diagnosis kit) a result of improving supply of commodities.
facilities tested
Malaria cases Proportion of Confirmed Malaria Cases treated 80% 100% 100% 92% 97% 99% Availability of diagnosis equipment and treatment,
treated in Artemisinin Combination Therapy enabled this achievement
accordance to the (ACTs)
Kenya Malaria
Treatment
Guidelines
Long Lasting Number of Routine Long Lasting Insecticidal 1.7 2.2 2.3 1.42 1.48 1.8 These Nets are partner procured. However, the number of nets
insecticidal nets Nets distributed(millions) provided by the partner is not sufficient to cover the entire
distributed through target. The Government needs to allocate more resources to
Maternal and Child cover the shortfall
Health (MCH)
clinics
Institutional Framework developed 0 1 0 0 1 0 Target Achieved
framework for
Malaria Youth
Army developed
Larval Source Proportion of breeding habitats identified and 0 90% 90% 0 75% 80% Variance in achieving target was as a result of insufficient
Management appropriately managed funding for the planned activities
enhanced
SP 1.2 Non- Non- TOTs trained on Number of ToTs trained on diabetes and 500 1500 124 498 87 50 There was variation since there was delay in inception of a
Communicable Communicable Diabetes and cardiovascular diseases prevention and project that was to support the ToT training
diseases Diseases Cardiovascular management
Diseases prevention
and management
Nuclear safety Cumulative Proportion of nuclear siting N/A 0 20% N/A 0 20% The authority partnered with Nuclear Power and Energy
assurance regulations developed Agency to develop a framework for nuclear power siting

110
Programme Delivery Unit Key Outputs Key Performance Indicators Planned Targets Achieved Targets Remarks
2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
SP 1.3- Radiation Kenya Nuclear Strengthened Cumulative percentage of enforcement officers 2% 5% 10% 2% 5% 10% The authority utilizes available opportunities to sensitize law
Safety and Regulatory nuclear security and trained on nuclear security enforcement officers on nuclear security
Nuclear Security Authority safety Cumulative percentage of nuclear security 0 3% 20% 0 5% 0.2 This is an ongoing effort. A draft radiation detection
detection architecture developed architecture has been developed
Proportion of category I and II radiation 25% 50% 100% 25% 50% 100% This was achieved through extra budgetary support from
facilities complying with physical protection development partners
measures
Safe radiation free Percentage of environmental projects N/A 10% 20% N/A 10% 10% During the period environmental impact assessment reports
environment complying with radiation safety guidelines were not evaluated but an MoU has been initiated with the
Communications Authority of Kenya
Percentage of radio analysis tests performed on 50% 50% 50% 50% 50% 50% Target achieved
imported goods
Percentage of radiation workers captured under N/A 10% 20% N/A 10% 40% Overachievement due to Government directive on offering
the national dose register services through e-citizen
Number of radiation dose inter-comparison N/A 1 2 N/A 1 1 Target was not achieved due to resources being directed to
exercises conducted operationalizing the e-citizen adoption
Quality assurance Percentage of radiation facilities inspected 45% 80% 90% 45% 80% 90% Target achieved by utilizing joint inspection opportunities
in applications of with other agencies in the Ministry
radiation Percentage of radiation facilities licensed 45% 60% 70% 45% 60% 70% Target achieved due to utilization of ecitizen platform
SP 1.4 Division of Malnutrition Proportion of children 6-59 months who 80 83 90 86 86 83.7 Vitamin A target is usually 80% as recommend by WHO as
Reproductive Nutrition and prevention & received 2 doses of Vitamin A safe levels where children are unlikely to get deficiency. The
Maternal Dietetics Nutrition promotion Supplementation (VAS) target is to maintain above 80% (Target achieved)
Neonatal Child & Services services Number of children 6-23 months receiving N/A N/A 218,977 N/A N/A 0 The micronutrient powders were never procured in FY
Adolescent Micronutrient Powders (MNPS) 2022/23
Health- Number of healthcare workers trained on high N/A 1323 800 N/A N/A 2,102 Data based on health care workers trained on the revised
RMNCAH impact nutrition interventions IMAM guideline, on MIYCN-e and BFCI
Number of community health volunteers N/A 6,000 6,000 N/A 5865 6014 Target achieved
trained on key nutrition practices at critical
stages in the life cycle
Effective treatment Treatment cure rate of acutely malnourished 80% 80% 83% 90% 86% 90.5% The targets were achieved
for malnourished children 6-59 months
children under 5 Treatment cure rate of acutely malnourished 100 100% 90% 80 86% 90.3 There has been progressive improvement in achieving the
years of age, pregnant and lactating women target
pregnant and
lactating women
Nutrition policies, Number of Policies, guidelines, strategic plans 4 5 7 3 3 5 The high cost and Long process for finalization Policies,
legislations, and legislations developed and disseminated guidelines, strategic plans and legislations resulted in the
strategic plans and underachievement
guidelines
developed and
disseminated
SP 1.5 Division of Sanitation and Proportion of Villages certified as open 20 31 31 25 29 30 The 1% under coverage is attributed to weak latrine structures
Environmental Water Sanitation hygiene practices defecation free that could not withstand the effects of climate change (floods)
Health and Hygiene improved in flood prone areas
Proportion of population accessing safely N/A N/A 25 N/A 25 30 The intensified campaigns by partners led to the coverage
managed sanitation facilities beyond the targets set for the year.
Division of Food safety and Proportion of foods complying with food N/A N/A 85 N/A N/A 80 There was no funding to carry out a third surveillance which
Food Safety and quality control safety and control requirements would have informed further on the achievement.
Quality Control strengthened
Division of Waste management Number of health facilities with installed and N/A N/A 50 N/A N/A 9 10 microwaves installed with 9 commissioned in phase1
Waste and climate change compliant waste treatment and disposal system
management, mitigation measures
Pollution enhanced
Control, and
Climate Change

111
Programme Delivery Unit Key Outputs Key Performance Indicators Planned Targets Achieved Targets Remarks
2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
Occupational Occupational Proportion of healthcare facilities N/A 15 5 N/A 5 10 So far the 15 health facilities covered in the last two years
Health and Health and Safety implementing occupational health and safety have been achieved. The project that supported this has come
Safety Division standards standards to an end and therefore the Ministry need to pick it up for the
implemented remaining level 4 and 5 facilities
Port Health Port Health Number of travellers screened for notifiable N/A N/A 7,361,622 N/A N/A 5,694,927 Much as there was marked increase in the number of
Services Services improved diseases travellers arriving into the country (8.8M), the descalation of
Division the COVID-19 travel requirements meant a reduction in
enhanced screening for communicable diseases.
Number of travellers issued with vaccination N/A N/A 249,600 N/A N/A 23,440 COVID-19 restriction measures were amended reducing the
certificates as per travel requirements necessity to subject travellers to COVID-19 vaccination.
Otherwise, this achievement indicates travellers vaccinated
against other travel related vaccine preventable diseases other
than COVID-19.
Number of tonnes of cargo cleared as per N/A N/A 1,460,000 N/A N/A 2,214,892 Easing of COVID-19 restriction measures promoted trade
health requirements at POEs thus allowing the increase of movement of cargo of public
health importance across major POEs
Number of conveyances inspected and issued N/A N/A 265,000 N/A N/A 423, 989 Easing of COVID-19 restriction measures allowed the
with disinfection/disinfection certificates increase of movement of cargo across all the POEs
Vector and Vector and vermin Number of POEs capacity build to undertake N/A N/A 10 N/A N/A 8 inadequate resources hindered the achievement of the planned
Vermin Control infestations control vector and vermin control services targets
Division services enhanced
Air pollution Air pollution and No. of Community Health Volunteers trained 94 1200 2500 65 1500 2668 At the beginning the TOTs were targeted for training and only
and Health health standards on Household Air Pollution using module 14 2 TOTs were trained from 32 counties. In the subsequent
developed and years we surpassed the target as trainings were organized in
implemented every county
Tobaccco Tobacco Control Tobacco control policy document N/A N/A 1 1 1 2 The process of reviewing the Tobacco Control Policy
Control Board Policy developed commenced in April 2022 however it has not been finalized.
The Board also developed two strategic documents that is the
Resource Mobilization Strategy and the Stakeholder
Engagement Strategy.
Instruments to Number of instruments to operationalize the 4 4 3 4 2 1 Tobacco Control Fund disbursement guidelines were
operationalize fund developed finalized. The Fund Regulations are still before relevant
tobacco control committees of Parliament for consultation.
fund developed
SP 1.6 Disease Division of Reduction of Acute flaccid paralysis case detection rate N/A 2.3 2.5 N/A 4.06 2.8 Good achievement, as Detection rate is expected to be at
Surveillance and Disease mortality and 2/100,000 of <15 yrs,
Response Surveillance and morbidity due to Number of counties with functional N/A 5 8 N/A 8 7 sub optimal performance due to inadequate funds as a result
Response public health Community Events Based Surveillance of donor dependency
emergencies (CEBS)
Number of hospitals with Functional Events N/A 2 62 N/A 62 84 The number increased 22 as counties embraced EBS and
Based Reporting System rallied financial support to scale up
Sub County weekly epidemic reporting Rates N/A 80 72 N/A 72 96 Optimal performance way above cutline of recommended
80%.Lots of financial and technical support from partners,
weekly bulletin as a form of feedback
Division of Number of counties with functional command N/A N/A 1 N/A N/A 0 Lack of funds to set up command and control centres
Health and control centres linked to ambulance
Emergencies dispatch
and Disaster Number of centres for management of CBRN N/A N/A 15 N/A N/A 0 Lack of funds to establish centres
Management Incidents established
Public Health Proportion of Public Health Emergencies N/A 52 62 N/A 62 60 "There was no variance
Emergency responded to. The division was able to coordinate and respond to all
Operations emergencies"
Centre
Field Number of FELTP students who have N/A 20 20 N/A 20 20 The target number of graduants achieved as targeted
Epidemiology & graduated
Laboratory
Training

112
Programme Delivery Unit Key Outputs Key Performance Indicators Planned Targets Achieved Targets Remarks
2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
Program
(FELTP)
Division of People treated for Number of people treated for Lymphatic N/A 2.5 1.6 N/A 4.07 0 Lack of donated drugs for treatment
Vector Borne & Lymphatic filariasis filariasis (Millions)
Neglected (LF), Trachoma, Number of people treated for trachoma N/A 1.5 1.4 N/A 2.05 2.4 The division was able to achieve above 90% of the target
Tropical bilharzia, and (Millions) activity
Diseases intestinal worms Number of people treated for Bilharzia. N/A N/A 3.5 N/A 3.5 6 The division surpassed its target
(Millions)
Number of people treated for intestinal worms. N/A 4 7 N/A 7 12 The division surpassed its target
(Millions)
Division of Surveillance of Number of people diagnosed with Rabies N/A N/A 10 N/A N/A 5 Rabies in humans is largely diagnosed at postmortem. There
Zoonotic Zoonotic diseases is a large pool of untrained personnel to obtain appropriate
Diseases sample
Number of counties supported to investigate N/A 3 4 N/A 3 5 Counties were supported through MoH, FELTP and partners
and respond to priority zoonotic diseases
Division of National Public Number of regulations developed on N/A N/A 1 0 1 Optimal performance as a result of multi sectoral
Global Health Health Institute NPHI/CDC operationalized collaboration
Security /Centre for
Diseases Control
(NPHI/CDC)
established
Department of Testing capacity of Proportion of national and county reference N/A 31% 31% N/A 31% 32% Scale-up of molecular testing platforms in level IV and V
Laboratory laboratory network laboratories able to conduct molecular testing laboratories
Services for referral services for emerging and re-emerging diseases
expanded Number of medical laboratories with capacity N/A 17 17 N/A 17 17 Sensitization and activation of targeted laboratories in AMR
to detect and report on Antimicrobial surveillance
Resistance
Molecular testing Number of High-risk HPV tests performed N/A 3,000 4200 N/A 4,822 24,310 Effective sensitization by the National Cancer Control
capacity for High Program
risk HPV Proportion of laboratories with capacity to N/A N/A 9.10% N/A 9.10% 10.60% Effective sensitization by the National Cancer Control
Established conduct molecular testing of High risk HPV Program
COVID-19 tests Number of COVID-19 tests performed N/A 1,900,000 1,200,000 N/A 1,375,986 174,308 De-escalation of COVID-19 as a global health emergency
performed requiring only targeted testing
Surveillance of Proportion of mycotoxin tests on foods N/A N/A 86% N/A N/A 86.40% Public Health Officers (PHO) initiative for sampling of food,
contaminants in complying with food safety standards water and feeds for compliance to standards
foods and Water Proportion of tests (Flouride, Nitrates and N/A N/A 80% N/A N/A 92.60% Public Health Officers (PHO) initiative for sampling of food,
carried out sulfates ) on water complying with standards water and feeds for compliance to standards
Food fortification Proportion of tests on maize and wheat flour N/A N/A 38% N/A N/A 72.30% Increased surveillance and sensitization of the flour milling
monitoring complying with food fortification standards industry
conducted
Kenya National Kenya National Human Resource Instruments Developed N/A N/A 1 N/A N/A 0.5 Draft HR instrument
Public Health Public Health
Institute Institute
operationalized
Field response Proportion of public health emergencies N/A N/A 100% N/A N/A 100% No Variance
Missions conducted responded to
Number of regional emergency operations N/A N/A 11 N/A N/A 18 Target surpassed to financing from CDC
centers established
Number of surge health care workers trained N/A N/A 100 N/A N/A 159 Target surpassed to financing from CDC
on emergency response

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Programme Delivery Unit Key Outputs Key Performance Indicators Planned Targets Achieved Targets Remarks
2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
Programme 2: Research, Training and Development
Programme Outcome: Health workers and professionals trained
SP:2.1 Capacity Kenya Medical Health workers and Proportion of health professionals(cohort) 96% 97% 98% 95% 96% 95% Discontinuation of students due to lack of fees, natural
Building & Training professionals certified attrition, inability to attain academic requirements for
Training (Pre- College trained progression.
service and In-
service Training)
Number of students enrolled 12,692 16,800 18,250 17,241 21,700 25,889 Target surpassed due to increase in infrastructural
development, introduction of new programs.

No. of evidence-based policies developed 12 8 9 10 8 20 Target achieved and surpassed. More funding was allocated
and desire for individual career progression under research.

Number of curriculums reviewed 11 11 6 1 10 10 Target surpassed due to emerging issues in the market that
necessitated fast tracking of more review of curriculum like
new technologies and new trends
Number of CHEWs trained 90 57 200 66 57 30 Training for CHEWs is demand driven.

Number of CHAS trained 400 600 1,000 938 700 3,519

Target surpassed as more counties, donors and the national
government came on board for sponsorship and also high
demand for the course and expansion of our campuses.
Number of CHAS’s students attached to the 6,042 4,000 10,000 293 8,000 3,519
primary health facilities The target not achieved due to lack of infrastructure,
teaching/medical equipment's and lecturers.

SP 2.2: Research Division of Anti-Microbial Number of facilities with laboratory capacity 12 17 22 11 17 18 Mbagathi Hospital Has been added to the previous 17
and Innovation on Patient and Resistance (AMR) to detect and report on Antimicrobial facilities. Inadequate microbiology capacity in health care
Health Healthcare surveillance system Resistance facilities has been hindering progress
Worker Safety strengthened
Infection Number of Training Institutions with IPC 30 15 25 0 1 1 The training curriculum was developed and approved in 1
Prevention and Mainstreamed institution only (Kenyatta University). Lengthy approval
Control (IPC) processes for the curriculum has hindered mainstreaming.
Mainstreamed in Final approval with Commission for Higher Education is
Training Pending
Institutions
Division of Health Norms and Number of Norms and Standards developed N/A 1 1 N/A 1 1 Target achieved
Norms and Standards/Guidelin
Standards es developed
Division of Coordination of Number of Bills /Regulations developed to 4 3 3 2 2 3 Target achieved
Legislation/Reg Health Act, 2017 operationalize the Health Act, 2017
ulation operationalized
Division of Technical Number of Counties implementing eKQMH 15 30 41 8 47 47 Target surpassed due to availability of extra funds through
Quality assistance on resource mobilization from the Global fund.
Assurance quality
improvement
provided electronic
Kenya Quality
Model for
Health(eKQMH)
Quality of Care Number of Health facilities assessed and 20 15 20 6 50 109 Target surpassed due to extra funding from Global Fund
Certification certified using Quality of Care Certification
Framework Framework
implemented

114
Programme Delivery Unit Key Output Key Performance Indicators Planned Targets Achieved Targets Remarks
2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
Programme 3: General Administration and Human Resources Management
Programme Outcome: Strengthen Governance and Leadership in the State Department
SP 3.1: Health Kenya Health Compliance to set Proportion of health facilities compliant to N/A 13 20 N/A 7 22 The target was surpassed due to concerted efforts between
Standards, Professions norms and norms and standards of healthcare delivery National and County Governments
Quality Oversight standards of Proportion of training institutions compliant to N/A 33 50 N/A 23 0 Activity was not carried out due to government cost cutting
Assurance & Authority training and health norms and standards of training measures
Standards care services Proportion of internship training hospitals N/A 25 50 N/A 20 0 Activity was not carried out due to government cost cutting
compliant to set norms and standards of measures
training
Proportion of health facilities graded based on N/A 20 20 N/A 0 0 Activity was not carried out due to government cost cutting
implementation of quality of care indicators measures
Competent Health Proportion of health professionals in the N/A N/A 50 N/A N/A 0 Activity was not carried out due to government cost cutting
Professionals duplicate register with valid practice licence measures
Number of unregulated health professionals N/A N/A 500 N/A N/A 998 This target was surpassed as many professionals responded
registered
Patient Complaints Proportion of complaints and disputes received 100 100 100 100 100 100 This target was achieved
and Disputes from and handled
Regulatory Bodies
and Aggrieved
Parties resolved
Kenya Health Career Progression Career Progression Guidelines finalized 1 1 1 0 0 0.8 Document finalization is not done since it is awaiting review
Human Guidelines finalized and approval by the Public Service Commission
Resource Human Resource Human Resource Policies and Procedures 1 1 1 0 0 0.8 Document finalization is not done since it is awaiting review
Advisory Policies and Manual and approval by the Public Service Commission
Council Procedures Manual
(KHHRAC) finalized
Salary Structure KHHRAC Salary Structure 1 1 1 0 0% 80% Document finalization is not done since it is awaiting review
completed and approval by the Public Service Commission
Uniform norms and Uniform norms and standards of a master N/A 1 N/A N/A N/A 0% Norms &Standards finalization not done due to inadequate
standards of a register for all health professionals developed funds
master register for
all health
professionals
developed
Mapping of Report on medical specialists in the Country 1 1 1 1 0.5 0.5 Mapping for medical specialists in the country was done .Draft
medical specialists mapped report available but not validated
in the Country
conducted

Number of counties trained to implement the 18 43 4 47 47 47 At least 2 representatives from all 47 counties were trained
National Health NHWA with the support of partners
Workforce Number of faith based and private health N/A N/A 10 N/A N/A 20 Data sharing agreement with individual organizations not
Accounts (NHWA) facilities implementing NHWA finalized. Negotiations on-going
in the Country
implemented
Undertake trainings Number of Counties trained on Workload N/A N/A 3 N/A N/A 47 At least 2 representatives from all 47 counties were trained
in the counties on Indicators of Staffing Need (WISN) with the support of partners
Workload
Indicators of
Staffing Need
(WISN).
Operationalization Number of Council members and staff N/A N/A 24 N/A N/A 16 12 Council members were inducted and for staff not carried
of the Council capacity built due to low staff numbers and delayed release of exchequer.
Competent Health Number of Medical and Dental Officer Interns 1,342 1,500 900 1,329 1,600 912 Medical/Dental internship training is a mandatory requirement
Professionals placed to qualify for registration and licensing in Kenya.

115
Programme Delivery Unit Key Output Key Performance Indicators Planned Targets Achieved Targets Remarks
2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
Kenya Medical Number of practitioners to be registered and 12,586 15,700 16,000 12,586 15,839 16,455 Fully digitization of the licensing renewal process and
Practioners and licensed enhancement of awareness.
Dentist Council Number of new health institution and health 6,227 7,600 8,000 5,277 7,050 7,086 Underachievement was due to lack of personnel, logistic
facilities registered and licensed challenges and dependent on other government agencies for
joint inspections.
Compliance to set Proportion of Medical, dental internship and 47 75 80% 40 86 100% Overachievement was due to organization commitment to
standards of specialist training Centres inspected. inspect all Internship and Collegiate Training Centres.
training and Number of compliance inspections carried out 2,650 2,800 3,100 2,720 3,141 3,560 Overachievement was due to frequent routine inspections.
healthcare services Proportion of determined malpractice cases N/A N/A 75% N/A N/A 80% "Overachievement was due to increase in Disciplinary and
Ethics Committee hearings' to determine the lodged cases.
Nursing Council Competent health Proportion of nurses and midwives with valid N/A 100 55 N/A 50 46.5 Inadequate retention compliance audits due to budget
of Kenya professionals practising licence constraints
Number of students indexed N/A 3500 6400 N/A 5852 19249 The overachievement was occasioned by enhanced
compliance audit and clearing the backlog caused by Covid
Number of eligible candidates examined 7,000 8,000 10,000 7,205 12,418 10,937 Target was slightly surpassed because some students were
resitting some papers.
Number of nurses and midwives newly 6,000 8,857 9,000 4,533 6,238 6,341 Some of the nurses are unable to meet the registration
registered requirements
Number of guidelines reviewed/Developed N/A 4 4 N/A 2 3 Over the period the targets were not achieved due to the delay
in the approval process
Compliance to set Proportion of training institutions that are N/A 100 100 N/A 80 88.3 Most of non-compliance are HR related
standards of compliant to set norms and standards
training institutions
and health facilities
Number of health facilities compliance 8 2 19 4 2 19 The council participated in all joint inspections upon invitation
inspections carried out
Career growth and Number of nurses and midwives exported to N/A 200 450 N/A 17 128 The target was not met due to delay in development of the
development work in UK Under the UK -Kenya BLA recruitment guidelines and limited job orders

Programme Delivery Unit Key Output Key Performance Indicators Planned Targets Achieved Targets Remarks
2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
Programme 4: Health Policy, Standards and Professional Management
Programme Outcome: Strengthened Health Policy, Standards and Regulations
4.1: Health National Quality Access to quality Proportion of medical drugs tested for quality, 100% 100% 100% 74.1% 69.4% 93% We were not able to meet the target for drug testing because
Standards, Control drugs and medical safety of the citizens. most of our HPLC machines were not calibrated due to lack of
Quality Laboratory devices funds hence couldn’t be used for testing
Assurance & Access to quality Proportion of medical devices tested for 100% 100% 100% 80% 10% 100%
Standards For medical testing we surpassed the target. This is because
medical devices quality , safety of citizens
our equipment was services and calibrated for use
safety for citizens
SP4. 2: Health Department of Policies developed Number of policies developed N/A N/A 1 N/A N/A 1
Policy, Planning Health Policy
Targets achieved
&
Financing

116
2. ANALYSIS OF EXPENDITURE TRENDS FOR THE FY 2020/21-2022/23

The approved budget for the Sector was KSh. 120,833 million, KSh. 129,781 million and KSh.
116,397 million in FY 2020/21, FY 2021/22 and FY 2022/23 respectively. The actual expenditures
were KSh. 105,470 million, KSh. 109,400 million and KSh. 98,658 million translating to
absorption rates of 87.5%, 84.3% and 84.8% in FY 2020/21, FY 2021/22 and FY 2022/23
respectively.

1. ANALYSIS OF RECURRENT EXPENDITURE (KSH. MILLION)

The approved recurrent budget for the Sector was KSh. 67,719 million, KSh. 65,972 million and
KSh. 72,074 million in FY 2020/21, FY 2021/22 and FY 2022/23 respectively. The actual
expenditures were KSh. 63,861 million, KSh. 65,944 million and KSh. 67,601 million translating
to recurrent absorption rates of 94 percent, 100 percent and 94 percent in FY 2020/21, FY 2021/22
and FY 2022/23 respectively.

Table 2.2: Analysis of Recurrent Expenditure (KSh. Million)

Approved Budget
Actual Expenditure
Allocation
Economic Classification 2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
Health Sector
Gross 67,719 65,972 72,074 63,861 65,944 67,601
AIA 16,233 18,448 21,644 14,421 18,370 18,716
NET 51,486 47,524 50,430 49,440 47,574 48,885
Compensation to Employees 13,239 13,718 14,354 13,243 13,717 14,137
Transfers 52,653 49,841 55,161 48,839 49,836 50,911
Other Recurrent 1,827 2,413 2,559 1,779 2,391 2,557
Utilities 109 0 114 108 0 86
Rent 3 0 1 3 0 0
Insurance 2 0 0 1 0 0
Subsidies 0 0 0 0 0 0
Gratuity 0 0 0 0 0 0
Contracted guards & Cleaners
56 0 70 55 0 62
Services
Others (Specify) 1,657 2,413 2,374 1,612 2,391 2,379

Table 2.2a: Analysis of Recurrent Expenditure (KSh. Million) – State Department for
Medical Services

Economic Classification Approved Budget Allocation Actual Expenditure

2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
Gross 67,719 65,972 69,199 63,861 65,944 65,620
AIA 16,233 18,448 20,466 14,421 18,370 17,550

117
 NET 51,486 47,524 48,733 49,440 47,574 48,070
Compensation to Employees 13,239 13,718 14,354 13,243 13,717 14,137
Transfers 52,653 49,841 52,520 48,839 49,836 49,111
Other Recurrent 1,827 2,413 2,325 1,779 2,391 2,372
Insurance Costs 2 - 1 -
Utilities 109 104 108 78
Rent 3 1 3 -
Contracted Guards & Cleaners Services 56 70 55 62
Others 1,657 2,413 2,150 1,612 2,391 2,232
Contracted guards & Cleaners Services 0 0
Others (Specify) 224 147

Table 2.2b: Analysis of Recurrent Expenditure (KSh. Million) – State Department of

Public Health and Professional Standards

Economic Classification Approved Budget Allocation Actual Expenditure

2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
Gross 2,875 1,981
AIA 1,178 1166
NET 1,697 815
Compensation to Employees - -
Transfers 2,641 1,800
Other recurrent of which 234 185
Utilities 10 8
Rent 0 0
Insurance 0 0
Subsidies 0 0
Gratuity 0 0
Contracted guards & Cleaners Services 0 0
Others (Specify) 224 147

2.2.2 ANALYSIS OF DEVELOPMENT EXPENDITURE (KSH. MILLION)

The approved development budget for the Sector was KSh. 52,864 million, KSh. 63,809 million
and KSh. 44,323 million in FY 2020/21, FY 2021/22 and FY 2022/23 respectively. The actual
expenditures were KSh. 41,609 million, KSh. 43,456 million and KSh. 31,057 million translating
to development absorption rate was 79 percent, 68 percent and 70 percent in FY 2020/21, FY
2021/22 and FY 2022/23 respectively.

Table 2.3: Analysis of Development Expenditure (KSh. Million)

Description Approved Budget Actual Expenditure

2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
Gross 52,864 63,809 44,323 41,609 43,456 31,057
GOK 32,007 35,479 27,898 28,902 29,406 22,567
Loans 11,005 19,524 8,180 7,585 10,442 5,041
Grants 9,852 8,805 8,245 5,122 3,608 3,449
Local AIA - - - - - -
118
Table 2.3a: Analysis of Development Expenditure (KSh. Million) – State Department of
Medical Services
Approved Budget Actual Expenditure
Description
2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
Gross 52,864 63,809 41,986 41,609 43,456 31,057
GOK 32,007 35,479 25,561 28,902 29,406 22,567
Loans 11,005 19,524 8,180 7,585 10,442 5,041
Grants 9,852 8,805 8,245 5,122 3,608 3,449
Local AIA - - - -

Table 2.3b: Analysis of Development Expenditure (KSh. Million) – State Department of

Public Health and Professional Standards

Description Approved Budget Allocation Actual Expenditure

2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
Gross - - 2,337 - - -
GOK - - 2,337 - - -
Loans - - - - - -
Grants - - - - - -
Local AIA - - - - - -

2.2.3 ANALYSIS OF PROGRAMME EXPENDITURE

During the period under review the Sector implemented eight (8) programmes and 25 Sub-
programmes whose allocation and actual expenditure is detailed in Tables 2.4.

Table 2.4a: Analysis of Programme FY 2020/21 – 2022/23 (KSh. Million) – State Department
of Medical Services
Programme Approved Budget Actual Expenditure
2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
Programme 1 – Preventive & Promotive Health Services including RMNCAH
SP1.2 - Non-communicable 367 535 670 333 394 529
disease prevention & control
SP1.3 - RMNCAH 8,047 7,648 7,155 4,445 3,232 3,040
SP1.4 - Radiation Protection 142 235 191 142 235 108
SP1.5 -Communicable 6,367 6,391 7,140 5,581 3,774 5,019
Disease Control
SP1.8- Disease Surveillance 13,516 15,139 4,684 5,485 7,773 2,989
and Response
SP1.5 Environmental Health 66 128 500 146 75 463
Total Expenditure 28,505 30,076 20,340 16,132 15,483 12,148
Programme 1
Programme 2 - National Referral and specialized Services
SP2.1 - National Referral 33,095 37,098 41,799 31,883 35,887 41,370
Services
SP 2.2 Mental Health - - 125 - - 111
SP 2.3 Forensics and - - 2,067 - - 1,483
Diagnostics

119
 Programme Approved Budget Actual Expenditure
2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
SP2.4 - Free Primary 8 - - 8 - -
Healthcare
SP 2.5 Specialized Medical 6,205 7,205 3,795 6,195 7,205 3,712
Equipment
SP2.6 – National Blood 1,705 1,988 129 1,035 985 125
Transfusion Service
SP2.7 - Health Products and 3,692 3,990 2,907 3,817 3,934 1,325
Technologies
Total Expenditure 44,705 50,281 50,822 42,938 48,011 48,126
Programme 2
Programme 3 - Health Research and Development
SP3.1 - Capacity Building & 7,130 7,860 6,701 5,850 7,760 4,894
Training
SP3.2 – Research & 2,643 3,493 3,315 2,701 3,461 3,013
Innovations
Total Expenditure 9,773 11,353 10,016 8,551 11,221 7,907
Programme 3
Programme 4 - General Administration, Planning & Support Services
SP 4.1 - Health Policy, 1,866 1,527 1,958 1,193 963 1,425
Planning & Financing
SP 4.2 – Health Standards, - - 1,116 - - 644
Quality Assurance &
Standards
SP4.3 – National Quality - - 118 - - 117
Control Laboratories
SP 4.4 Human Resource 6,117 6,574 6,893 6,088 6,571 6,928
Management
Total Expenditure 7,983 8,101 10,085 7,281 7,534 9,114
Programme 4
Programme 5 - Health Policy, Standards and Regulations
SP5.1 -Health Policy, 14,445 17,059 12,268 17,127 15,940 11,787
Planning & Financing
SP5.2 -Health Standards and 957 406 436 843 401 366
Regulations
SP5.3 -Social Protection in 14,216 12,504 7,218 12,598 10,810 7,229
Health
Total Expenditure 29,618 29,969 19,922 30,568 27,151 19,382
Programme 5
Total Vote 1082 120,584 129,780 111,185 105,470 109,400 96,677

Table 2.4b: Analysis of Programme FY 2020/21 – 2022/23 (KSh. Million) – State Department
of Public Health and Professional Standards
Programme Approved Budget Actual Expenditure

Programme1: Preventive & Promotive Health Services

SP1.1 Non-communicable - - 1.8 0.6
Disease Prevention &
Control

120
 Programme Approved Budget Actual Expenditure

SP2.1Reproductive Maternal - - 975.0 26.0

Neo-natal Child &
Adolescent Health-
RMNCAH
SP3.1 Radiation Safety and 64.0 36.0
Nuclear Security
SP4.1Communicable Disease 1,350.0 52.0
Control
SP5.1: Disease Surveillance 100.0 -
and Response
SP6.1: Environmental Health 32.0 11.0
Total Programme 1 2,522.8 - - 125.6
Programme 2: Health Research and Development
SP 2.1: Capacity Building 2,154.0 1,622.0
and Training
SP 2.2: Research and 25.0 25.0
Innovation on Health
Total Programme 2 2,179.0 1,647.0
Programme 3: General Administration and Human Resource Management
SP3.1 Health Standards, 365 135
Quality Assurance &
Standards
SP3.2 Human Resource 65 41
Management and
Development
SP3. 3: Health 50 20
Administration
Total Programme 3 480 196
Programme 4: Health Policy, Standards and Regulations
SP4.1 Health Policy, 21.0 2.0
Standards and Regulations
SP4. 2: Health Policy, 10.0 11.0
Planning & Financing
Total Programme 4 31.0 - 13.0
Total Vote 1083 5,212.8 - - 1,981.6

2.2.4 ANALYSIS BY CATEGORY OF EXPENDITURE ECONOMIC

CLASSIFICATION
This section shows the breakdown of approved and actual expenditures in FY 2020/21 to FY
2022/23 disaggregated by economic classifications. Analysis of expenditures by Economic
classification indicates transfers to government agencies consumed the largest share of funds. The
Transfer to Government Agencies accounted for 76 percent of budget allocation in FY 2022/23
followed by Compensation to Employees at 12 percent. Detailed analysis is provided in Table 2.5.

Table 2.5: Analysis by Category of Expenditure: Economic Classification (KSh. Million)

Expenditure Classification Approved Budget Actual Expenditure
2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
State Department of Medical Services

121
Expenditure Classification Approved Budget Actual Expenditure
2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
Programme 1: Preventive and 28,505 30,077 20,340 16,132 15,483 12,148
Promotive Health Services
including RMNCAH
Current Expenditure 5,149 3,077 2,001 5,115 3,069 1,854
Compensation to Employees 3,872 1,667 712 3,872 1,667 690
Use of Goods and Services 236 231 242 227 227 232
Grants and other Transfers 1,041 1,179 1,047 1,016 1,175 932
Other Recurrent - - - - - -
Capital Expenditure 23,356 27,000 18,339 11,017 12,414 10,294
Compensation to Employees 17 - - 15 -
Use of Goods and Services 4,639 4,611 1,690 984 1,141 1,180
Capital Govt Agencies 18,256 22,131 15,615 9,582 11,018 8,452
Other Development (Non-financial) 461 240 1,034 451 240 662
Programme 2: National Referral 44,705 50,281 50,822 42,938 48,011 48,126
and specialized Services
Current Expenditure 34,792 37,524 41,471 34,020 37,620 41,011
Compensation to Employees 1,122 1,152 1,117 1,122 1,152 1,049
Use of Goods and Services 600 640 826 605 637 693
Subsidies
Current Govt Agencies 32,922 35,631 39,186 32,146 35,737 39,012
Social Benefits 100 100 100 100
Other Recurrent- Non-financial 48 102 242 47 94 157
Capital Expenditure 9,913 12,757 9,351 8,918 10,391 7,115
Compensation to Employees
Use of Goods and Services 7,068 8,355 4,618 7,059 7,872 4,367
Subsidies
Capital Govt Agencies 1,348 1,943 2,751 1,602 1,486 1,792
Other Development (Non-financial) 1,497 2,459 1,982 257 1,032 956
Programme 3: Health Research 9,773 11,353 10,016 8,551 11,221 7,907
and Development
Current Expenditure 9,140 10,066 8,688 7,863 10,061 6,679
Compensation to Employees 58 58
Use of Goods and Services
Subsidies
Current Govt Agencies 9,082 10,066 8,688 7,805 10,061 6,679
Other Recurrent-
Capital Expenditure 633 1,287 1,328 688 1,160 1,228
Compensation to Employees
Use of Goods and Services
Subsidies
Capital Govt Agencies 360 1,136 1,096 436 1,009 1,026
Other Development 273 151 232 252 151 202
Programme 4: General 7,983 8,102 10,086 7,281 7,535 9,114
Administration, Planning &
Support Services
Current Expenditure 6,738 7,042 8,824 6,766 7,044 8,262
Compensation to Employees 5,900 5,382 6,923 5,900 5,382 6,863
Use of Goods and Services 744 1,018 1,004 714 1,020 811
Subsidies
Current Govt Agencies 94 636 886 152 636 579
Other Recurrent- 5 11 5 9
Capital Expenditure 1,245 1,060 1,262 515 491 852
122
Expenditure Classification Approved Budget Actual Expenditure
2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
Compensation to Employees
Use of Goods and Services
Subsidies
Capital Govt Agencies 1,245 1,060 1,082 515 491 802
Other Development 180 50
Programme 5: Health Policy, 29,618 29,967 19,921 30,568 27,150 19,382
Standards and Regulations
Current Expenditure 11,901 8,262 8,211 10,097 8,149 7,814
Compensation to Employees 2,287 5,516 5,602 2,291 5,516 5,535
Use of Goods and Services 173 397 186 161 388 168
Subsidies - - - -
Current Govt Agencies 9,414 2,330 2,103 7,621 2,226 1,909
Other Recurrent- 26 19 320 25 19 202
Capital Expenditure 17,717 21,705 11,710 20,471 19,001 11,568
Compensation to Employees
Use of Goods and Services 697 1,420 306 795 1,366 299
Subsidies
Capital Govt Agencies 16,972 19,305 11,398 19,612 16,671 11,263
Non-financial Assets 48 980 6 64 964 6
Total Vote 120,584 129,780 111,185 105,470 109,400 96,677
State Department for Public Health and Professional Standards
Programme1 Preventive & Promotive Health Services
Current Expenditure
Compensation to employees - -
Use of goods and services 44.0 36.0
Grants and other transfers 309.0 69.0
Other recurrent 21.0 21.0
Capital Expenditure
Acquisition of Non –Financial
Assets
Capital Grants to Government 2,148.0 -
Agencies
Other Development -
TOTAL PROGRAMME 1: 2,522.0 - - 126.0
Programme 2: Health Research and Development
Current Expenditure
Compensation to employees - -
Use of goods and services
Grants and other transfers 1,990.0 1,391.0
Other recurrent -
Capital Expenditure -
Acquisition of Non –Financial -
Assets
Capital Grants to Government 189.0 -
Agencies
Other Development -
TOTAL PROGRAMME 2 2,179.0 - - 1,391.0
Programme 3: General Administration,
Current Expenditure
Compensation to employees - -
Use of goods and services 132.0 102.0
Grants and other transfers 329.0 329.0

123
 Expenditure Classification Approved Budget Actual Expenditure
2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
Other recurrent 19.0 13.0
Capital Expenditure
Acquisition of Non –Financial - -
Assets
Capital Grants to Government - -
Agencies
Other Development - -
TOTAL PROGRAMME 3 480.0 - - 444.0
Programme 4:Health Policy, Standards and Regulations
Current Expenditure
Compensation to employees - -
Use of goods and services 14.0 11.0
Grants and other transfers 12.0 4.0
Other recurrent 5.0 5.0
Capital Expenditure
Acquisition of Non –Financial
Assets
Capital Grants to Government
Agencies
Other Development -
TOTAL PROGRAMME 4 31.0 - - 20.0
Total Vote 5,212.0 - - 1,981.0

2.2.5 ANALYSIS OF SAGAS RECURRENT BUDGET VS ACTUAL EXPENDITURE

Table 2.6: Analysis of SAGAs Recurrent Budget Vs Actual Expenditure (KSh. Millions)
SAGAS UNDERSTATE DEPARTMENT OF MEDICAL SERVICES

1. Kenyatta National Hospital (KNH)

Approved Budget Approved Expenditure
Economic
2020/21 2021/22 2022/23 2020/21 2021/2022 2022/2023
Classification
Gross 14,474 15,202 18,092 16,784 18,327 18,385
AIA 5,093 5,382 7,651 7,403 8,507 7,944
NET 9,381 9,820 10,441 9,381 9,820 10,441
Compensation to
10,223 11,484 12,415 12,333 13,042 12,766
Employees
Other Recurrent 4,251 3,718 5,677 6,747 6,556 7,882
Insurance 8 11 97 7 3 105
Utilities 679 438 395 611 642 574
Rent 0 0 0 0 0 0
Contracted
Professionals
98 121 131 70 103 155
(Guards, Cleaners
etc)
Others 3,466 3,148 5,054 6,059 5,808 7,048

124
 Surplus/Deficit 0 0 0 (2,296) (1,271) (2,263)

The deficit of KSh 2.3Billion is attributed to high provision for bad debt due to inability of patients
seeking medical services especially indigents patients to pay for services rendered.

2. Mwai Kibaki Hospital- Othaya (Kenyatta National Hospital)

Economic Approved Budget Approved Expenditure
Classification 2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
Gross 760 800 1,012 967 1,117 1,265
AIA 0 40 217 207 357 470
NET - Exchequer 760 760 795 760 760 795
Compensation to
510 579 611 500 550 863
Employees
Other Recurrent 250 221 401 467 565 499
Insurance 0 0 0 0 8 0
Utilities 17 26 35 17 34 37
Rent 0 0 0 0 0 0
Contracted
Professionals
10 18 17 10 22 21
(Guards, Cleaners
etc.)
Others 223 177 349 440 501 441
Surplus/Deficit 0 0 0 0 2 (97)

The deficit of KSh 97 Million is attributed to high provision for bad debt due to inability of patients
seeking medical services especially indigents patients to pay for services rendered.

3. Mama Margaret Uhuru Hospital (Kenyatta National Hospital)

Approved Budget Approved Expenditure
Economic 2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
Classification
Gross - 350 401
AIA - Internally - 51
Generated Revenue
NET - Exchequer - 350 350
Compensation to 264 345
Employees
Other Recurrent - 124 102
Of Which:
Insurance 45 45
Utilities 20 15
Rent
Contracted 16 17
Professionals
(Guards, Cleaners)
125
 Approved Budget Approved Expenditure
Economic 2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
Classification
Others 43 25
Deficit/Surplus (46)

The deficit of KSh 46Million is attributed to high provision for bad debt due to inability of patients
seeking medical services especially indigents patients to pay for services rendered.

4. Moi Teaching and Referral Hospital (MTRH)

ECONOMIC Approved Budget Approved Expenditure
CLASSIFICATION 2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
GROSS 11,307 11,205 12,053 11,471 11,529 11,803
AIA 3,259 3,434 3,605 3,423 3,758 3,755
Net Exchequer 8,048 7,771 8,448 8,048 7,771 8,048
Compensation of
8,266 8,104 8,018 8,287 8,570 8,792
Employees
Other Recurrent 3,041 3,101 4,035 3,184 2,959 3,011
Of Which:
Utilities 122 149 167 122 152 166
Rent 1.2 3.0 1.6 1.2 1.0 1.6
Insurance 308 326 361 308 314 361
Subsidies 0 0 0 0 0 0
Gratuity 12 43 12 43 0
Contracted Guards &
Cleaners services - - - - - -
Others 2,598 2,580 3,505 2,741 2,449 2,482

The KSh.774 Million in PE shortfall in FY 2022/23 is a result of inadequate provision for

Personnel Emoluments. In the supplementary allocations towards the end of FY2022/23, KSh 400
Million was allocated but no disbursement was done.

5. Kenyatta University Teaching Referral and Research Hospital (KUTRRH)

ECONOMIC Approved Budget Approved Expenditure
CLASSIFICATION 2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
GROSS 2,901 4,293 5,429 3,532 4,462 5,511
AIA - Internally Generated
Revenue 750 1,700 2,836 1,381 1,869 2,918
Net Exchequer 2,151 2,593 2,593 2,151 2,593 2,593
Compensation of Employees 1,383 2,141 3,020 1,536 2,177 3,215
Other Recurrent 1,518 2,152 2,409 1,996 2,285 2,296
Of Which:
Utilities 148 154 154 126 156 216

Rent - - - - - -
126
 ECONOMIC Approved Budget Approved Expenditure
CLASSIFICATION 2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
Insurance 174 216 216 35 204 250

Subsidies - - - - - -

Gratuity - - - - - -
Contracted Professional 185 258 258 91 224 265
Others 1,011 1,524 1,524 1,744 1,701 1,565

The Hospitals’ FY2022/23 approved AIA budget was KSh 2.836Billion however, the hospital was
able to collect KSh 2.918Billion for FY2022/23. This was mainly attributed to increased patients'
number, operationalized specialized clinics and other clinical areas such as the Integrated
Molecular Imaging Center. The compensation of employees grew from the budgeted KSh 3.020B
to KSh 3.215B in the FY 2022/2023. This was due to recruitment of new staff to operationalize
the hospital. The utilities grew by 40% this was due increased operational cost.

6. Gatundu Level V Hospital

ECONOMIC Approved Budget Approved Expenditure
CLASSIFICATION 2020/2 2021/2 2022/2 2020/2 2021/2 2022/2
1 2 3 1 2 3
GROSS 493 574 574 253 324 500
AIA - Internally Generated
Revenue 240 250 250 - - -
Net Exchequer 253 324 324 253 324 500
Compensation of Employees 68 93 130 35 92 102
Other Recurrent 425 481 444 218 232 398
Of Which
Utilities - 1 1 0 0.44 0.44
Rent - - - - - -
Insurance - - - - - -
Subsidies - - - - - -
Gratuity - - - - - -
Contracted Professional - - 2 2
Others 425 480 480 218 230 396

AIA collection at the Hospital is still a function of the County Government. However, the
implementation of the MOU is still on-going and the issue of AIA collection is being addressed to
allow for the AIA to reflect against the Hospitals budget. In regard to PE Absorption, the on-
boarding of staff from Gatundu Level V Hospital to KUTRRH is Work in Progress and this will
increase the PE budget absorption once the exercise is complete.

7. Kenya Medical Research Institute (KEMRI)

ECONOMIC Approved Budget Approved Expenditure
CLASSIFICATION 2020/21 2021/22 2022/23 2020/21 2021/22 2022/23

127
 Gross 2,493 2,787 2,966 2,671 2,823 3,022
AIA - Internally Generated
130 184 184 300 220 240
Revenue
NET - Exchequer 2,363 2,603 2,782 2,371 2,603 2,782
Compensation to Employees 1,920 2,342 2,342 1,999 2,431 2,780
Other Recurrent 573 445 624 672 392 242
Of Which:
Utilities 105 110 110 92 112 120
Rent & Rates 2 2 2 2 2 2
Insurance 12 16 16 10 17 18
Subsidies 0 0 0 0 0 0
Gratuity 0 0 0 0 0 0
Contracted Professional
64 64 64 63 55 59
(Guards & Cleaners)
Others 390 252.5 431.5 505 206 43

In the FY 2020/21, FY 2021/22 and FY 2022/23, the actual expenditure in PE was attributed to
the implementation of SRC job evaluation phase II for recruitment of 65 employees to help in
UHC and Covid-19 management.

Deficit in FY 2021/22 and 2022/23 is attributed to increased PE due to Court order dated 14
October Case no 37 of 2010 which ordered reinstatement of 34 employees.

In the FY 2022/23, there was an increase in AIA by KSh 58M from the approved budgeted amount
of KSh 184M. The growth was attributed to sale of commercial products (t-bicide and sanitizers).
This trajectory is however not sustainable considering there are currently many players
manufacturing the same products.

8. Kenya Medical Supplies Authority (KEMSA)

ECONOMIC Approved Budget Approved Expenditure
CLASSIFICATION 2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
Gross 3,285 3,027 3,931 3,282 3,083 4,791
AIA - Internally
Generated Revenue 3,160 2,927 3,811 3,157 2,983 4,671
NET 125 100 120 125 100 120
Compensation to
Employees 1,268 1,256 1,276 1,264 1,224 1,209
Other Recurrent 2,017 1,770 2,656 2,018 1,860 3,582
Of Which
Utilities 18 15 25 19 14 25
Rent 217 88 15 217 86 15
Insurance 159 150 179 159 150 179
Subsidies
Gratuity

128
 Contracted
Professional 146 199 163 146 199 163
Services
Others 1,477 1,319 2,274 1,477 1,411 3,200
*KEMSA Actual AIA and expenditure for FY 2022/23 was slightly above budget due
impairment loss and forex exchange loss suffered by the Authority

KEMSA total expenditure for FY2022/23 was KSh 4.79 Billion marking a substantial 55%
increase from the previous financial year (FY 2021/22) performance of KSh 3.08 billion. In
comparison to the budget, this represented a 122% performance. This increase can be attributed to
tax penalties imposed on the Authority and losses incurred due to a weakening shilling in foreign
exchange. The mandatory costs were funded through the Authority's collection of outstanding
debts.

Compensation for employees has shown a declining trend, reducing from KSh 1.264 billion (FY
2020/21) to KSh 1.224 billion (FY 2021/22) and further to KSh 1.208 billion (FY 2022/23). This
continued decrease in compensation of employees is attributed to the ongoing human resource
reorganization within KEMSA. There has been no increase in GOK funding for KEMSA
personnel, with allocations remaining at KSh 125 million (FY 2020/21), KSh 100 million (FY
2021/22), and KSh 120 million (FY 2022/23). This lack of GoK support on personnel emoluments
has placed significant constraints on the Authority's liquidity, as the disbursed funds do not
adequately cover the Authority's Personal Emoluments.
National Commodities Storage Centre (KEMSA Supply Chain center) construction updates; The
project was originally planned to be completed in 130 weeks, commencing in April 2018.
However, the project's completion has been delayed due to the unavailability of funds. The
allocation of KSh. 310 FY 22/23 million was not received and KSh. 250 million FY 2020/21 were
also not received.

9. National Health Insurance Fund (NHIF)

ECONOMIC Approved Budget Approved Expenditure
CLASSIFICAT 2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
ION
Gross 94,516 94,590 93,072 62,159 78,159 80,964
AIA 94,516 94,590 93,072 62,159 78,159 80,964
NET - - - - - -
Compensation to 5,083 5,083 6,044 5,211 5,037 5,289
Employees
Transfers - - - - -
*Member 79,663 79,680 79,160 52,671 68,655 74,225
Benefits ( Cost
of Sales)
Other 2,730 2,730 4,105 1,392 1,967 2,358
recurrent
Of which:
Utilities 58 58 216 52 98 216

129
 Rent & Rates - - - - - -
Insurance 405 405 417 301 353 347
Subsidies - - - - - -
Gratuity - - - - - -
Contracted
Professional 611 611 1,089 160 373 593
(Guards &
Cleaners)
Others 1,011 1,011 1,739 351 597 590
Depreciation 645 645 645 529 546 613
Surplus
(Deficit) 7,041 7,097 3,762 2,885 2,499 (908)

In FY2022/23, the Fund had projected to collect revenue amounting to KSh 93 billion however it
missed the target by 12% and collected KSh 82.1 billion. The slight negative variance was
attributable to the low retention rate, especially in the informal sector of the national scheme due
to adverse selection of the members under this sector and the difficult economic times experienced
in recent years. The NHIF 2018-2022 strategic plan targeted a member retention rate of 88% for
the formal sector and 74% for the informal sector. However, the actual performance of 77% and
22% for formal and informal sectors respectively in FY 2022/23 affected the revenue collected.

Further, In FY 2022/23 the total member benefits paid amounted to 74.2 billion compared to a
budget of KSh 79.1 billion representing a performance of 94%. Compared to premiums and
contributions for the year, the benefit pay-out ratio stood at 90% higher than the projected pay-out
ratio of 85%. Benefits paid out have continued to grow over the last three years amounting to KSh
52.6 billion in FY 2020/21, KSh 68.6 billion in FY 2021/22 and KSh 74.2 billion in FY 2022/23.

Personnel emoluments amounted to KSh 5.2 billion compared to a budget of KSh 6 billion while
other recurrent expenditure amounted to KSh 3.5 billion vis-à-vis a budget of KSh. 4.1 billion.
The deficit of KSh 908.6 million in FY2022/23 was attributed to the low income collected during
the period.

N/B: The annual financial statements for FY 2022/23 are unaudited.

10. National Aids Control Council (NACC)

ECONOMIC Approved Budget Approved Expenditure
CLASSIFICATION 2020/21 2021/22 2022/23 2020/2 2021/2 2022/
1 2 23
Gross 942 714 877 968 747 691
AIA - - - - - -
Net 942 714 877 968 747 691
Compensation to employees 517 517 496 502 501 438
Other recurrent 426 198 381 466 246 253
Of Which - - - - -
Utilities 4 4 63 4 10 47
Rent 72 71 73 70 78 72

130
 Insurance 9 2 45 7 4 5
Subsidies - - - - -
Gratuity - - 74 - - 74
Contracted Professionals 16 6 25 14 13 25
(Guards and Cleaners )
Others 326 116 101 371 141 29

In FY 2022/23, The NACC did not receive the full allocation for the FY2022/23 as provided in
the approved estimates resulting to the variance between the approved budget for FY 2022/23 and
the actual for FY 2022/23. An amount of KSh 186M was not disbursed. This affected the
effectiveness of the NACC planned activities and committed objectives resulting to Pending Bills.

The majority of the NACC programmes are recurrent in nature as they involve facilitating
communities and stakeholders to undertake prevention interventions, capacity building of
communities and advocacies. For this reason, the NACC recurrent budget is n4ot only for PE and
utilities but also for programme operations therefore more resources should be allocated for the
recurrent expenditures.

11. The National Cancer Institute-Kenya

ECONOMIC Approved Budget Approved Expenditure
CLASSIFICATION 2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
Gross 80 120 140 75 120 140
AIA - - - - - -
NET 80 120 140 74.8 120 140
Compensation to
- - 45 - - 15
Employees
Other Recurrent 80 120 95 75 120 125
Of Which
Utilities - - 20 - - 22
Rent - - 15 - - 21
Insurance - - - - - -
Subsidies - - - - - -
Gratuity - - - - - -
Contracted Professionals
- - 12 - - 11
(Guards, Cleaners etc.)
Others 80 120 48 75 120 71

In FY 2022/23, the National Cancer Institute of Kenya was allocated Kshs140 million as Recurrent
grant representing a 15% increase in allocation compared to KSh.120 million allocated in 2021/22.
NCI-Kenya successfully utilized allocated GOK funds to cater for its various administrative and
programmatic activities, with 100% absorption rates reported in FY 2021/22. However, there was
non-release of KSh 18Million which led to accrual of pending bills.

12. Blood Transfusion and Transplant Authority

ECONOMIC Approved Budget Approved Expenditure
CLASSIFICATION 2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
131
 Gross 0 0 241 0 0 241
AIA 0 0 0 0
NET 0 0 241 0 0 241
Compensation to 0 0 197 0 0 197
Employees
Transfers 0 0 0 0
Other Recurrent 0 0 45 0 0 44
Of which
Utilities 0 0 3 0 0 3
Rent 0 0 0 0 0 0
Insurance 0 0 0 0 0 0
Subsidies 0 0 0 0 0 0
Gratuity 0 0 0 0 0 0
Contracted Guards 0 0 2 0 0 2
& Cleaners Services
Other specify 0 0 40 0 0 40

In the FY2022/23, the Kenya Tissue and Transplant authority was allocated Kshs241Milion as
recurrent grants. The KTTA successfully utilized allocated GoK funds to cater for its various
services and programmatic activities, with 100% absorption rate reported in the same year.

13. Biovax Institute

ECONOMIC APPROVED BUDGET ACTUAL EXPENDITURE
CLASSIFICATION 2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
Gross 0 100 100 0 91 58
AIA - - - - - 12
NET 0 100 100 0 91 58
Compensation to - - 12 - - 12
Employees
Other Recurrent 0 100 88 0 19 54
Of Which:
Utilities - - - - - -
Rent & Rates - 19 19 - - -
Insurance - - - - - -
Subsidies - - - - - -
Gratuity - - - - - -
Contracted
Professional (Guards &
Cleaners) - - - - - -
Others - 81 69 - 19 54
Surplus - - - - 72 4
The low absorption in the Recurrent Budget 2021/22 was as a result of delays in the approval of
the Institutes HR tools that resulted in the postponement of the recruitment of staff. The SCAC
approvals have since been obtained and the recruitment is in its final process.

132
SAGAS UNDERSTATE DEPARTMENT OF PUBLIC HEALTH AND PROFESSIONAL
STANDARDS

14. KENYA MEDICAL PRACTITIONERS & DENTISTS COUNCIL

ECONOMIC Approved Budget Approved Expenditure
CLASSIFICATION 2020/21 2021/2 2022/2 2020/2 2021/22 2022/2
2 3 1 3
Gross 720.10 840.20 810.45 700.80 836.60 792.90
AIA 533.90 340.20 350.45 513.95 336.60 332.90
Net 186.25 500.00 460.00 186.25 500.00 460.00
Compensation to 127.00 165.00 205.00 126.50 163.00 195.00
Employees
Transfers 0 0 0 0 0 0
Other Recurrent 593.10 675.20 605.45 574.30 673.60 597.90
Of Which
Utilities 5.50 2.15 3.50 4.30 2.10 3.10
Rent 0 0 5.00 0 0 3.90
Insurance 15.00 17.00 21.00 14.15 16.70 18.70
Subsidies 0 0 0 0 0 0
Gratuity 30.00 47.35 25.00 26.50 47.18 23.35
Contracted Professional 1.90 2.60 2.35 1.85 2.50 2.30
Services (Guards &
Cleaners)
Others 540.70 606.10 548.60 527.50 605.12 546.55

15. Kenya Medical Training College

ECONOMIC Approved Budget Approved Expenditure
CLASSIFICATION 2020/21 2021/2 2022/2 2020/2 2021/2 2022/23
2 3 1 2
Gross 6,589 7,179 7,859 5,813 8,345 7,862
AIA 3,640 3,640 3,640 2,864 4,806 4348
Net 2,949 3,539 4,219 2,949 3,539 3,514
Compensation to 4,155 4,279 4,315 4,093 4,118 4,303
Employees
Transfers 0 0 0 0 0 0
Other Recurrent 2,434 2,900 3,544 1,720 4,227 3,559
Of Which
Utilities 222 164 160 113 154 156
Rent 4 4 4 2 3 4
Insurance 632 700 650 542 403 605
Subsidies 0 0 0 0 0 0
Gratuity 40 65 120 10 33 114
Contracted Professional 300 350 350 288 307 345
Services (Guards &
Cleaners)

133
Others 1,236 1,617 2,260 775 3,360 2,335

16. Kenya Board of Mental Health

ECONOMIC Approved Budget Approved Expenditure
CLASSIFICATION 2020/21 2021/2 2022/2 2020/2 2021/2 2022/2
2 3 1 2 3
Gross 0 0 1.7 0 0 0
AIA 0 0 0 0 0 0
Net-Exchequer 0 0 1.7 0 0 0
Compensation to 0 0 0 0 0 0
Employees
Transfers 0 0 0 0 0
Other Recurrent Of Which 0 0 0 0 0
Utilities 0 0 0 0 0 0
Rent 0 0 0 0
Insurance 0 0 0 0 0 0
Subsidies 0 0 0 0 0 0
Gratuity 0 0 0 0 0 0
Contracted Professional 0 0 0 0 0 0
Services (Guards &
Cleaners)
Others 0 0 0 0 0 0

17. Nursing Council of Kenya

ECONOMIC Approved Budget Approved Expenditure
CLASSIFICATION 2020/21 2021/2 2022/2 2020/2 2021/2 2022/2
2 3 1 2 3
Gross 355 424 440 284 438 541
AIA 355 346 390 284 360 496
Net-Exchequer 0 78 50 0 78 45
Compensation to 104 108 103 90 110 103
Employees
Transfers 0 0 0 0 0 0
Other Recurrent 251 316 337 194 328 438
Of Which
Utilities 12.1 16.7 27 11.5 16.8 26.9
Rent 0 0 0 0 0 0
Insurance 11.3 12.8 19.2 10.6 11.3 19
Subsidies 0 0 0 0 0 0
Gratuity 9.6 11.9 13.6 10.5 12.4 13.1
Contracted Professional 2.1 2.5 3 2.1 2.3 3.8
Services (Guards &
Cleaners)
Others 215.9 272.1 274.2 159.3 285.2 375.2

134
 18. Kenya Nuclear Regulatory Authority (KENRA)
ECONOMIC Approved Budget Approved Expenditure
CLASSIFICATION 2020/21 2021/2 2022/2 2020/2 2021/2 2022/2
2 3 1 2 3
Gross 119 241 245 113 254 285
AIA 22 100 100 16 119 140
Net-Exchequer 97 141 145 97 135 145
Compensation to 0 22 22 0 18 30
Employees
Transfers 0 0 0 0 0 0
Other Recurrent 119 219 223 113 236 255
Of Which
Insurance 0 2 3 0 1 2
Utilities 7 6 7 8 5 6
Rent 21 22 16 16
Contracted Professional 5 6 22 4 5 10
Services (Guards &
Cleaners)
Others 107 184 169 101 209 221

19. National Quality Control Laboratories

ECONOMIC Approved Budget Approved Expenditure
CLASSIFICATION 2020/21 2021/2 2022/2 2020/2 2021/2 2022/2
2 3 1 2 3
Gross 0 0 8 0 0 6
AIA 0 0 6 0 0 6
Net-Exchequer 0 0 2 0 0 0
Compensation to 0 0 0 0
Employees
Transfers 0 0 0 0 0 0
Other Recurrent 0 0 0
Of Which 0 0 0 0 0 0
Utilities 0 0 0 0 0 0
Rent 0 0 0 0 0 0
Insurance 0 0 0 0 0 0
Subsidies 0 0 0 0 0
Gratuity 0 0 0 0 0 0
Contracted Professional 0 0 0 0 0 0
Services (Guards &
Cleaners)
Others 0 0 0 0 0 0

20. Kenya Human Resource Advisory Council

135
ECONOMIC Approved Budget Approved Expenditure
CLASSIFICATION 2020/21 2021/2 2022/2 2020/2 2021/2 2022/2
2 3 1 2 3
Gross 0 0 11 0 0 9
AIA 0 0 0 0 0 0
Net-Exchequer 0 11 0 0 9
Compensation to 0 0 0 0 0 0
Employees
Transfers 0 0 0 0 0 0
Other Recurrent Of 0 0 0.5 0 0 0
Which
Utilities 0 0 0.25 0 0 0
Rent 0 0 0 0 0
Insurance 0 0 0 0 0
Subsidies 0 0 0 0 0 0
Gratuity 0 0 0 0 0
Contracted Professional 0 0 0 0 0
Services (Guards &
Cleaners)
Others 0.25 0 0 0

21. Kenya Health Professions Oversight Authority

ECONOMIC Approved Budget Approved Expenditure
CLASSIFICATION 2020/21 2021/2 2022/2 2020/2 2021/2 2022/2
2 3 1 2 3
Gross 0 0 24 0 0 9
AIA 0 0 12 0 0 0
Net-Exchequer 0 0 12 0 0 0
Compensation to 0 0 0 0 0
Employees
Transfers 0 0 0 0 0 0
Other Recurrent Of 0 0 0 0 0
Which
Utilities 0 0 0 0 0 0
Rent 0 0 0 0 0 0
Insurance 0 0 0 0 0
Subsidies
Gratuity
Contracted Professional
Services (Guards &
Cleaners)
Others

22. Kenya Biovax Institute (KBVI)

136
ECONOMIC Approved Budget Approved Expenditure
CLASSIFICATION 2020/21 2021/2 2022/2 2020/2 2021/2 2022/2
2 3 1 2 3
Gross 0 0 25 0 0 25
AIA 0 0 0 0 0 0
Net-Exchequer 0 0 25 0 0 25
Compensation to 0 0 0 0 0 0
Employees
Transfers 0 0 25 0 0 25
Other Recurrent of Which 0 0 0 0 0 0
Insurance 0 0 0 0 0 0
Utilities 0 0 0 0 0 0
Rent 0 0 0 0 0 0
Contracted Professional 0 0 0 0 0 0
Services (Guards &
Cleaners)
Others 25 0 0 25

23. National Aids Control Council (NACC)

ECONOMIC Approved Budget Approved Expenditure
CLASSIFICATION 2020/21 2021/2 2022/2 2020/2 2021/2 2022/2
2 3 1 2 3
Gross 0 0 219 0 0 219
AIA 0 0 0 0 0 0
Net-Exchequer 0 0 219 0 0 219
Compensation to 0 0 0 0 0 0
Employees
Transfers 0 0 0 0 0 0
Other Recurrent Of 0 0 219 0 0 219
Which
Insurance 0 0 0 0 0 0
Utilities 0 0 0 0 0 0
Rent 0 0 0 0 0 0
Contracted Professional 0 0 0 0 0 0
Services (Guards &
Cleaners)
Others 0 0 219 0 0 219

24. Tobacco Control Board

Vote: 1083 Approved Budget Approved Expenditure
2021/2 2022/2 2020/2 2021/2 2022/2
Economic classification 2020/21 2 3 1 2 3
Gross 62 56 56 62 55 41
AIA 0 0 0 0 0 0
NET exchequer 62 56 56 62 55 41

137
Vote: 1083 Approved Budget Approved Expenditure
2021/2 2022/2 2020/2 2021/2 2022/2
Economic classification 2020/21 2 3 1 2 3
Compensation to 0 0 0 0 0 0
Employees
Transfers 0 0 0 0 0 0
Other Recurrent of which 62 56 56 62 55 41
Utilities 0 0 0 0 0 0
Rent 0 0 0 0 0 0
Insurance 0 0 0 0 0 0
Subsidies 0 0 0 0 0 0
Gratuity 0 0 0 0 0 0
Contracted Guards & 0 0 0 0 0 0
Cleaners Services
Total of the SAGAs 62 56 56 62 55 41

138
2.3 ANALYSIS OF PERORMANCE OF CAPITAL PROJECTS FY 2020/21-2022/23
Table 2.7 9(a): Analysis of Performance of Capital Projects FY 2020/21 - 2022/23 (KSh. Million) – State Department for Medical Services

Est Cost of the Project

Timeline FY 2020/21 FY 2021/22 FY 2022/23 Remarks
(Financing)
Total Est.
Project Code Cost of
No
& Project Project or
. Actual Completi Actual Completi
Title Contract Completion Actual Outstanding
Value (a) Exp Approved Cumulative on stage Approved Cumulative Approved on stage
Foreign Start Approved Approved stage as at Approved Cumulative Balance as at
GOK Completi Foreign Exp up to as at 30th Foreign Exp up to Foreign as at 30th
Financed Date GoK Budget GoK 30th June GoK Exp up to 30th 30th June
on Date Financed 30th June June 2021 Financed 30th June Financed June 2023
Budget 2022 (%) Budget June 2023 2023
Budget 2021 (%) Budget 2022 Budget (%)

Kshs Million
Kshs Million Kshs Million Kshs Million

1 1081101700 3/3/20 8/20/2025 19 250 928 24 540 502 1,829.24 3,629.76 34 The contractor
KNH Burns 5,459.00 3,482.00 1,977.00 18 250 1,044 1,334.24 resumed works on
and Pediatrics site on 13 th
Centre December, 2022.
Currently the
super structure is
at 62% of the
builders
works. KNH has
engaged key
stakeholders
(MOH &amp; NT)
to ensure timely
submission of
withdrawal forms
to
development
partners for
prompt
disbursement to
the contractor.

2 1081101800 26/01/ 30/9/2023 77 333.1 92 310 0 3,841.10 136.83 97 The project

National 3,977.93 3,004.83 973.10 2018 - - 3,067 3,667.10 completion has
Commodities been delayed due
Warehousing to unavailability of
Center funds as per the
(KEMSA) budget estimates.
GoK Allocation of
Ksh. 310 Milion
which was NOT
disbursed and lack
of sufficient
internally
generated funds to
support the
construction
during the year.

139
 Est Cost of the Project
Timeline FY 2020/21 FY 2021/22 FY 2022/23 Remarks
(Financing)
Total Est.
Project Code Cost of
No & Project Project or
. Title Contract Actual Completi Actual Completi
Completion Actual Outstanding
Value (a) Exp Approved Cumulative on stage Approved Cumulative Approved on stage
Foreign Start Approved Approved stage as at Approved Cumulative Balance as at
GOK Completi Foreign Exp up to as at 30th Foreign Exp up to Foreign as at 30th
Financed Date GoK Budget GoK 30th June GoK Exp up to 30th 30th June
on Date Financed 30th June June 2021 Financed 30th June Financed June 2023
Budget 2022 (%) Budget June 2023 2023
Budget 2021 (%) Budget 2022 Budget (%)

Kshs Million
Kshs Million Kshs Million Kshs Million

3 1081102500 2/18/1 2/18/2024 36 200 960 51 118 1082 2,075.40 1,598.60 56 East Africa
East Africa's 3,674.00 334.00 3,340.00 6 50 1,314 1,866.40 Centre of
Centre of excellence
Excellence managed to pay
for Skills & Interim Payment
Tertiary Certificates 18 and
Education 19 for works done
towards
completion of the
complex. The
project is at 84%
comletion rate.

4 1081103200 7/11/2 7/11/2026 0 80 0 60 0 17.00 6,157.00 0 The project was

Dietics 6,174.00 6,174.00 011 - - - 26.70 moved to the State
Services Department of
Improvement Public Health and
(Nutrition) Professional
Standards

5 1081103500 7/2/20 7/2/2025 48 0 2600 48 0 0 8,423.00 9,177.00 48 There was no

Health 17,600.00 - 17,600.00 15 - - 8,423 8,423.00 allocation for FY
System 22/23
Management

6 1081103700 7/1/20 6/30/2024 0 0 200 15 0 600 217.00 1,099.04 16 The project was
Clinical 1,316.04 120.00 1,196.04 21 - - - 200.00 moved to the State
Waste Department of
Disposal Public Health and
System Professional
Project(Phase Standards
II)

7 1081104000 1/7/20 6/30/2023 51 0 500 53 0 500 552.80 499.20 53 The project was
Clinical 1,052.00 1,052.00 16 - - 534 552.80 moved to the State
Laboratory Department of
and Public Health and
Radiology Professional
Services Standards
Improvement

140
 Est Cost of the Project
Timeline FY 2020/21 FY 2021/22 FY 2022/23 Remarks
(Financing)
Total Est.
Project Code Cost of
No & Project Project or
. Title Contract Actual Completi Actual Completi
Completion Actual Outstanding
Value (a) Exp Approved Cumulative on stage Approved Cumulative Approved on stage
Foreign Start Approved Approved stage as at Approved Cumulative Balance as at
GOK Completi Foreign Exp up to as at 30th Foreign Exp up to Foreign as at 30th
Financed Date GoK Budget GoK 30th June GoK Exp up to 30th 30th June
on Date Financed 30th June June 2021 Financed 30th June Financed June 2023
Budget 2022 (%) Budget June 2023 2023
Budget 2021 (%) Budget 2022 Budget (%)

Kshs Million
Kshs Million Kshs Million Kshs Million

8 1081104100 7/7/20 7/7/2021 100 0 0 0 0 0 - 43.10 0 The project was

Expansion of 43.10 43.10 15 - - 43 - completed
Ileho Health
Centre
(KIDDP).

9 1081104400 7/10/2 7/10/2026 58 7205 0 66 3375 0 56,047.60 23,454.40 70 The project came
Managed 79,502.00 79,502.00 013 6,205 46,468 52,672.60 to an end. There is
Equipment a 1 year extension
Service-Hire as negotiations are
of Medical ongoing to transit
Equipment to National
for 98 Equipment
Hospital Program Services
(NEPS)

10 1081104500 7/10/2 7/10/2026 49 4098 55 4098 42,635.25 27,452.75 61 Funds disbursed to

Free 70,088.00 70,088.00 013 4,098 34,439 38,537.25 NHIF to facilitate
Maternity Linda mama
Program Programme for the
(Strategic following benefits:
Intervention) Inpatient,
Caeserian Section,
Normal delivery,
ante-natal and
postnatal care. A
total of 927,102
deliveries recorded
in FY 22/23.

141
 Est Cost of the Project
Timeline FY 2020/21 FY 2021/22 FY 2022/23 Remarks
(Financing)
Total Est.
Project Code Cost of
No & Project Project or
. Title Contract Actual Completi Actual Completi
Completion Actual Outstanding
Value (a) Exp Approved Cumulative on stage Approved Cumulative Approved on stage
Foreign Start Approved Approved stage as at Approved Cumulative Balance as at
GOK Completi Foreign Exp up to as at 30th Foreign Exp up to Foreign as at 30th
Financed Date GoK Budget GoK 30th June GoK Exp up to 30th 30th June
on Date Financed 30th June June 2021 Financed 30th June Financed June 2023
Budget 2022 (%) Budget June 2023 2023
Budget 2021 (%) Budget 2022 Budget (%)

Kshs Million
Kshs Million Kshs Million Kshs Million

11 1081104800 7/30/2 6/30/2025 9 300 14 110 317.90 1,332.10 19 The project is

Modernize 1,650.00 1,650.00 013 - - 145 236.40 complete.
Wards &
Staff house-
Mathari
Teaching &
Referral
Hospital

12 1081104900 7/30/2 6/30/2026 4 100 9 53 125.50 665.80 16 Construction of

Construct a 791.30 791.30 014 - - 29 72.50 the wall and
Wall, renovation of the
renovation & inpatient wards
Procure were completed.
Equipment at An ambulance was
National procured.
Spinal Injury However, some
Hospital other activities
were not done due
to limited funding.

13 1081105100 2/7/20 2/7/2025 14 600 18 619 2,140.90 6,255.40 25 The program

Procurement 8,396.30 8,396.30 15 600 1,158 1,540.90 continues to
of Equipment provide aceess to
at the safe blod and
National blood
Blood componentsaccros
Transfusion s the country in
Services the year 2022/23.
The program had a
financial gap of
1.4B.

14 1081105200 8/13/2 8/13/2025 8 200 8 154 1,032.00 9,646.00 10 The project was
Procurement 10,678.00 10,678.00 014 200 878 878.00 moved to the State
of Anti TB Department of
Drugs Not Public Health and
covered under Professional
Global fund Standards
Tb
programme

142
 Est Cost of the Project
Timeline FY 2020/21 FY 2021/22 FY 2022/23 Remarks
(Financing)
Total Est.
Project Code Cost of
No & Project Project or
. Title Contract Actual Completi Actual Completi
Completion Actual Outstanding
Value (a) Exp Approved Cumulative on stage Approved Cumulative Approved on stage
Foreign Start Approved Approved stage as at Approved Cumulative Balance as at
GOK Completi Foreign Exp up to as at 30th Foreign Exp up to Foreign as at 30th
Financed Date GoK Budget GoK 30th June GoK Exp up to 30th 30th June
on Date Financed 30th June June 2021 Financed 30th June Financed June 2023
Budget 2022 (%) Budget June 2023 2023
Budget 2021 (%) Budget 2022 Budget (%)

Kshs Million
Kshs Million Kshs Million Kshs Million

15 1081105300 8/13/2 8/13/2026 9 863 12 428 1,916.00 10,299.00 16 No procurement

Procurement 12,215.00 12,215.00 014 559 1,052 1,488.00 was done in the
of Family last FY
Planning & 2022/2023.Howev
Reproductive er, there were
Health donations from
Commodities USAID and
UNFPA.There is
lag in FP
Commodities
Delivery.

16 1081105500 7/2/20 7/2/2025 10 1300 13 1708 1808 7,690.80 53,796.20 13 This programme
(Vaccines and 61,487.00 61,487.00 16 8,913 6,391 7,690.80 procured routine
Immunization Childhood
s) Vaccines to
improve
immunization
Coverage.

17 1081105502 1/1/20 7/6/2025 0 362.7 12 303 2,310.70 14,652.30 14 Funds were used
Acquisition of 16,963.00 16,963.00 21 1,645 - 1,645 2,007.70 to procure COVID
Covid - 19 19 vaccines.
Vaccines

18 1081105503 1/1/20 6/30/2022 0 1100 0 0 - 1,100.00 0 Being funds from

COVID - 19 1,100.00 1,100.00 22 - - - - the private sector
Vaccine to support against
Acquisition & COVID 19 in the
Development- country.Funds
KEPSA were not utilized
due to the fact that
the vaccine supply
had improved and
therefore the
Ministry did not
procure

19 1081105700 21/9/2 30/06/202 32 127.5 39 324 994.50 805.50 55 The project was
Construction 1,800.00 1,800.00 017 5 64 569 696.50 moved to the State
of buildings- Department of
Tuition Public Health and
blocks at Professional
KMTC Standards

143
 Est Cost of the Project
Timeline FY 2020/21 FY 2021/22 FY 2022/23 Remarks
(Financing)
Total Est.
Project Code Cost of
No & Project Project or
. Title Contract Actual Completi Actual Completi
Completion Actual Outstanding
Value (a) Exp Approved Cumulative on stage Approved Cumulative Approved on stage
Foreign Start Approved Approved stage as at Approved Cumulative Balance as at
GOK Completi Foreign Exp up to as at 30th Foreign Exp up to Foreign as at 30th
Financed Date GoK Budget GoK 30th June GoK Exp up to 30th 30th June
on Date Financed 30th June June 2021 Financed 30th June Financed June 2023
Budget 2022 (%) Budget June 2023 2023
Budget 2021 (%) Budget 2022 Budget (%)

Kshs Million
Kshs Million Kshs Million Kshs Million

20 1081105800 4/3/20 9/18/2024 59 553.8 78 483 2,282.00 43.10 98 The project was
Construction 2,325.10 2,325.10 18 419 1,365 1,819.00 moved to the State
and equipping Department of
of laboratory Public Health and
and class Professional
rooms KMTC Standards

21 1081106100 1/7/20 6/30/2026 11 12 1,377.40 6,622.60 17 Garissa ,Mombasa

Establishing 8,000.00 8,000.00 16 280 860 350.00 994.40 383.00 and Nakuru were
of Regional operationalized
Cancer ,awaiting
Centres establishment of
Kakamega and
Meru in the FY
2023/24

22 1081106400 15/2/1 12/8/2020 100 0 378.00 0 The project was

Completion 378.00 278.00 100.00 6 126 378 - - completed and
and operationalized
Equipping
Day-care
Centre –
KNH

23 1081107000 1/7/20 6/7/2026 59 65 1,267.50 575.50 69 To procure two

Cancer & 1,843.00 1,393.00 450.00 13 144 144 1,088 104.00 1,192.00 113.00 Radiotherapy
Chronic Machines (2
Disease Linear
Management Accelerators with
Centre – 3D
MTRH Conformational
Treatment Unit,
CT Simulator,
Treatment Plan
and all other
accessories)

144
 Est Cost of the Project
Timeline FY 2020/21 FY 2021/22 FY 2022/23 Remarks
(Financing)
Total Est.
Project Code Cost of
No & Project Project or
. Title Contract Actual Completi Actual Completi
Completion Actual Outstanding
Value (a) Exp Approved Cumulative on stage Approved Cumulative Approved on stage
Foreign Start Approved Approved stage as at Approved Cumulative Balance as at
GOK Completi Foreign Exp up to as at 30th Foreign Exp up to Foreign as at 30th
Financed Date GoK Budget GoK 30th June GoK Exp up to 30th 30th June
on Date Financed 30th June June 2021 Financed 30th June Financed June 2023
Budget 2022 (%) Budget June 2023 2023
Budget 2021 (%) Budget 2022 Budget (%)

Kshs Million
Kshs Million Kshs Million Kshs Million

24 1081107100 1/1/20 6/30/2026 29 40 498.30 581.70 46 The fund allocated

Construction 1,080.00 830.00 250.00 14 14 316 120.00 436.30 93.00 equipped the
and Equiping children hospital
Children with medical
Hospital- equipment for the
MTRH Pediatric Burns
Unit, ICU, HDU
and Theatre

25 1081107200 1/10/2 6/30/2025 6 14 80.50 269.50 23 The funds were

Equipping 350.00 350.00 019 - - 20 30.00 50.00 45.75 used to equip the
Maternity maternity unit
Unit(Mother with equipment
& Baby Unit) for the delivery
rooms, maternity
theatre, Maternity
ICU & HDU and
Equipment for the
neonatal unit
(Nursery).

26 1081107300 7/1/20 6/6/2025 41 44 249.00 235.00 51 The fund was used

Expansion 484.00 484.00 15 49 198 16.00 214.00 52.25 to equip the unit
and with ICU & HDU
Equipping of beds complete
ICU-MTRH with cardiac
monitors,
defibrillators,
suction machines
and syringe pumps

145
 Est Cost of the Project
Timeline FY 2020/21 FY 2021/22 FY 2022/23 Remarks
(Financing)
Total Est.
Project Code Cost of
No & Project Project or
. Title Contract Actual Completi Actual Completi
Completion Actual Outstanding
Value (a) Exp Approved Cumulative on stage Approved Cumulative Approved on stage
Foreign Start Approved Approved stage as at Approved Cumulative Balance as at
GOK Completi Foreign Exp up to as at 30th Foreign Exp up to Foreign as at 30th
Financed Date GoK Budget GoK 30th June GoK Exp up to 30th 30th June
on Date Financed 30th June June 2021 Financed 30th June Financed June 2023
Budget 2022 (%) Budget June 2023 2023
Budget 2021 (%) Budget 2022 Budget (%)

Kshs Million
Kshs Million Kshs Million Kshs Million

27 1081107500 17/09/ 6/30/2026 22 31 302.88 588.12 34 The disbursed

Situation 891.00 891.00 2016 43 197 75.60 272.88 58.50 funds were
Room for released towards
Real Time the end of the
Data & financial year (a
Information week to the end to
on HIV & the end of the
AIDS - financial year) and
NACC hence planned
activities could not
be carried out and
rolled over to the
next year.

28 1081107900 7/1/20 7/1/2025 24 28 232.37 402.63 37 Funds went to

Construction 635.00 635.00 16 28 153 55.10 180.37 57.00 upgrading research
and upgrading laboratories.
of KEMRI Forty-seven (47)
Laboratories labs require
(Nairobi, upgrading to
Kwale,Busia) international
standards in order
to provide reliable
quality data and
enhance
biosecurity levels.

29 1081109400 7/10/2 7/10/2026 19 27 33,292.47 66,707.54 33 Funds geared for

Rollout of 100,000.00 100,000.0 018 4,290 19,166 7,765.00 26,879.72 6,412.75 universal
Universal 0 healthcare
Health indexing,and
Coverage improving
accesabililty and
affordabilty of
healthcare in the
country

146
 Est Cost of the Project
Timeline FY 2020/21 FY 2021/22 FY 2022/23 Remarks
(Financing)
Total Est.
Project Code Cost of
No & Project Project or
. Title Contract Actual Completi Actual Completi
Completion Actual Outstanding
Value (a) Exp Approved Cumulative on stage Approved Cumulative Approved on stage
Foreign Start Approved Approved stage as at Approved Cumulative Balance as at
GOK Completi Foreign Exp up to as at 30th Foreign Exp up to Foreign as at 30th
Financed Date GoK Budget GoK 30th June GoK Exp up to 30th 30th June
on Date Financed 30th June June 2021 Financed 30th June Financed June 2023
Budget 2022 (%) Budget June 2023 2023
Budget 2021 (%) Budget 2022 Budget (%)

Kshs Million
Kshs Million Kshs Million Kshs Million

30 1081109500 2,000,0 8/10/2 8/10/2024 2 5 288.67 1,991.33 13 Challenges in

Construction 2,280.00 280.00 016 10 51 50.00 530.00 110.87 100.00 195.00 getting a letter of
of a Cancer no objection for
Centre at one of the partners
Kisii Level 5 in Saudia
Hospital Arabia,thus we
were unable to
progress.

31 1081110200 1/2/20 6/30/2021 100 0 3,192.00 0 The project was

Support to 3,192.00 3,192.00 17 - 952 3,193 - - - - completed
Universal
Health Care
in the
Devolved
system in
Kenya

32 1081110300 9/15/2 6/30/2023 82 96 24,491.80 798.20 97 Funds to support

Transforming 25,290.00 - 25,290.00 016 - - 20,686 - 4,459.00 24,340.00 - 500.00 all counties in the
Health health systems
Systems for strengthening,
Universal procurement of
care Project family planning
commodities and
capacity building.
The project is
coming to a close
on 30th September
2023

147
 Est Cost of the Project
Timeline FY 2020/21 FY 2021/22 FY 2022/23 Remarks
(Financing)
Total Est.
Project Code Cost of
No & Project Project or
. Title Contract Actual Completi Actual Completi
Completion Actual Outstanding
Value (a) Exp Approved Cumulative on stage Approved Cumulative Approved on stage
Foreign Start Approved Approved stage as at Approved Cumulative Balance as at
GOK Completi Foreign Exp up to as at 30th Foreign Exp up to Foreign as at 30th
Financed Date GoK Budget GoK 30th June GoK Exp up to 30th 30th June
on Date Financed 30th June June 2021 Financed 30th June Financed June 2023
Budget 2022 (%) Budget June 2023 2023
Budget 2021 (%) Budget 2022 Budget (%)

Kshs Million
Kshs Million Kshs Million Kshs Million

33 1081110700 23/8/2 6/9/2025 12 19 471.24 1,528.76 24 Phase one of the

Strengthening 2,000.00 2,000.00 018 46 231 140.00 371.24 100.00 project is
of Cancer completed and
Management was handed-over
at KNH to KNH on 3 rd
August, 2023.
Phase two of the
project has
commenced using
the allocated funds
in FY 2023/24. It
is expected to be
complete within
the FY 2023/24.
The Hospital
requires additional
funding to
complete
construction works
and acquisition of
equipment for full
operationalization.

34 1081110800 7/1/20 7/1/2025 17 19 1,410.80 4,989.20 22 Funds

Research and 6,400.00 6,400.00 14 151 1,057 151.00 1,208.10 292.00 werechanneled
Development towards
- KEMRI conducting
research to address
National Health
priority areas
including COVID-
19, Non-
communicable
diseases, drug
discovery and
vaccine
development,
neglected diseases
and emerging and
re-emerging
diseases

35 1081111300 1/1/20 6/30/2022 98 99 12,945.70 174.30 99 The

Special 13,120.00 13,120.00 18 12,920 - 25.70 12,945.70 - - programmeutilized
Global Fund the funds towards
HIV Grant procurement of
KEN-H-TNT- ARVS and
programmatic

148
 Est Cost of the Project
Timeline FY 2020/21 FY 2021/22 FY 2022/23 Remarks
(Financing)
Total Est.
Project Code Cost of
No & Project Project or
. Title Contract Actual Completi Actual Completi
Completion Actual Outstanding
Value (a) Exp Approved Cumulative on stage Approved Cumulative Approved on stage
Foreign Start Approved Approved stage as at Approved Cumulative Balance as at
GOK Completi Foreign Exp up to as at 30th Foreign Exp up to Foreign as at 30th
Financed Date GoK Budget GoK 30th June GoK Exp up to 30th 30th June
on Date Financed 30th June June 2021 Financed 30th June Financed June 2023
Budget 2022 (%) Budget June 2023 2023
Budget 2021 (%) Budget 2022 Budget (%)

Kshs Million
Kshs Million Kshs Million Kshs Million

(GLOBAL activities towards

FUND) prevention ,care
and treatment.

36 1081111400 1/1/20 6/6/2022 94 94 3,400.00 200.00 94 The project was

Special 3,600.00 3,600.00 18 800 3,400 175.00 3,400.00 moved to the State
Global Fund Department of
Malaria Grant Public Health and
KEN-M- Professional
TNT- Standards
(GLOBAL
FUND)

37 1081111700 896.00 24.00 97 It’s a one-off

Special 920.00 920.00 920.00 project funded
Upgrading during
Maternal & Supplementary II
New Born FY 2022/23
Care Units W.
Pokot,
Marakwet &
Makueni

38 1081111500 1/1/20 6/30/2022 100 100 5,032.00 20.00 100 The project was
Special 5,052.00 5,052.00 18 - - 5,032 2.00 5,032.00 920.00 moved to the State
Global Fund Department of
TB Grant Public Health and
KEN-T-TNT- Professional
(GLOBAL Standards
FUND)

39 1081111900 10/1/2 6/30/2022 77 100 250.00 - 100 The project is

PHG-Case 250.00 250.00 019 - - 192 57.90 250.00 completed
Study on
Integrated
Delivery of
Selected
NCD-MTRH

149
 Est Cost of the Project
Timeline FY 2020/21 FY 2021/22 FY 2022/23 Remarks
(Financing)
Total Est.
Project Code Cost of
No & Project Project or
. Title Contract Actual Completi Actual Completi
Completion Actual Outstanding
Value (a) Exp Approved Cumulative on stage Approved Cumulative Approved on stage
Foreign Start Approved Approved stage as at Approved Cumulative Balance as at
GOK Completi Foreign Exp up to as at 30th Foreign Exp up to Foreign as at 30th
Financed Date GoK Budget GoK 30th June GoK Exp up to 30th 30th June
on Date Financed 30th June June 2021 Financed 30th June Financed June 2023
Budget 2022 (%) Budget June 2023 2023
Budget 2021 (%) Budget 2022 Budget (%)

Kshs Million
Kshs Million Kshs Million Kshs Million

40 1081117600 1/6/20 30/06/202 23 32 218.70 347.30 39 The disbursed

Beyond Zero 566.00 566.00 16 3 24 130 49.90 179.70 39.00 funds were
Campaign- released towards
NACC the end of the
financial year (a
week to the end to
the end of the
financial year) and
hence planned
activities could not
be carried out and
rolled over to the
next year.

41 1081117800 7/1/20 6/6/2023 37 66 5,263.24 2,736.76 66 PFR budgetary

Health Sector 8,000.00 8,000.00 19 3,000 2,986 4,000.00 5,263.24 - - support from JICA
Support to for roll-out and
Universal scale up of
Health Universal Health
Coverage Coverage.

42 1081117900 01/07/ 30'06/202 100 0 - 20.00 0 The project was

Reconstructio 20.00 20.00 2019 1 18 20 - - - - - completed
n of drugs
Rehabilitaion
centre at
Coast General
Hospital

43 10811180000 01/07/ 30'06/202 100 0 - 30.00 0 Ths project is

Construction 30.00 30.00 2019 1 11 30 - - - - - stalled due to site
of a hospital dispute in Kieni
in Kiyawara- constituency. The
Kieni East matter is being
handled by the
Public Works

44 1081118100 1/7/20 1/6/2024 87 0 2,282.00 50.00 98 Funds were

Intergrated 2,332.00 2,332.00 20 2,032 2,032 - - 2,032.00 250.00 - utilized to
Molecular construct and
Imaging equip the
Centre Integrated
Molecular
Imaging Center to
offer specialized

150
 Est Cost of the Project
Timeline FY 2020/21 FY 2021/22 FY 2022/23 Remarks
(Financing)
Total Est.
Project Code Cost of
No & Project Project or
. Title Contract Actual Completi Actual Completi
Completion Actual Outstanding
Value (a) Exp Approved Cumulative on stage Approved Cumulative Approved on stage
Foreign Start Approved Approved stage as at Approved Cumulative Balance as at
GOK Completi Foreign Exp up to as at 30th Foreign Exp up to Foreign as at 30th
Financed Date GoK Budget GoK 30th June GoK Exp up to 30th 30th June
on Date Financed 30th June June 2021 Financed 30th June Financed June 2023
Budget 2022 (%) Budget June 2023 2023
Budget 2021 (%) Budget 2022 Budget (%)

Kshs Million
Kshs Million Kshs Million Kshs Million

diagnostic and
treatment services
to Cancer
Patients,however
the hospital did
not receive capital
grant F/Y 2022-
2023 as at the of
30th June 2023

45 1081118200 2/1/20 6/30/2024 9 20 4,764.35 10,475.65 31 Funds to Prevent,

Kenya 15,240.00 3,000.00 12,240.00 20 - - 1,399 400.00 5,632.00 2,983.00 - 2,577.00 detect and respond
COVID-19 to COVID-19 and
Emergency strengthen national
Response systems for public
Project health emergency
preparedness
having absorbed
only 26.3% of the
funds

46 1081118203 1/7/20 6/30/2023 0 24 3,241.89 10,158.11 24 The funds were

COVID 19 13,400.00 13,400.00 21 - - - - 3,800.00 3,189.00 - 76.00 used for
Vaccines Procurement of
Programme COVID-19
vaccines and
consumables

47 1081118600 1/7/20 6/30/2023 13 30 200.20 199.80 50 The project is

Infrastractural 400.00 400.00 20 50 50 100.00 121.60 103.00 ongoing and its at
Support to 80% completion
Kigumo
Hospital

151
 Est Cost of the Project
Timeline FY 2020/21 FY 2021/22 FY 2022/23 Remarks
(Financing)
Total Est.
Project Code Cost of
No & Project Project or
. Title Contract Actual Completi Actual Completi
Completion Actual Outstanding
Value (a) Exp Approved Cumulative on stage Approved Cumulative Approved on stage
Foreign Start Approved Approved stage as at Approved Cumulative Balance as at
GOK Completi Foreign Exp up to as at 30th Foreign Exp up to Foreign as at 30th
Financed Date GoK Budget GoK 30th June GoK Exp up to 30th 30th June
on Date Financed 30th June June 2021 Financed 30th June Financed June 2023
Budget 2022 (%) Budget June 2023 2023
Budget 2021 (%) Budget 2022 Budget (%)

Kshs Million
Kshs Million Kshs Million Kshs Million

48 1081118300 1/7/20 6/30/2023 13 49 401.00 369.00 52 Renovation and

renovation & 770.00 770.00 20 100 100 276.00 376.00 25.00 Improvement of
Improvement facilities was
for Gatundu completed.
Level 5 Construction of
Hospital the second tower
comprising an
Accident &
Emergency
Center, Outpatient
Clinics, Pharmacy,
Radiology,Plaster
Room, Laboratory
and wards is in
progress.The
hospital did not
receive the capital
grant for the F/Y
2022-2023 as at
30th June 2023

49 1081118900 1/1/20 1/6/2021 0 0 20.00 0 The project is yet

Equipping of 20.00 20.00 21 20 - to start due to land
Bildad disputes in the
Kaggia Level proposed site
4 Hospital
Muranga

50 1081119000 1/7/20 30/6/23 0 0 28.20 11.80 71 Funds were to

Customized 40.00 40.00 20 40 - 40.00 - 40.00 procure ten
Ambulances Customized
For COVID - Ambulances for
19 Response COVID-19
Response.

51 1081119100 1/1/20 30/6/2024 32 74 3,920.26 197.74 95 Funds towards

Supply of 4,118.00 4,118.00 21 - - 1,330 2,398.00 3,033.26 1,000.00 rehabilitation of
Medical the maternal and
Equipment baby care units at
and MTRH and to
Associated support COVID-
Sevices 19 Emergency
Response having
consumed 95% of
the allocated
funds.

152
 Est Cost of the Project
Timeline FY 2020/21 FY 2021/22 FY 2022/23 Remarks
(Financing)
Total Est.
Project Code Cost of
No & Project Project or
. Title Contract Actual Completi Actual Completi
Completion Actual Outstanding
Value (a) Exp Approved Cumulative on stage Approved Cumulative Approved on stage
Foreign Start Approved Approved stage as at Approved Cumulative Balance as at
GOK Completi Foreign Exp up to as at 30th Foreign Exp up to Foreign as at 30th
Financed Date GoK Budget GoK 30th June GoK Exp up to 30th 30th June
on Date Financed 30th June June 2021 Financed 30th June Financed June 2023
Budget 2022 (%) Budget June 2023 2023
Budget 2021 (%) Budget 2022 Budget (%)

Kshs Million
Kshs Million Kshs Million Kshs Million

52 1081119200 1/1/20 30/6/2024 21 28 1,722.70 2,137.30 45 Funds geared

GESDeK 3,860.00 3,860.00 21 - - 817 - 975.00 1,093.20 - 1,414.00 towards control
COVID 19 and prevention of
Response COVID-19 in the
Project country having
consumed 28.3%
of the funds

53 1081120100 1/1/20 30/6/2021 97 0 10.00 0 The project was

Monitoring 10.00 10.00 21 10 - - - - completed
and
Evaluation of
KIDDP
Projects

54 108119301 1/7/20 6/30/2024 0 3 2,916.54 25,524.46 10 The GoK

Special 28,441.00 25,906.00 2,535.00 21 - - - 1,200.00 510.00 716.70 2,315.25 1,015.00 component was
Global Fund not disbursed
HIV Grant partially due to
NFM3- exchequer issues.
NASCOP The foreign
finance was used
to procure
commodities.

55 1081119400 1/7/20 6/30/2025 0 12 2,778.00 9,243.00 23 The project was

Special 12,021.00 6,400.00 5,621.00 21 - - - 800.00 837.00 1,386.00 675.00 1,025.00 moved to the State
Global Fund Department of
Malaria Grant Public Health and
NFM3 - Professional
DOMC Standards

56 1081119500 1/7/20 6/30/2025 0 28 1,247.48 1,750.52 42 The project was

Special 2,998.00 2,998.00 21 - - - - 1,060.00 847.00 - 874.41 moved to the State
Global Fund Department of
TB Grant Public Health and
NFM3 Professional
Standards

153
 Est Cost of the Project
Timeline FY 2020/21 FY 2021/22 FY 2022/23 Remarks
(Financing)
Total Est.
Project Code Cost of
No & Project Project or
. Title Contract Actual Completi Actual Completi
Completion Actual Outstanding
Value (a) Exp Approved Cumulative on stage Approved Cumulative Approved on stage
Foreign Start Approved Approved stage as at Approved Cumulative Balance as at
GOK Completi Foreign Exp up to as at 30th Foreign Exp up to Foreign as at 30th
Financed Date GoK Budget GoK 30th June GoK Exp up to 30th 30th June
on Date Financed 30th June June 2021 Financed 30th June Financed June 2023
Budget 2022 (%) Budget June 2023 2023
Budget 2021 (%) Budget 2022 Budget (%)

Kshs Million
Kshs Million Kshs Million Kshs Million

57 1081119600 1/7/20 6/30/2024 0 51 650.00 35.00 95 The funds were for

Procurement 685.00 685.00 21 - - - 350.00 350.00 300.00 the procurement
of Cyberknife and installation of
Radiotherapy Cyberknife.The
Equipment equipment was
for KUTRRH installed In
february 2023
.The hospital did
not receive the
capital grant F/Y
2022-2023 as at
30th June 2023

58 1081119800 1/7/20 6/30/2024 31 31 1,100.00 2,400.00 31 UNFPA procured

9TH GoK/ 3,500.00 3,500.00 21 - 1,100 1,100 - 1,096.00 1,100.00 - 800.00 the commodities
UNFPA and delivery done
County to the facilities.
Programmes

59 1081119900 7/1/20 6/30/2024 0 19 1,233.12 501.88 71 Funds to cater for

Primary 1,735.00 1,735.00 21 - - - - 434.00 326.00 495.00 1,102.55 level II and III
Health Care public hospitals
in the and National
Devolved Level activities
Context

60 10811200 1/1/20 6/30/2022 0 100 1,000.00 - 100 Funds to support

Supply of 1,000.00 1,000.00 22 - - - - 1,000.00 1,000.00 - - COVID 19
Medical interventions that
Equipment were transferred to
for Covid - 19 Crown Agents

61 1081120200 1/7/20 30/6/2022 0 0 19.00 31.00 38 The project did not

Infrastructure 50.00 20.00 21 - - - 50.00 - 19.00 start off due to
Support to donor commitment
Diff Hospital challenges
in Wajir

154
 Est Cost of the Project
Timeline FY 2020/21 FY 2021/22 FY 2022/23 Remarks
(Financing)
Total Est.
Project Code Cost of
No & Project Project or
. Title Contract Actual Completi Actual Completi
Completion Actual Outstanding
Value (a) Exp Approved Cumulative on stage Approved Cumulative Approved on stage
Foreign Start Approved Approved stage as at Approved Cumulative Balance as at
GOK Completi Foreign Exp up to as at 30th Foreign Exp up to Foreign as at 30th
Financed Date GoK Budget GoK 30th June GoK Exp up to 30th 30th June
on Date Financed 30th June June 2021 Financed 30th June Financed June 2023
Budget 2022 (%) Budget June 2023 2023
Budget 2021 (%) Budget 2022 Budget (%)

Kshs Million
Kshs Million Kshs Million Kshs Million

62 1081120300 1/1/20 6/30/2025 0 6 400.00 6,000.00 6 Funds earmarked

Human 6,400.00 6,400.00 21 - - - 400.00 - 400.00 - - for refurbishment
Vaccine and
Production oprationalization
(KBVI) of the BIOVAX
warehouse in
Embakasi. Non-
disbursement of
funds for FY22/23
impacted on the
refurbishment and
enabling works.

63 1081120400 1/1/20 6/30/2025 0 4 400.00 9,600.00 4 Construction of a

Nueropsychia 10,000.00 10,000.00 21 - - - 400.00 - 400.00 79.15 - new mental health
tric National hospital to offer
Teaching & specialized
Referral psychiatry services
Hospital and training for
mental health

64 1081205000- 1/1/20 6/30/2025 0 16 500.00 2,600.00 16 Funds to

Construction 3,100.00 3,100.00 21 - - - 500.00 - 500.00 - undertake the
of New Level Presidential
III Hospitals Directive of
constructing 50
new level III
hospitals in line
with third
financial stimulus
programme
targeting strategic
interventions

65 1081120600 1/1/20 6/30/2022 0 100 200.00 - 100 Funds to improve

Infrastracture 200.00 200.00 22 - - 200.00 200.00 infrastractural
Support to support at Narok
Narok Hospital
Hospital

155
 Est Cost of the Project
Timeline FY 2020/21 FY 2021/22 FY 2022/23 Remarks
(Financing)
Total Est.
Project Code Cost of
No & Project Project or
. Title Contract Actual Completi Actual Completi
Completion Actual Outstanding
Value (a) Exp Approved Cumulative on stage Approved Cumulative Approved on stage
Foreign Start Approved Approved stage as at Approved Cumulative Balance as at
GOK Completi Foreign Exp up to as at 30th Foreign Exp up to Foreign as at 30th
Financed Date GoK Budget GoK 30th June GoK Exp up to 30th 30th June
on Date Financed 30th June June 2021 Financed 30th June Financed June 2023
Budget 2022 (%) Budget June 2023 2023
Budget 2021 (%) Budget 2022 Budget (%)

Kshs Million
Kshs Million Kshs Million Kshs Million

66 1081120700- 1/1/20 6/30/2026 0 2 150.00 7,909.00 2 Renovation of

Refurbishmen 8,059.00 8,059.00 22 - - 150.00 150.00 Level eight of the
t/Renovation tower block
of ongoing at 80%.
Infrastracture However, project
-KNH is experiencing
challenges in
funds
disbursement. The
allocation for the
Hospital in the FY
2023/24 is being
used to rehabilitate
level 7 and acquire
equipment for
level 7&amp;8 as
well as replace all
old and obsolete
equipment and
machinery. In
addition, it will be
used to
replace old and
delipidated ICT
infrastructure.

67 1081120800- 1/1/20 6/30/2022 33 33 100.00 200.00 33 The oncology

Expansion of 300.00 300.00 22 100 100 100.00 100.00 100.00 extension building
Comprehensi will have
ve Cancer additional beds,
Centre - doctors and nurses
KUTRRH offices and patient
consultation rooms
to meet the
demand for
oncology services
in the hospital.
Construction of
the center is
ongoing.The
hospital did not
receive the capital
grant as at 30th
June 2023

156
 Est Cost of the Project
Timeline FY 2020/21 FY 2021/22 FY 2022/23 Remarks
(Financing)
Total Est.
Project Code Cost of
No & Project Project or
. Title Contract Actual Completi Actual Completi
Completion Actual Outstanding
Value (a) Exp Approved Cumulative on stage Approved Cumulative Approved on stage
Foreign Start Approved Approved stage as at Approved Cumulative Balance as at
GOK Completi Foreign Exp up to as at 30th Foreign Exp up to Foreign as at 30th
Financed Date GoK Budget GoK 30th June GoK Exp up to 30th 30th June
on Date Financed 30th June June 2021 Financed 30th June Financed June 2023
Budget 2022 (%) Budget June 2023 2023
Budget 2021 (%) Budget 2022 Budget (%)

Kshs Million
Kshs Million Kshs Million Kshs Million

68 1081120900- 7/1/20 6/30/2023 0 0 100.00 120.00 45 The project is in

Construction 220.00 220.00 - 22 - - - - - - 120.00 the initial
and equiping stage.The hospital
of children did not receive the
Hospital at capital grant as at
KUTRRH 30th June 2023

69 1081121100- 7/1/20 6/30/2023 50.00 - 100 It’s a one-off

Infrastructure 50.00 50.00 - 22 50.00 project funded
Support to during
Khwisero Supplementary II
Level 4 FY 2022/23
Hospital -
Khwisero

70 1081121200- 7/1/20 6/30/2023 0 0 - 420.40 0 It’s a one-off

Framework 420.40 - 420.40 22 - - - - 420.40 project funded
for return of during
Assets from Supplementary II
Crime & FY 2022/24
Corruption -
Kenya
(FRACCK)

71 1081121300- 7/1/20 6/30/2023 0 0 - 50.00 0 It’s a one-off

Technical 50.00 - 50.00 22 - - - - - 50.00 project funded
Assistance to during
finance Supplementary II
support for FY 2022/25
health sector
to combat
Covid 19

72 1081121400- 7/1/20 6/30/2023 0 150.20 349.80 30 It’s a one-off

Health 500.00 500.00 22 - 500.00 project funded
Infrastructure during
services Supplementary II
FY 2022/26

157
Table 2.7 (b): Analysis of performance of Capital projects FY 2021-2023 – State Department for Public Health and Professional Standards
Project Financing Timeline Actual Outstanding % project Approved Require ment Allocation for Allocation for Allocation for Remarks
code & cum ulative project cost completio GoK budget for FY FY 2024/25 FY 2025/26 FY 2026/27
tittle expenditure as at 30th n 2023/24 2024/25
as at 30th June 2023 (physical
June 2023 ) as of
30th June
2023
Est cost Gok Foreig Star Expec te d Go Foreig Go Foreig Go Foreig Gok Foreig Gok Foreig Gok Foreig Gok Foreig
of project n t com pletio k n k n k n n n n n
date n date
Diete tics 6,174 6,174 - - 20 - 1,99 200 - 210 - 221 -
services 8
improvemen
t
Clinical 1,696 500 1,196 - - - - 440 700 60 700 63 700 66 700
waste
dis posal
system
Clinical 1,052 1,052 - - - - 500 - 500 - 500 - 500
laboratory
and
radiology
services
improvemen
t
Procuremen 10,678 10,67 - - 51. - 1,04 300 - 315 - 331 -
t of anti tb 8 5 9
drugs not
covered
under
global fund
TB
progra mme
Cons truc tio 1,800 1,800 - - 33 - 670 132 - 139 - 146 -
n of
buildings-
tuition
blocks at
KMTC
Cons truc tio 2,799 2,799 - - 126 - 470 454 - 477 - 501 -
n and
equipping
of
laboratory
and class
rooms
KMTC
Special 12,021 6,400 5,621 - - 225 732 4,69 1,258 2,60 1,258 2,73 1,258 2,86 1,258
global fund 3 0 0 7
malaria
grant NFM3
- DOMC
Special 2,998 2,998 - - - 727 693 1,20 693 1,26 693 1,32 693
global fund 0 0 3
tb grant
nfm3
Infrastructu 321 251 70 - - - - 44 - 44 - 46 - 49 -
re upgrade

158
Project Financing Timeline Actual Outstanding % project Approved Require ment Allocation for Allocation for Allocation for Remarks
code & cum ulative project cost completio GoK budget for FY FY 2024/25 FY 2025/26 FY 2026/27
tittle expenditure as at 30th n 2023/24 2024/25
as at 30th June 2023 (physical
June 2023 ) as of
30th June
2023
Est cost Gok Foreig Star Expec te d Go Foreig Go Foreig Go Foreig Gok Foreig Gok Foreig Gok Foreig Gok Foreig
of project n t com pletio k n k n k n n n n n
date n date
at Kenya
institute of
primate
research

159
2.4 ANALYSIS OF PENDING BILLS FOR THE FY 2020/21 - 2022/23 (KSHS MILLION)
The Tables below present a summary of pending bills by nature and type during the period
under review. In the FY 2022/23, the health sector had total pending bills amounting to
KSh.70,461 Million comprising KSh. 7,966 Million due to lack of exchequer and KSh.62,495
million due to lack of budgetary provision.

Table 2.8. Summary of Pending Bills by Nature and Entity (KSh Million)
S/No ENTITY Due to Lack of Due to Lack of Provision
Exchequer
2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
1 Dept of Medical 45 5,009 952 32,985 40,890 39,613
Services
2 Dept of Public 2,473
Health
3 NCI-K - - 22 - - -
4 MTRH 442 438 1,456 513 1,077 1,262
5 KEMSA - - - 2,920 3,441 5,434
6 KEMRI 312 339 456 1,721 2,087 2,087
7 NHIF - - - 278 278 278
8 NACC - - 186
9 KNH-Mwai Kibaki - - 97 - - -
Hospital Othaya
10 KNH-Mama - - 346 - - -
Margaret
11 KNH 766 1,112 1,084 9,797 8,800 11,493
12 KMTC 482 100 894 4,143 2,240 2,328
TOTAL 2,047 6,998 7,966 52,357 58,813 62,495

Table 2.8. Summary of Pending Bills by nature (KSh Million)

Type/nature Due to lack of Exchequer Due to lack of Provision
2020/2 2021/2 2022/2 2020/21 2021/22 2022/23
1 2 3
1. Recurrent
Compensation of 1,242 854 1,984 2,678 15 16
Employees
Use of Goods and Services 11 1 1,426 17,789 5,330 6,543
Social Benefits - - - 24,116 11,585 14,034
Other expenses - - - 3,291 41,595 1,970
2. Development
Acquisition of Non- 794 6,143 2,172 269 269 269
financial assets
Use of goods and services - - - - - -
Other Specifics - - 2,384 4,214 50 39,663
Total Pending Bills 2,047 6,998 7,966 52,357 58,844 62,495

160
Table 2.8. Summary of Pending Bills by Nature (KSh Million) for Sub sector
1. State Department of Medical Services

Type/nature Due to lack of Exchequer Due to lack of Provision

2020/ 2021/ 2022/ 2020/ 2021/22 2022/23
21 22 23 21
1. Recurrent
Compensation of Employees - - - 2,678 - -
Use of Goods and Services
e.g Rent, Utilities, Insurance, 11 1 367.4 12,690 -
-
Contracted Services
Social Benefits - - - 11,233 - -
Other expenses - - - 2,241 40,890 -
2. Development
Acquisition of Non-financial
34 5,008 584.20 - - -
assets
Use of goods and services - - - - - -
Other expenses (Court
- - - 4,143 -
Awards) 39,613
Total Pending Bills 45 5,009 952 32,985 40,890 39,613

1. State Department of Public Health

Due to lack of Exchequer Due to Lack of Provision
TYPE/ NATURE
2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
1. Recurrent
Compensation to employees -
Use of goods and services 89.0
Social Benefits -
Others -
2. Development -
Acquisition of Non –Financial assets -
Use of goods and services
Others 2384
Total Pending Bills 2473

2. National Health Insurance Fund (NHIF)

Type/nature Due to lack of Exchequer Due to lack of Provision
2020/2 2021/2 2022/ 2020/2 2021/2 2022/2
1 2 23 1 2 3
1. Recurrent
Compensation of Employee - - - - - -
Use of goods - - - - - -
Social benefits-pension - - - - - -
Other expenses (Advertising & Publicity) - - - 9 9 9
2. Development
Acquisition of Non-financial assets (ICT
- - - 269 269 269
Infrastructure)
Use of goods and services - - - - - -
Other Specifics - - - - - -
TOTAL PENDING BILLS - - - 278 278 278

The pending bill for Advertising and Publicity is under investigation while that of ICT
infrastructure is awaiting a court's decision on eligibility for payment.

161
 3. Kenya Medical Supplies Authority (KEMSA)
Type/nature Due to lack of Exchequer Due to lack of Provision
2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
1. Recurrent
Compensation of Employees - - - - 15 16
Use of goods and services - - - 2,920 3,427 4,153
Social benefits - - - - - -
Other expenses - - - - - 1,265
2. Development
Acquisition of Non-financial assets - - - - - -
Use of goods and services - - - - - -
Other Specifics - - - - - -
Total Pending bills - - - 2,920 3,441 5,434

The pending bills under the category of goods and services are the outcome of unpaid invoices
of KSh. 4,153 billion, which have been delayed due to outstanding debts owed to the Authority
by counties, development partners, and the Ministry of Health.
The pending bill under employee compensation pertains to the accrued half salary of KSh. 16
million for staff who are currently on suspension.

In addition, on 11th April, 2022, KEMSA received KRA assessment/ Demand Notice from
KRA for Corporation Tax and Value Added Tax (VAT) of KSh. 3,010,854,284 as Total debts.
Following this huge tax liability, the organization engaged a tax consultant to work with KRA
on tax the tax workings. After several considerations a revised tax obligation was arrived at
KSh. 1,265,576,505 which was to be paid in instalments of 22 months.

4. Kenya Medical Research Institute (KEMRI)

Type/nature Due to lack of Exchequer Due to lack of Provision
2020/21 2021/22 2022/23 2020/2 2021/2 2022/2
1 2 3
1.Recurrent 292 292 317 1,650 2,037 2,037
Compensation of 292 292 317
Employee
use of goods - - - - - -
Social benefits-pension - - - 1,650 2,037 2,037
Other expenses - - - - - -
2.Development
Acquisition of non- 20 47 139 - - -
financial assets
(Development grant)
Use of goods and - - - - - -
services
Others specify (CDC 71 50 50
vendors and debts) - - -
Total Pending Bills 312 339 456 1,721 2,087 2,087

The Pending Bill under the Recurrent budget was due to non-remittance of capitation to
KEMRI in the FY2017/18 (KSh 139M), FY2018/19 (Kshs153M) and KSh 25M in the FY
2022/23.
The pending Bill is also compounded by KEMRI Retirement Benefits Scheme (DB) which was
established in 1983 and has an actuarial valuation deficit of KSh 2.037 Million as at 30th June

162
2021. The Institute has not been able to settle outstanding benefits amounting to KSh 587.7
Million. As a result, retirees have taken the Institute to court demanding payment of their
benefits. This may have an adverse effect in the financial position of the Authority.
Under development budget, the pending bill refers to development grant of KSh 20 Million not
remitted to KEMRI in the FY2017/18, KSh 27 Million in the FY2021/22 and KSh 92Million
in the FY2022/23. The Institute committed to pay vendor debts and the interest that accrued
over the years following the collapse of the CDC/Kisumu CoAg in 2015.

5. Kenyatta National Hospital (KNH)

Due to Lack of Liquidity Due to Lack of Provision
Type/Nature 2020/2 2021/2 2022/2 2020/2 2021/2 2022/202
1 2 3 1 2 3
1. Recurrent
Compensation of Employees 124 124 124 - - -
Use of goods and services - - - 753 826 1,128
Social Benefits -(NSSF and - - - 8,963 7,278 9,669
Pension Deficit)
Other expenses (Tax Liability) - - - 81 696 696
2. Development
Acquisition of Non-financial 642 988 960 - - -
assets
Use of goods and services - - - - - -
Other Specifics - - - - - -
Total Pending Bills 766 1,112 1,084 9,797 8,800 11,493

The Hospital’s Pending Bills under the Use of goods and services category are as a result of
unsettled invoices that are delayed by the resultant non-collection of debt owed to the hospital
by indigents patients. The NSSF contribution pending bills relates to arrears for the period July
1991 to November 2009 when the Minister had not given express authority for exemption in
contribution. The hospital has been including this amount in its budget for consideration for
funding and to date it remains unfunded.
The Defined Benefits (DB) scheme for KNH has a deficit of KSh 9.526 billion as at 30th June
2023 arising from the actuarial valuation for the closed-to-new-member scheme.
The tax liability of KSh. 696M comprises of two components: Tax Liability of KSh 81 Million
is Interest payable to Kenya Revenue Authority (KRA) arising from tax penalties and interest
following an in-depth audit in 2014 and tax demand by KRA for Corporation tax KSh 615
million arising for rental income and interest earned, for which the hospital had treated as tax
exempt as per Income Tax Act.

6. Mama Margaret Kenyatta Hospital (MMKH-KNH)

Due to Lack of Budgetary
Due to Lack of Liquidity
Provision
Type/Nature
2020/2 2021/2 2022/2 2020/2 2021/2 2022/202
1 2 3 1 2 3
1. Recurrent
Compensation of employees - - - - - -
Use of goods and services - - 46 - - -
Social Benefits -NSSF - - - - - -
Other expenses - - - - - -

163
 2. Development
Acquisition of Non-financial
- -
assets - - 300 -
Use of goods and services - - - - - -
Other Specifics - - - - - -
Total Pending Bills - - 346 - - -

Following the transfer of the Mama Margaret Kenyatta Hospital to KNH, claims which were
incurred prior to handover are awaiting settlement. These include: Compensation for
compulsory acquisition of land at KSh 53.3M following a court decree; KSh 47M for
consultancy services; The final account payment for construction works estimated at KSh 99M;
and Equipment supply estimated at KSh 200M.

7. Mwai Kibaki Hospital - Othaya

Due to Lack of Liquidity Due to Lack of Provision
Type/Nature
2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
1. Recurrent
Compensation of Employees - - - - - -
Use of Goods and Services - - 97 - - -
Social Benefits (NSSF and Pension Deficits) - - - - -
Other expenses (Tax Liability) - - - - - -
2. Development
Acquisition of Non-financial assets - - - - - -
Use of goods and services - - - - - -
Other Specifics - - - - - -
Total Pending Bills - - 97 - - -

The Pending Bills of KSh 97Million is as a result of unsettled invoices due to non-collectability
of debt owed to the hospital by indigent patients.

8. National Aids Control Council (NACC)

Type/nature Due to lack of Exchequer Due to lack of Provision
2020/2 2021/2 2022/2 2020/2 2021/2 2022/2
1 2 3 1 2 3
1. Recurrent
Compensation of Employees - - 87 - - -
Use of Goods and Services - - 99 - - -
Social Benefits - - - - - -
Other expenses - - - - - -
2. Development - - - - - -
Acquisition of Non-financial assets (ICT
Infrastructure) - - - - - -
Use of goods and services - - - - - -
Other Specifics - - - - - -
Total Pending Bills 0 0 186 0 0 0

The NACC did not receive its FY2022/23 4th Quarter Recurrent Budget allocation resulting to
the variance between the approved budget for FY 2022/23 and the actual for FY 2022/23. An
amount of KSh 186M was not disbursed. This rendered the NACC incapable of conducting all
the planned activities and non-fulfilment of some committed objectives resulting to Pending
Bills.

164
 9. Moi Teaching & Referral Hospital (MT&RH)

Type/nature Due to lack of Exchequer Due to lack of Provision

2020/21 2021/22 2022/23 2020/2 2021/22 2022/2
1 3
1. Recurrent
Compensation of Employees 442 438 1,456 0 0 0
Use of Goods and Services 513 1,077 1,262
- - -
Social Benefits
- - - - - -
Other expenses
- - - - - -
2. Development
- - - - - -
Acquisition of Non-financial assets (ICT
Infrastructure) - - - - - -

Use of goods and services - - - - - -

Other Specifics - - - - - -
Total Pending Bills 442 438 1,456 513 1,077 1,262

The pending bill of KSh 1,262 Million for FY2021/22 relates to payment of Suppliers for goods
and services as at 30th June 2022. This was as a result of the use of the Hospitals’ A-I-A to
supplement its wage bill as a first charge because of inadequate provision for PE and Indigent
patients who are unable to pay their bills for services offered by the hospital resulting to waivers
of Kshs.400 Million annually.

10. National Cancer Institute

Due to Lack of Exchequer Due to lack of Provision
Type/Nature 2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
1. Recurrent
Compensation to - - - - - -
Employees
Use of Goods and - - 22 - - -
Services
Social Benefits - - - - - -
Other Expenses 0 0 0 0 0 0
2. Development
Acquisition of Non- - - - - - -
financial Assets
Use of Goods and - - - - - -
Services
Others Specify - - - - - -
Total Pending Bills - - 22 - - -

The Pending bill of KSh 22Million relates to payments owed to service providers especially
for provision of conference services and provision of cancer sensitization media coverage.
These expenses had been budgeted for under the Institute’s Annual Procurement Plan but due
to non-remittance of exchequer the Institute was unable to process the payments.

165
 11. Kenya Medical Teaching College
Type/nature Due to lack of Exchequer Due to Lack of Provision
2020/21 2021/22 2022/23 2020/21 2021/22 2022/23
Recurrent
Compensation of 384 - -
employees
Use of good and services 705 913 -
Social Benefits NSSF 730 730 746
Social benefits Pension 1,540 1,540 1,582
deficit
Provision for CBA from 960 - -
1st July 2014 (@240M
P.A.)
Development
Acquisition of non- 98 100 189
financial assets
Use of goods and
services
Others – Specify
Total Pending Bills 482 100 894 4,143 2,240 2,328

166
2.5 ANALYSIS OF COURT AWARDS
During the period under review the state had a court award of KSh. 40.5 billions as show in the
table below.
Table 2.9 (a): Summary of Court Awards – State Department of Medical Services
DATE OF AMOUNT PAYMENT TO
DETAILS OF THE AWARD
AWARD (KSHS) DATE
A KENYA MEDICAL RESEARCH INSTITUTE
1 KSh. 214,833,044 KSh. 27,863,665
ELRC Cause No. 37(N) of 2010.
( Being Arrears (Salary Paid from
Agnes Muthoni & 34 Others vs 18th October 2021
payable from 1st December 2021
KEMRI
2009 to @ 2022) to 30th June 2022)
2 KSh. 2,636,109.28
(Salary Paid from
1st January 2023 to
31st August 2023
Civil Appeal No. E046 of 2022. KSh. and
28th October 2021
KEMRI vs James Maringa Mwangi 12,384,382.50 KSh. 3,295,136.60
Projections from
September 2023 to
June 2024

TOTAL KEMRI 227,217,426.50 30,499,774.28

B STATE DEPARTMENT FOR MEDICAL SERVICES

1. DR. SAMUEL KABERERE
NJENGA –VS- AG& PS File No. 2011 1,427,538.00 None
450/2011
2. VULCAN LTD VS. AG File
2000 1,000,000,000 None
No.NRBI HCCC 1361/2000
3. ABEDNEGO OCHOLA V AG File
No.KSM H/C , MISC CIV APP NO’ 2013 612,032 None
86/2013
4. FARAM E.A. LTD VS THE AG &
2 OTHERS File No.HCC AT 2013 190,813,115 None
NAIROBI NO. 245 OF 2013
5. SIMON KAMAU NJOROGE VS.
PRINCIPAL SECRETARY File 2014 169,999 None
No.411/2014
6. ELDORET CHILDRENS CASE
EUNIFER JEROTICH VS.
2004 144,000 None
DAVID KIBIWOTT File
No.44/2004
7. DR.LAWRENCE NJOGU CHEGE
VS THE ATTORNEY 2016 219,748 None
GENERAL File No.372/2016
8. SUSAN WAMAITHA KAMAU VS
PRINCIPAL SECRETARY
2016 63,702.40 None
MINISTRY OF HEALTH File
No.NRBI HC JR NO. 173 OF 2016

167
 DATE OF AMOUNT PAYMENT TO
DETAILS OF THE AWARD
AWARD (KSHS) DATE
9. CAROLINE WAMAITHA(SUING
THROUGH NEXT OF
FRIENDS) ESTHER NJOKI
WANJIRU V MURIGI CHEGE,
2015 1,363,118 None
MOH MARAGWA DISTRICT
HOSPITAL & AG File No. PMC
AT KANDARA CIVIL CASE NO
188 OF 2015
10. EQUIP AGENCIES LTD VS. AG
File No. MILIMANI HCCC 55 1999 15,250,000,000 None
/2017 FORMERLY (1459/1999)
11. MAGGY AGULO
CONSTRUCTION CO. LIMITED
VS.
MINISTRY OF PUBLIC HEALTH
AND 4 OTHERS File No.HIGH 2017 42,447,990 None
COURT KAKAMEGA CIVIL SUIT
NO. 01 OF
2017
12. IN THE MATTERS OF
ARBITRATION BETWEEN
MELLECH ENGINEERING
&COOSTUCTION LTD AND 2017 1,032,500.000 None
HENRY M. JACKSON
FOUNDATION & ANOTHER
13. UNITED MEDICAL SUPPLIES VS
THE AG File No. HIGH
1995 17,839,728,834 None
COURT SUIT AT NAIROBI NO.
2332 OF 1995
14. PETER BUTALIU SABWAMI VS
ARCHDIOCESE OF NAIROBI
KENYA ,DR. LILIAN WANGU &
DR MUCHAI 2010 5,045,879 None
GACHOGO File No. HCC NO 399
OF 2010
15. UASIN GISHU MEMORIAL
HOSPITAL VS MOI TEACHING
File No. CIVIL APPEAL AT NRB
NO 184 OF 2012 & REFERAL 2012 1,738,630,267 None
HOSPITAL BOARD, MOH AND
THE AG
16. ELIZABETH AWINO ONYANGO
VS CABINET
SECRETARY, MIN OF HEALTH 2013 244,839 None
& 2 OTHERS File No. MISC CIV
SUIT NO 391 OF 2013
17. KEVIN MUZINDI WAMBUGU VS
THE HON. ATTORNEY 244,730.00 As at
2004 21st December None
GENERAL File No. NAIROBI
2012
CMCC NO. 11160 OF 2004
18. ROCKEY AFRICAN LIMITED
File No. HCCC 1361 OF 2000 2000 1,869,390,102 None

168
 DATE OF AMOUNT PAYMENT TO
DETAILS OF THE AWARD
AWARD (KSHS) DATE
19. EMMANUEL MUNENE –VS- THE
ATTORNEY GENERAL &
HYLINE MEMBA File No. CMCC 2013 12,204,618 None
NO. 1558 OF 2013
20. EUROTECH INTERNATIONAL –
V- THE ATTORNEY
1999 2,250,000,000 None
GENERAL File No. HCCC NO.
1460 of 1999
21. ROSE MUMBI MUTURI VS.
DIRECTOR NATIONAL
YOUTH SERVICE, ATTORNEY 2012 615,788 None
GENERAL & ANOTHER File No.
THIKA CMCC NO. 820 OF 2012
22. YUNITA AKUNGU VS TEDDY
OKUKU OPIYO & HON.
ATTORNEY GENERAL File No. 2015 832,188 None
MBITA PMCC NO. 14 OF 2015

23. ANTHONY SAA MWATEBWE

VS FRANKLIN MWAMBENI &
THE HON. ATTORNEY 2018 5,178,924 None
GENERAL File No. KILIFI
SPMCC 349 OF 2018
24. EUGENE REEKSTING VS THE
HON. ATTORNEY
GENERAL File No. NAIVASHA 2013 3,893,309 None
HCCC NO.8 OF 2019(FORMERLY
NAKURU HCCC NO. 25 OF 2013)
25. EMMANUEL ODUMO VS THE
HON. ATTORNEY File No. BUSIA
2018 427,314 None
CMCC NO. 9 OF 2018
GENERAL
26. KENYA NATIONAL UNION OF
NURSES VS THE PERMANENT
SECRETARY MINISTRY OF 2012 385,164.00 None
HEALTH & 2
OTHERS File No. NAIROBI ELRC
CAUSE NO. 1116 OF 2012
27. REPUBLIC VS PRINCIPAL
SECRETARY MINISTRY OF
HEALTH & THE HONOURABLE 2017 127,995 None
ATTORNEY GENERAL Ex parte
GEOFFREY GATWAI MWANGI
28. File No. NAIROBI HIGH COURT
JUDICIAL REVIEW MISC. None
APPLICATION 202 OF 2017
29. EMMANUEL MUNENE(A minor
suing through mother and next
friend CHRISTINE NTHOKI
MUANGE) VS THE HON. 2013 17,046,364 None
ATTORNEY GENERAL & 2
OTHERS File No. MOMBASA
CMCC 1558 OF 2013

169
 DATE OF AMOUNT PAYMENT TO
DETAILS OF THE AWARD
AWARD (KSHS) DATE
30. FARAM E.A LIMITED VS HON.
ATTORNEY GENERAL 2018 33,555,476 None
AND ANOTHER
31. File No. NAIROBI HIGH COURT
COMMERCIAL CASE NO.103 OF None
2018
32. BENARD WASONGA VS AG File
2008 153,072 None
No. SRMCC No. 250/08
33. MICHAEL N. SIMIYU V A.G File
No. Nairobi 3/16 2016 462,500 None
34. ELIZABETH GATHONI MITEY
File No. Nairobi 98/15 2015 727,750 None
35. JAPHET MURIUKI V AG File No.
MERU CMCC No. 232A/011 2011 738,210 None

36. KIMEU MUSYOKI File No.13/16 2016 926,856 None

37. SIMON MUTHUMA NGANGA
File No.421/18 2018 1,255,189 None
38. ELISHA OKINYO OGOLA VS AG
File No.17/11 2011 1,976,770 None
39. SEKUNDU MURIIRA IBAYA VS
DR. NGATIA & 3 OTHERS File 2016 7,158,000 None
No. MERU CMCC 190/2016
40. ELRC CAUSE NO. 37(N) OF 2010.
AGNES MUTHONI & 34 OTHERS 18th October 2021 214,833,044 None
VS KEMRI
41. CIVIL SUIT NO 2473 OF 1998
BETWEEN GERRISHON
KAMAU KIRIMA V/S 25th September 53,363,161 None
ATTORNEY GENERAL OF THE 2007
REPUBLIC OF KENYA
42 TOTAL COURT AWARDS 40,547,440,085 None

Table 2.9 (b): Summary of Court Awards – State Department of Public Health
During the period under review the state department of public health and professional standards
had a court award of 54 Millions as show in the table below.

Details of
Date of AMOUNT
NO Court Payment to date
Award (SHS) Million
Awards
Payment of
nutritionist and
Case No 504 of dietician’s
2018 internship 29th July 2022 176 0
allowances for
the year 2017

170
CHAPTER THREE: MEDIUM TERM PRIORITIES AND FINANCIAL
PLAN FOR THE MTEF PERIOD

1. PRIORITIZATION OF PROGRAMMES AND SUB-PROGRAMMES

The Sector is committed to translating the government priorities to realize the constitutional right
to health by ensuring Universal Health Coverage (UHC) through.

1. Universal seamless health insurance system comprising Social Health Insurance cover
(SHI).
2. Fully publicly financed primary healthcare (Curative, outpatient and basic diagnostic
services), that gives patients choice between public, faith based and private providers,
based on a regulated tariff.
3. National fund for chronic and catastrophic illness and injury costs not covered (or with
very restrictive cover) by insurance (cancer, diabetes, strokes & accident rehabilitation,
pandemics) to be funded by a combination of insurance levy and Government.
4. Enhanced prevention and promotion of health through community involvement and
ownership to reduce disease burden due to preventable causes.
5. Strategic recruitment, management, and retention of Human Resources for Health for
enhanced quality health care.
6. Strengthened governance and administration of health services, quality health standards &
regulations.

These pillars are aimed at primarily preventing disease and promoting good health for general
wellness and wellbeing. They also ensure that any Citizen who otherwise, falls ill, will have access
to quality affordable healthcare without the risk of getting into financial hardship with a special
focus on the poor and vulnerable. Strengthened governance, emphasis of standards and quality of
care have been identified as core to the delivery of healthcare. The sector has also prioritized
human resources for health that impact quality of care as well as digitization of Health services.
Digitization will increase efficiency, transparency and ensure seamless service delivery between
providers across all levels of the health system. It will also enhance claims management at health
facilities for reimbursable services and commodity management through provision of end-to-end
supply chain management.

Sector financing will be strengthened, and the sector will collaborate with the county government
to ensure retention of funds collected at health facility level for improvement of the facility
operations. Most importantly, the Sector, County governments, and the National Treasury will also
engage in considering ring-fencing of funds for Health Products and Technologies (HPT). Primary

171
Care Networks will be established and operationalized in the counties to offer effective services
to the community through proper referrals and engagement of multidisciplinary teams right from
the community level.

Overall, these programmes aim at achieving improved accessibility, affordability of quality health
services, reduction of health inequalities and optimal utilization of health services and promotion
of health. The following are the programmes and respective sub-programmes to be implemented
during the period, FY 2024/25-2026/27.

3.1.1. Programmes and their Objectives

The Health Sector will implement the following 8 programmes and sub programmes, 4 in each
State Department, in the Financial Years FY 2024/25-2026/27 which are in line with the priorities
mentioned above:

Programmes and their Strategic Objectives

Table 3.1 (a): Programmes and their Strategic Objectives

S/NO PROGRAMME PROGRAMME OBJECTIVES

State Department for Medical Services
1. Programme 1: National Referral and Specialized Services To increase access and range of
quality specialized healthcare
services

2. Programme 2: Curative and Reproductive Maternal To increase access to quality

Neonatal Child & Adolescent Health (RMNCAH) Services curative and reproductive healthcare
services

3. Programme 3: Health Innovations and Research To increase capacity and provide

evidence for policy formulation and
practice

4. Programme 4: General Administration and Support Services. To offer Governance and enabling
services for service delivery

State Department for Public Health and Professional Standards

5. Programme 1: Preventive & promotive health services To reduce disease burden due to
preventable causes

6. Programme 2: Health resource development & innovation To enhance health human resources
for quality health care

7. Programme 3: Health policy standards & regulations To strengthen quality health

standards & regulations

172
 8. Programme 4: General administration To strengthen governance &
administration of health services

Programmes and Sub-programmes

Table 3.1(b): Programmes and Sub-programmes
Programme Sub Programmes
State Department for Medical Services
National Referral & Specialized i. SP1.1 National Referral & Specialized Health Services
services ii. SP1.2 Health Infrastructure and Equipment
iii. SP1.3 Health Products and Technologies
iv. SP1.4 National Blood Transfusion Services

Curative and Reproductive v. SP 2.1 Communicable Disease Control

Maternal Neonatal Child & vi. SP2.2 Non-Communicable disease prevention and control
Adolescent Health (RMNCAH) vii. SP2.3 Reproductive Maternal Neonatal Child &
Adolescent Health (RMNCAH)
viii. SP 2.4 Immunization Management

Health Research and Innovations ix. SP3.1 Health Innovations

x. SP3.2 Medical Research

General Administration xi. SP4.1 General Administration & Human Resource

Management & Development
xii. SP4.2 Finance and Planning
xiii. SP4.3 Social Protection in Health

State Department for Public Health and Professional Standards

P1. Preventive and promotive i. SP 1.1 Communicable diseases control
health service ii. SP1.2 Disease surveillance and response
iii. SP1.3 Public Health Services
iv. SP1.4 Radiation safety and nuclear security
v. SP1.5 Primary Health Care

173
Programme Sub Programmes
P2. Health resource development vi. SP2.1 Capacity building and training (Preservice and
& innovation Inservice training)
vii. SP2.2 Research and Innovation on health
viii. SP2.3 Health Profession Services

P3. Health Policy Standards and ix. SP3.1 Health Standard Quality Assurance
Regulation x. SP3.2 Healthy Policy planning and Financing

P4. General Administration xi. SP4.1 General administration Human resource

Planning and support services management and development
xii. SP4.2 Finance and Planning

174
3.1.2 Summary of Programmes, Key Outputs, Performance Indicators and targets for FY 2024/25 - 2026/27

Table 3.1: Programmes/Sub programmes, Outcome, Outputs and KPIs

Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

STATE DEPARTMENT FOR MEDICAL SERVICES

Programme 1: National Referral Facilities and Specialized Services
Programme Outcome: Increased access and range of quality specialized health care services
S.P 1.1 Kenyatta National Specialized health Number of Heart 395 627 658 691 726 762
National Hospital care services surgeries done
Referral & Number of other 1127 1238 1240 1250 1301 1366
Specialized cardiothoracic
Health surgeries
Services conducted
Number of 20 19 20 25 30 32
Kidney
Transplants
conducted.
Number of 5,956 6,113 6,144 6,451 6773 7112
minimally
invasive surgeries
done
Number of 589 524 570 587 604 634
patients
undergoing
specialized Burns
treatment (OBD)
Number of 44,068 37,772 40,372 40,574 41,776 42,815
oncology sessions
on

175
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

(Chemotherapy
and radiotherapy)
Health Research Number of briefs 2 2 3 4 4 4
disseminated developed and
disseminated to
inform national
policy
Average waiting Average Length 36 38 37 35 33 32
time for of Stay (ALOS)
specialized for trauma
diagnostic and patients (days)
treatment services Average waiting 90 85 80 70 63 60
reduced time for kidney
transplant (days)
Average waiting 19 22 17.3 17 16.8 16.5
time (days) for
radiotherapy
Average waiting 16 14.5 13.5 12 10.5 10
time (days) for
chemotherapy
Multidisciplinary Number of Multi- 67 391 393 395 397 417
Outreaches disciplinary
Conducted Outreaches in
Counties
Mwai Kibaki Specialized health Number of 1541 1907 1922 2003 2103 2208
Hospital care services minimally
invasive surgeries
done
Number of NCD 104 122 130 163 196 206
screening
sessions

176
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Number of 21 19 23 24 26 27
specialized clinics
available in the
facility
Average length of 14 15 14.8 14.3 14 13.5
stay for trauma
patient (days)
Number of 943 1411 1455 1482 1556 1634
oncology sessions
on
(Chemotherapy
and radiotherapy
Health Research Number of briefs N/A N/A 1 2 3 4
disseminated disseminated to
inform national
policy
Multidisciplinary Number of Multi- 25 15 17 19 20 22
Outreaches disciplinary
Conducted Outreaches with
Counties
Mama Margaret Specialized Number of new 3 13 14 15 16 17
Uhuru Hospital healthcare specialized clinics
services established
Health research Number of N/A N/A 104 110 121 127
disseminated minimally
Multidisciplinary invasive surgeries
Outreaches done
Conducted Number of N/A N/A 52 57 63 67
oncology sessions
on

177
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

(Chemotherapy
and radiotherapy)
Number of briefs N/A N/A 1 2 3 5
to inform national
policy
Number of Multi- 12 6 14 16 18 20
disciplinary
Outreaches in
Counties
Moi Teaching and Reduced Average Average Length 11.7 11.5 11.4 11.3 11.2 11
Referral Hospital Waiting Time for of Stay for
Treatment and Orthopedic
Specialized Surgery (Trauma
Diagnostic Patients) Days
Services Average Length 31.3 30.6 30.5 30.3 30.1 30
of Stay for
Pediatric Burns
Patients(days)
Average waiting 90 47 45 43 42 41
time (days) for
Radiotherapy
Specialized Number of 18 18 18 19 20 21
Healthcare Kidney
Services Transplants
undertaken
Number of 2,700 3,202 3400 3500 3600 3700
Minimally
Invasive
Surgeries

178
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Number of 16,600 17,622 17,750 17,850 17,950 18,000

Chemotherapy
sessions done
Number of Open- 44 52 60 70 80 90
Heart Surgeries
conducted
Number of 10200 10808 10100 10150 10200 11000
External Beam
Radiotherapy
Sessions.
Number of 135 153 160 170 180 190
Brachytherapy
Sessions
Number of 11 13 14 15 16 17
Corneal
Transplants
conducted
Health Research Number of 24 27 30 30 30 30
disseminated Research Papers
Published
Number of Briefs 3 4 4 5 6 6
to inform
National Policy
Multidisciplinary Number of Multi- 25 57 60 60 60 60
Outreaches disciplinary
Conducted Outreaches in
Counties
Kenyatta Specialized Number of Open 24 35 30 40 45 50
University Health care Heart Surgeries
Teaching, Referral Services conducted

179
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

and Research Number of 10 0 15 15 20 25

Hospital Kidney
Transplants
conducted
Number of 850 1234 1000 1300 1350 1400
minimally
invasive surgeries
conducted

Number of 8,500 9,635 10,200 11,000 11,500 12,000

patients on
Hemodialysis

Number of 25,500 28,752 30,500 32,000 33,500 34,500

patients receiving
chemotherapy &
radiotherapy
treatment
Number of 1000 1112 1200 1400 1600 1700
specialized
Gynaecology
procedures
conducted
Reduced Average Average waiting 16 56 50 45 40 30
Waiting Time for time (days) for
Treatment and radiotherapy
Specialized Average waiting 7 5 6 6 5 4
Diagnostic time (days) for
Services Chemotherapy

180
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

ALOS for 15 11 14 10 9 8
orthopedic
patients’ (days)
ALOS (days) for 7 6 7 6 6 5
surgery patients
(days)
Studies & Number of 5 3 6 5 7 10
Research research
conducted conducted &
completed
Cancer Diagnosis Number of PET 4000 3685 4500 5000 5500 6000
& Treatment Scan
Services Provided examinations
conducted
Number of 500 1570 1000 1800 2000 2200
SPECT CT-Scan
examinations
conducted
Number of 400 0 600 800 1200 1500
Stereotactic
Radiosurgery
conducted
Number of 800 854 900 1000 1200 1500
Brachytherapy
sessions
conducted
Mathari National Policies, Number of 1 2 3 3 3 3
Teaching and Standards and Policies,
Referral Hospital Regulations Standards and
developed to Regulations
developed

181
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

operationalize
MNTRH
Human Resource Proportion of N/A N/A 60 40 0 0
instruments organizational
finalized Human resources
instruments
finalized
Specialized Re-admission N/A N/A 42 32 22 12
mental health Rate (proportion
services of patients
readmitted in a
year)
Average Length 50 44 44 42 40 38
of Stay for civil
psychiatric
inpatients (Days)
Number of 48 100 100 100 100
weekly
community
mental health
outreaches
conducted

Number of N/A N/A N/A 780 740 700

forensic
outpatients
receivingpsychiat
ric services
Number of N/A N/A N/A 200 190 180
forensic
inpatients

182
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

receiving
psychiatric
services
Percentage N/A N/A 61 51 41 31
reduction in
outpatient revisits
Abandoned Proportion of N/A N/A 90 95 100 100
Patients Re- abandoned
integrated into the patients re-
community integrated into the
community
Spinal Injury Specialized spine Out-patient spine 1.5 1.2 1.5 2 1.4 1.1
Hospital services services
utilization rate
ALOS for spine 83.2 83 83.2 83 83 83
patients (days)
Average waiting 270 265 210 180 150 150
time for spine
services(days)
Proportion of 50 31 60 80 100 100
patients re-
integrated into
community
Forensic and Forensic services Proportion of 30 100 100 100 100 100
Pathology services for administration Clinical and
of justice forensic autopsies
performed
Proportion of 100 100 100 100 100 100
Expert opinions
given

183
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Proportion of 25 100 100 100 100 100

exhumations
performed for
medical forensics
Proportion of 30 100 100 100 100 100
Criminal related
death scenes
viewed.
Histology and Percentage of 45 60 70 80 100 100
Pathology Histo-
services cytopathology
examination for
cancer diagnosis
carried out
Proportion of 45 100 100 100 100 100
scientific
interpretations of
pathology results
for clinical
decisions
Orthopedics and Health Percentage of 40 10 60 80 100 N/A
Trauma Unit Legislation on completion of
Orthopedic Orthopedics
Trauma &Trauma bill
Technologist and
Technician Bill
Clinical Services Operationalizatio The number of N/A 400 400 400 400 400
n of Afya House clients screened
Staff clinic
(dispensary)

184
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Radiology & Operationalizatio Percentage of 30 0 40 60 80 100

Medical Diagnostic n of implementation
Services Radiographers act of the
Radiographers
Act
Service Access Service Access N/A N/A 88 90 92 100
increased Inde
x
Rehabilitative Counties Proportion of 10 0 20 30 42 47
Services supported to counties
implement the supported to
Disability implement
Medical Disability
Assessment and Medical
Categorization Categorization
Guidelines
Operationalize Number of AT 2 1 1 1 N/A N/A
National policies
Assistive developed
Technology (AT)
Centre of
Excellence
Oral health Dental amalgam Number of 4 0 4 4 1 1
services phase down amalgam phase
down tools
developed
Nursing services Critical care Number of nurses 200 150 250 300 350 350
services sponsored for
critical care
services training

185
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Ophthalmic Expanding Number of New 3 1 6 9 10 10

Services specialized eye Diabetic eye care
care services centers
established in 10
facilities
Number of 5 5 10 15 10 10
Centers offering
Refractive Low
Vision Services
Eye health Number of eye 2 2 4 4 5 10
infrastructure Health Facilities
upgraded Rehabilitated
SP 1.2. Health Health MES Equipment Percentage of 100 100 100 100 100 100
Infrastructur Infrastructure installed and Public hospitals
e and Management offering essential equipped with
Equipment and critical health MES equipment
care services achieving an
uptime of 95%
Kisii level 5 Percentage of 50 10 65 85 100 100
cancer center completion rate
constructed
East African Completion rate 75 84 75 85 100 N/A
Centres of on construction
excellence for works
skills & Tertiary
Education
established
Kigumo Hospital Completion rate 60 80 78 82 100 N/A
upgraded to level of the upgrading
4 status works

186
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Regional cancer Completion rate 50 0 60 80 100 N/A

centres in of establishing
Kakamega and the cancer centres
Meru established
MOH Number of MOH 84 33 39 11 11 N/A
equalization equalization
funds projects funds projects
completed
Norms and Proportion of 85 85 87 89 91 93
Standards for health facilities
health with health norms
infrastructure and and standards
equipment Proportion of 80 85 87 89 91 93
operationalized health facilities
complying with
medical norms
and standards
SP 1.3 National Blood Blood transfusion Number of 400,000 412,868 450,000 450,000 500,000 500,000
National Transfusion services Whole blood
Blood Services units collected
Transfusion Proportion of N/A N/A 100 100 100 100
Services blood and blood
components
collected and
screened for HIV,
HBV,HCV and
Syphilis.
Proportion of 70 67 70 70 70 70
whole blood units
collected and
converted to safe

187
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

blood
components for
transfusion
Number of N/A N/A 30 35 40 47
Satellite Blood
Transfusion
Centres with
Capacity to
prepare blood
components
Number of N/A N/A 350 450 500 600
transfusing
facilities with
Hemovigilance
surveillance
reporting capacity
Proportion of N/A N/A 60 70 80 85
blood donors
notified on their
status of
Transfusion
Transmissible
Infections (TTIs)
serological results
Number of N/A N/A 150 200 250 300
Satellite Blood
Transfusion
Centres and
transfusing
facilities using
the Damu-KE

188
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

platform for
Accountability
and Traceability
of blood and
blood products
Human Cells, Percentage of the N/A N/A 70 30 N/A N/A
Tissue and Organ guidelines and
Transplant standards
Services completed and
disseminated
Number of N/A N/A 10 5 5 5
registered human
cells, Tissue and
organ transplant
centres mapped
and register
Percentage of N/A N/A 50 40 20 10
Completion rate
Digital Tissue
Banking
Management
Information
System
(BTBaMS))
SP 1.4 Health Division of Health Health products Percentage N/A NA 22 100 100 0
Products & Products and and technologies completion of
Technologies Technologies policies and development of
guidelines the National
developed (2 Health Products
policies- National and Technologies
Pharmaceutical Policy

189
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Policy and The Proportion of N/A N/A 35 50 80 85

HPT Donations donations made
Policy) through the HPT
donations portal
Proportion of N/A N/A 70 80 100 NA
Counties with
HPT guidelines
disseminated
Technical Proportion of N/A N/A 100 75 75 75
assistance and functional County
capacity building Health Products
to counties and Technologies
Units
Number of staff 200 217 200 200 200 200
capacity built on
HPT supply chain
management
Local Percentage of N/A N/A 60 80 100 N/A
manufacturing for completion on
HPT fast-tracked development of
Local
manufacturing
roadmap
Scaling up Number of health 20 15 10 5 5 5
capacity by health facilities with
facilities to oxygen machines
produce oxygen delivered and
commissioned
(PSA Plants and
with Liquid
oxygen tanks)

190
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Pharmacy Services Quality Health Number of 3 5 2 N/A N/A 3

Products and essential HPT
Technologies lists reviewed
services Proportion of N/A N/A 70 75 80 100
essential HPT
lists Disseminated
to counties
Number of N/A 4 5 11 21 42
functional County
Medicines
Therapeutics
Committees
Number of annual N/A 1 1 1 1 1
Joint supportive
supervision and
data quality
audits done for
HPT
Increased Percentage of N/A N/A 50 50 60 70
availability of health facilities
Health Products with essential
and Technology tracer medicines
Percentage of N/A N/A 50 50 60 70
health facilities
with essential
tracer diagnostics
Percentage of N/A N/A 50 50 60 70
health facilities
with essential
tracer medical
supplies

191
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Division of Policy guidelines Percent 60 80 90 100 NA NA

traditional and and regulatory completion of the
alternative framework for Traditional &
medicine traditional and Alternative
alternative Medicine Policy
medicine guideline
(TAM)services Percent 40 70 80 100 NA NA
established completion of the
Traditional and
alternative
medicine Bill
Kenya Medical Health Products Percentage of 90 51 90 90 90 90
Supplies Authority & technologies order fill rate for
availed HPTs
Order turnaround 10 16.9 10 7 7 7
time(days) PHFs
Order turnaround 7 14.4 7 5 5 5
time(days)
Hospitals
Percentage of last 100 100 100 100 100 100
mile deliveries
made to health
facilities
National Percentage 100 84 90 100 N/A N/A
Commodities completion rate
Storage(supply (Initial Contract)
chain) center Percentage 100 75 90 100 N/A N/A
established completion rate
(remeasured
Contract)

192
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Equipping, Percentage of 46.4 0 12 46 65 100

Warehouse completion of
Layout, operationalization
Automation &
Operationalizatio
n of the New
Warehouse
Expansion and Percentage of N/A N/A 100 100 N/A N/A
Operationalizatio completion
n of Kisumu Kisumu Regional
Regional Distribution
Distribution Centre
Centre
Expansion and Percentage of N/A N/A 100 100 N/A N/A
Operationalizatio completion of
n of Mombasa Mombasa
Regional Regional
Distribution Distribution
Centre Centre
Establishment of Percentage of N/A N/A 50 50 50 50
Meru/Isiolo completion
Regional Meru/Isiolo
Distribution Regional
Centre Distribution
Centre
Fencing and Percentage of N/A N/A 30 40 60 60
Operationalizatio completion of
n of Eldoret Eldoret Regional
Depot Distribution
Centre
Programme 2: Curative and RMNCAH

193
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Programme Outcome: Increased access to quality curative and reproductive health care services
NSDCC Reduce new HIV Total annual new N/A 34,540 22,779 16,566 10,354 10,354
SP 2.1 infections by 75% HIV infections
Communicabl
Reduce AIDS- Annual AIDS N/A 22,373 14,698 12,598 10,499 10,499
e disease
related mortality deaths
control by 50%

Reduce HIV Percentage HIV N/A 23% <25% <25% <25% <25%
related stigma and related stigma and
discrimination to discrimination
less than 25%

Increase domestic Percentage of N/A 34% 34% 40% 45% 50%

financing for the total funding for
HIV response and the HIV response
other syndemic and syndemic
diseases to 50% diseases coming
from domestic
sources.

Effective sectoral Proportion of N/A N/A 25% 50% 75% 100%

workplace MDAs reporting
programmes for on Work place
the prevention programmes
and response to
syndemic diseases Estimated N/A 8.60% <5% <5% <5% <5%
in place percentage of
children newly
infected with HIV
from mother-to-
child transmission

194
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

among women
living with HIV
delivering in the
past 12 months
(MTCT Rate)

Number of new N/A 10,020 7,873 5,726 3,578 3,399

HIV infections
among
adolescents and
young people (15-
24 years)

Country and Proportion of N/A 20% 40% 60% 80% 100%

global reporting counties
obligations for visualizing
HIV and other through the
syndemics National digitized
honored. platform and
using real-time
data for decision
making for HIV
and other
syndemic diseases
response
(situaiton room)

Effective Proportion N/A 20% 40% 60% 80% 100%

multisectoral multisectoral
coordination and partners reporting
accountability on prevention and

195
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

platforms in response to HIV

place. and other
syndemic
diseases.

Increased uptake Research, N/A 1 1

uptake of research surveys, policy 1
for HIV and other briefs and forums
syndemic diseases conducted on HIV
research findings and other
to inform policy syndemic
and practice diseases.

NASCOP HIV, STI and Number of people 1,287,89 1,330,565 1,319,871 1,353,450 1,387,029 1,420,60
Hepatitis Currently on 0 8
Prevention and ART
management in Proportion of 98 90 95 97 98 100
the Health Sector HIV positive
pregnant women
who are currently
on ART
Coverage of 77 97 98 99 99 99
Antiretroviral
therapy (Adults)
Antiretroviral 93 80 85 90 95 95
therapy coverage
(Children)
Viral suppression N/A N/A 92 94 95 97
among PLHIVS
EID coverage 60 70 80 90 90 90

196
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Mother to Child 9 8 7 6 5 5
transmission Rate
Number of people N/A N/A 50,000 100,000 250,000 500,000
tested for HBV
SP 2.2 Non- National Cancer Cancer Number of 500,000 345,576 700,000 750,000 800,000 850,000
Communicabl Control Prevention and women of
e diseases Programme Control Services reproductive age
prevention screened for
and control cervical cancer
Proportion of 0 1% 10% 10% 20% 30%
women who
undergo
screening as a
proportion of the
eligible
population (40-74
years)
Proportion of N/A N/A 30% 40% 50% 60%
health facilities
providing cancer
screening and
early diagnosis
services
Number of 3,000 6,805 3000 4000 5000 6000
primary
healthcare
workers trained
on cancer
screening and
early detection

197
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Regional cancer Number of cancer 9686 N/A 12,634 14,740 16,846 18,952
centers patients receiving
established and radiotherapy
functional services
Proportion of the 20% 16% 30% 40% 50% 60%
essential cancer
medicines
available at
cancer centers
Number of cancer 4 2 5 5 6 6
centres
established
National Cancer Cancer research Number of N/A N/A 3 10 25 50
Institute Kenya conducted researches
conducted
Number of 3 0 2 4 5 10
policies,
guidelines,
protocols and
standards
developed
Public education Number of people 15 19 30 35 40 45
in cancer reached with
prevention and cancer Prevention
control & Control
messages in
(Millions)
Partnerships and Proportion of 10 10 55 100 100 100
coordination in counties with
county specific

198
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

cancer prevention cancer control

and control frameworks
Number of N/A N/A 10 15 20 25
MOUs signed
Number of N/A N/A 10 15 20 25
Multisectoral
Forums
Conducted
Number of 22 22 44 88 116 250
MDAs trained to
implement
workplace cancer
prevention and
control programs
Capacity Number of pre N/A N/A 5 10 15 25
enhancement in and in-service
cancer prevention training
and control programmes
integrated
Quality assurance Number of 5 5 6 25 50 100
in cancer care cancer treatment
services facilities that
have met the
minimum
standards of care
Number of 30 78 80 100 150 200
Cancer Care
Centers certified
Number of N/A N/A 30 50 60 100
Cancer

199
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Diagnostic
Centers certified
Cancer Number of cancer 8 8 10 50 60 100
information registry hubs
platforms established
established in
National and
County levels
National Cancer Number of 32 0 75 75 50 50
Institute of Kenya officers recruited
operationalized
with optimal
staffing
Division of Mental Effective Number of 2 2 4 4 2 2
Health management of counties
mental health supported to
within the develop mental
Counties health action
plans
Number of 2 2 8 16 24 32
counties
supported to
develop mental
health promotion
and prevention
programme.
Kenya Board of Improved quality Number of 4 4 4 7 11 16
Mental Health of mental health mental health
Non- care in the units inspected
Communicable country against WHO

200
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Diseases Diabetes and Quality Rights

(NCD)Prevention hypertension standards
and Control Unit curative services Number of 226,310 179,028 250,000 300,000 320,000 340,000
diabetes patients
receiving
treatment
Number of 1,100,00 513805 500,000 700,000 800,000
hypertensive 0 350,000
patients receiving
treatment
Violence and Trauma registry Percentage 100% 0% 75% 100% 100% 100%
Injuries Prevention established completion of
and Control Trauma registry
Division
Geriatrics Geriatrics Proportion of 5% 0% 10% 15% 30% 45%
Medicine services counties with
HCPs trained on
integrated care of
older persons.
Percentage 50% 0% 75% 100% 100% 100%
completion of
Parkinson's
Disease registry
SP 2.3 Department of Family Planning Proportion of 55% 74 53 55 56 57%
Reproductive Family Health Services Women of
Maternal reproductive age
Neonatal receiving FP
Child and commodities
Adolescent Maternal Proportion of 57% 51.9% 65 69 74 79%
Health Neonatal and pregnant women

201
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Child Health attending at least

Services 4 ANC visits
Proportion of 50% 37.9% 58 62 66 70%
women receiving
post-natal care
within 2-3 days of
delivery
Proportion of 80 76 88 90 92 94
mothers delivered
by Skilled Birth
Attendant
Facility based 100 86 97 94 91 88
maternal
mortality rate per
100,000
deliveries
Facility based 11 10 8 7 6 4
neonatal deaths
per 1000 live
births
Under five 52 41 40 35 30 25
mortality rate per
1,000 live births
Proportion of 70% 78% 82% 85% 87% 80%
children under
age 5
developmental
milestones on
track in health,
learning, and

202
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

psychosocial
wellbeing.
Number of Pre- 6 4.50 6 6 6 6
school and school
going children
de-wormed in
Millions
Effective Treatment cure N/A N/A 84% 85% 85% 85%
treatment for rate of acutely
malnourished malnourished
children under 5 children 6-59
years of age, months
pregnant and Treatment cure N/A N/A 90% 92% 95% 95%
lactating women rate of acutely
malnourished
pregnant and
lactating women
Nutrition policies, Number of N/A N/A 3 2 2 2
legislations, Policies,
strategic plans guidelines,
and guidelines strategic plans
developed and and legislations
disseminated developed and
disseminated
SP 2.4 Division of Vaccines and Proportion of 86 84.7 89 90 90 92
Immunization National Vaccine Immunization fully immunized
Management and immunization Services children under
Program 1year (Proxy
Penta 3)
Proportion of 94 85 90 92 92 94
Health Facilities

203
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

with Functional
Cold Chain
Equipment
Proportion of 100 38.4 100 100 100 100
fully immunized
adults with
Covid19 vaccine
Programme 3: Health Research and Innovations
Programme Outcome: Increased capacity and provide evidence for policy formulation and practice
SP:3.1 Health Digital Health Operationalizatio Proportion of N/A N/A 10 25 50 75
Innovations Agency n of the Digital shared services
Health Agency on boarded onto
the Agency.
National health Total number of N/A N/A 3 6 N/A N/A
registries national health
established registries
Integrated and Proportion of 20 20 50 60 80 100
comprehensive Level 2,3, 4,5,
end to end POCs public health
at all levels facilities
implementing the
digital health
National Health Proportion of N/A N/A 10 30 60 90
Information health encounters
Exchange fully captured
established within the
National SHR
Comprehensive Proportion of N/A N/A 20 50 70 100
Integrated Health public health
Information facilities with
Management adequate power

204
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

System and connectivity

established to support the
facility level POC
Primary Number of N/A N/A 6 18 105 105
HealthCare Primary
Networks (315 HealthCare
PCNs) digitalized Networks (PCNS)
digitalized
Kenya Biovax Human vaccine Percentage 50 16.5 50 60 70 90
Institute Fill and Finish completion rate
facility of human vaccine
established fill-and-finish
facility
Vaccine No. of products N/A N/A N/A N/A N/A 1
production manufactured
capacity
established
Vaccine Research Percentage N/A N/A 5 10 15 20
& Development completion rate
centre established of Research &
Development
centre
Technology Number of 1 0 1 1 1 1
transfer of HPTs technology
acquired transfers
agreements
Personnel trained Number of 20 20 30 50 60 70
in administrative personnel trained
and specialized in administrative
HPTs and specialized
manufacturing

205
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

HPTs
manufacturing
Staff recruited Number of staff 23 1 30 20 20 20
recruited
Quality Percentage 50 25 60 75 85 95
Management completion rate
Systems of quality
established management
systems
established
Partnerships & Number of 4 1 3 3 3 3
Collaborations partnerships and
established collaborations
SP 3.2 Kenya Medical Research Number of New 178 191 196 200 205 210
Medical Research Institute protocols research protocols
Research approved approved
Number of 500 516 522 527 535 540
ongoing Research
Projects
Research Number of 350 525 522 525 528 530
Findings research Papers
Disseminated published
Number of 191 209 210 215 218 220
research
Abstracts
presented
Number of 4 2 3 3 3 3
Scientific &
Health
Conferences held

206
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Number of 15 12 13 14 15 16
Evidence briefs
developed
Number of 88 90 100 100 100 100
Students enrolled
MSc & PhDs
Research and Number of 293,000 162,213 180,487 189,511 198,986 208,936
innovation Diagnostic kits
produced
Number of 568,242 971,376 971,376 1,019,944 1,070,942 1,124,48
Specialized 9
laboratory tests
conducted
Partnerships & Number of 80 78 85 86 87 88
Collaborations partnerships and
established collaborations
Programme 4: General Administration
Programme Outcome: Effective Governance and administration services strengthened
SP 4.1 : General Coordination of Number of 5 5 5 5 5 5
General Administration support services workplace
Administratio Services policies
n & Human developed and
Resource implemented
Management Proportion of N/A N/A 100 100 100 100
& complaints
Development addressed within
21 days from
lodge
Client satisfaction N/A N/A 80 80 90 95
index

207
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Coordination of Guideline for 1 1 1 1 1 1

Donations donations
management
developed and
implemented
ICT Services ICT networking Ratio of staff to 3:01 3:01 2:01 1:01 1:01 1:01
and equipment functional
provided computers/laptop
s
Proportion of N/A N/A 50 75 100 100
institutions with
functional LAN
and WAN

Human Resource Capacity building Number of health 0 0 146 470 100 120
Management & of health care care workers
Development workers recruited
division
Number of health 9500 4165 0 0 0 0
care workers
placed on
internship.

Percentage of in- 10% 0% 15% N/A N/A N/A

Operational post employees
efficiency in state trained
corporations
Number of N/A N/A N/A 1100 1375 2062
employees trained

208
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Percentage of N/A N/A 15% 74% 100% N/A

state corporations
Organization
structures
reviewed.
Technical Services Kenya Health Proportion N/A N/A 100 100 100 100
Sector directors recommendations
caucus implemented
operationalized
Regional and Proportion of N/A N/A 100 100 100 100
International Resolution
health governance implemented
forums facilitated
Health statistics Number of N/A N/A 2 2 2 2
published publications on
Medically
Certified Cause
of Death
(MCCoD)
statistics
Publish annual N/A N/A 1 1 1 1
health statistics
SP 4.2 Finance division Coordination of Percentage of 100 96 100 100 100 100
Finance and budget allocated funds
Planning preparation and utilized as per
reporting plan
Number of 4 4 4 4 4 4
quarterly budget
reports submitted

209
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Collection of Total AIA 16 17.3 18 19 20 21

public health collected(KSH.B)
sector financial
resources
increased
Central Planning& Coordination of Number of policy 4 1 10 6 6 6
Projects national briefs prepared
Monitoring Unit development Number of capital 2 0 4 4 4 4
projects
monitored for
progress
Number of N/A N/A 47 47 47 47
Counties trained
on planning,
budgeting and M
&E
Number of N/A N/A 15 15 15 15
SAGAs and
regulatory bodies
sensitized on
planning,
budgeting and M
&E
Universal Health Universal Health 100 79 80 85 88 90
Coverage Index Coverage Index
UHC service 100 87 90 90 92 95
coverage index
UHC service 100 83 80 85 90 95
access index
UHC quality 100 60 65 70 75 80
index

210
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Counties trained Number of N/A N/A 23 24 23 24

in data analytics Counties trained
on data analytics
Primary Health Number of N/A N/A 47 47 47 47
Care Progress counties
measured supported to
strengthen PHC
measurement
mechanisms(Vital
signs profiles)
SP4.3 Social Division of Health- Facility Number of 47 23 24 12 11 N/A
Protection in Care Financing Improvement Counties
Health Fund (FIF) sensitized on FIF
Guideline guideline.
disseminated to
County Health
Management
Teams
Standard county Standard Facility 1 1 50 25 25 N/A
Facility Improvement
Improvement Fund bill
Fund Bill developed and
developed shared with
Counties
Capacity building Number of health 100 0 100 50 50 N/A
of 100 health care care providers
providers in trained in
Health care strategic
financing and purchasing for
strategic health care
purchasing for services

211
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

health care
services
Costing of Proportion N/A N/A 50 25 25 N/A
Healthcare Costing of
services for Level Healthcare
1-6 services done for
Levels 1 - 6
Kenya Household Kenya Household N/A N/A 1 1 N/A N/A
and Health and Health
Expenditure and Expenditure and
Utilization Utilization
Survey Survey conducted
Essential Benefits Operational N/A N/A 1 1 N/A N/A
Package (EBP) Essential Benefit
reviewed and Package
operationalized
Social Health Operational N/A N/A 1 1 N/A N/A
Insurance Fund Social Health
operationalized Insurance Fund
National FIF Bill National FIF Bill N/A N/A 1 1 N/A N/A
development, and regulations
enactment and developed
dissemination of enacted and
FIF regulations disseminated
SHA Indigents and Number of 1 1 1.5 2.5 3.9 5.2
Vulnerable indigents
Insurance accessing
Coverage government
increased health insurance
subsidies in
Millions

212
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Number of 253,400 253,400 253,400 496,664 695,330 834,396

indigents
accessing
healthcare
through HISP
Number of 58,800 58,800 58,800 82,320 115,248 172,872
elderly & persons
with severe
disabilities
accessing
healthcare
Number of 484,086 0 484,086 531,086 531,086 584,195
elderly persons
accessing Inua
Jamii Subsidy
program
Number of 1,231,20 1,186,004 1,231,200 1,299,903 1,414,292 1,470,86
mothers accessing 0 4
healthcare
services through
the Linda mama
program
STATE DEPARTMENT FOR PUBLIC HEALTH AND PROFESSIONAL STANDARDS

Programme 1: Preventive and Promotive Health Services

Programme Outcome: Reduced disease burden due to preventable causes

SP 1.1 TB Programme TB clients Number of TB

Communicabl identified cases notified (All
forms) 99,226 82,302 99,878 99,318 98,037 94,902

213
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

e disease Number of MDR-

control TB cases notified 800 924 1,085 1,081 1,068 1,041

TB clients treated Proportion of

successfully treated
TB cases (all forms
of TB) 90 85 88 90 92 94

Proportion of Multi
drug resistant TB
successfully treated 70 79 81.5 82 82.5 83

Number of people
TB Prevention in contact with TB
intervention patients who began
enhanced preventive therapy
treatment 31,747 29,635 75,184 95,346 116,613 136,276

National Malaria Prompt Malaria Number of 6.3 6.5 6.9 7.0 7.4 8.0
Programme treatment Artemisinin
enhanced Combination
Therapy (ACTs)
doses distributed
to public health
facilities
(millions)

Malaria incidence 80 105 82 80 75 70

per thousand
population

Proportion of 100 99 100 100 100 100

Confirmed

214
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Malaria Cases
treated (%)

Malaria cases in Proportion of 100 89 100 100 100 100

public health suspected cases
facilities tested tested
(microscopy or
Rapid Diagnosis
kit)

Malaria cases Proportion of 100 95 100 100 100 100

treated in Confirmed
accordance to the Malaria Cases
Kenya Malaria treated
Treatment
Guidelines

Long Lasting Number of 2.3 1.8 2.2 2.3 2.4 2.5

insecticidal nets Routine Long
distributed Lasting
through Maternal Insecticidal Nets
and Child Health distributed
(MCH) clinics (millions)

SP 1.2 Disease Division of Reduction of Non Polio Acute 2.5 2.8 3 3 3 3

Surveillance Disease mortality and Flaccid Paralysis
and Epidemic Surveillance and morbidity due to Detection rate
Response Response public health (NPAFP) per
emergencies 100,000

Number of 6 6 8 5 5 5
counties with
functional

215
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Community
Events Based
Surveillance
(CEBS)

Number of 62 84 20 20 25 30
hospitals with
Functional Events
Based Reporting
System

Division of Health Number of 1 0 1 1 1 1

Emergencies and counties with
Disaster functional
Management command and
control centres
linked to
ambulance
dispatch

Number of 15 0 15 15 15 15
centres for
management of
CBRN Incidents
established

Public Health Public Health Number of 50 100 100 100 100 100
Emergency Emergency County PHEOC
Operations Centre Operationalized staffs trained on
Rapid Response

Number of 18 9 5 5 5 5
Counties with

216
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Functional
PHEOCs

Proportion of 100 100 100 100 100 100

Public Health
Emergencies
responded to.

Field Health Care Number of Health 20 20 30 30 30 20

Epidemiology & workers trained care trained on
Laboratory FELTP
Training Program
(FELTP)

Division of Vector People treated for Number of people 1.4 2.4 1.2 0.5 0.3 0.1
Borne & Neglected Lymphatic treated for
Tropical Diseases filariasis (LF), trachoma
Trachoma, (Millions)
bilharzia, and
intestinal worms Number of people 3.5 6 6 6 6 6
treated for
Bilharzia.
(Millions)

Number of people 7 12 12 12 12 12
treated for
intestinal worms.
(Millions)

Division of Surveillance of Number of people 10 5 5 5 5 5

Zoonotic Diseases Zoonotic diseases diagnosed with
Rabies

217
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Number of 4 5 7 10 12 15
counties
supported to
investigate and
respond to
priority zoonotic
diseases

Division of Testing capacity Number of 21 17 20 26 36 47

National of laboratory medical
Laboratory network for laboratories with
Services referral services capacity to detect
expanded and report on
Antimicrobial
Resistance

Implementation Number of N/A 0 4 7 10 11

of laboratory accredited
Quality laboratories in the
Management ASAL
System (QMS) categorized
improved cohort

Number of N/A 0 30 60 90 110

certified
laboratories in the
Laboratory
Continuous
Quality
Improvement
(LCQI) program

218
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Number of N/A 9 10 10 11 11
External Quality
Assurance (EQA)
scopes in the
Kenya National
External Quality
Assurance
Scheme
(KNEQAS)

Healthcare waste Number of N/A 0 65 80 95 110

management facilities with
improved molecular testing
platforms linked
to a functional
incinerator for
healthcare waste
management
referral

SP 1.3: Environmental Sanitation and Proportion of 31 30 37 49 55 60

Public Health Health hygiene services Villages certified
Services as open
defecation free

Proportion of 25 30 30 35 40 45
population
accessing safely
managed
sanitation
facilities

219
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Waste Number of health 11 11 11 15 20 25

management and facilities with
climate change installed and
mitigation compliant waste
measures treatment
enhanced equipment

Number of health N/A 16 16 20 40 55

facilities
reporting on
greenhouse gas
emissions

Occupational Number of 15 5 5 10 15 20
Health and Safety healthcare
standards facilities
implemented implementing
occupational
health and safety
standards

Number of the 5 0 5 3 2 1
healthcare
workers exposed
to workplace
occupational
health hazards

Center of 20 20 60 100 N/A N/A

excellence for
monitoring air
pollution fully

220
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

established and
operationalized

MoH HAP N/A N/A 20 40 100 N/A

control Strategy
developed and
launched

Tobacco Control Tobacco control Number of 400 200 400 600 800 1000
Board and enforcement Enforcement
services enhanced officers trained

Number of N/A N/A 0 15 35 47

Counties with
functional
multisectoral
Tobacco control
Committees

Number of 5 2 4 5 6 7
Tobacco Control
advisories
developed and
submitted to the
Minister

Vector and Vermin Vector and Number of POEs 10 8 8 13 18 23

Control Division vermin capacity build to
infestations undertake vector
control services and vermin
enhanced control services

221
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Number of food N/A N/A 4000 4000 4000 4000

handlers
medically
examined at the
POEs

Division of Family Malnutrition Proportion of 80 86 80 86 86 86

Wellness, Nutrition prevention & children 6-59
and Dietetics Nutrition months who
promotion received 2 doses
services of Vitamin A
Supplementation
(VAS)

Number of N/A N/A 218,977 240,875 264,963 291459

children 6-23
months receiving
Micronutrient
Powders (MNPS)

Number of 7323 7141 6800 7450 7600 71150

healthcare
workers trained
on high impact
nutrition
interventions

Effective Treatment cure 80 83 83 84 85 85

treatment for rate of acutely
malnourished malnourished
children under 5 children 6-59
years of age, months

222
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

pregnant and Treatment cure 100 86 90 90 92 95

lactating women rate of acutely
malnourished
pregnant and
lactating women

Nutrition policies, Number of 5 3 7 3 2 2

legislations, guidelines,
strategic plans Strategic Plans
and guidelines and legislations
developed developed

Family wellness Number of N/A N/A N/A 3 N/A N/A

policies, strategic policies, strategic
plan and plan and
guidelines guidelines
developed developed

Operationalizatio Number of N/A N/A N/A 10 20 20

n of wellness wellness centers
centers in public in public
institutions institutions

Kenya National Kenya National Human Resource 0 0 0 3 N/A N/A

Public Health Public Health Instruments
Institute Institute Developed
operationalized
Strategic plan 0 0 0 1 N/A N/A
developed

Port Health Screened Number of 7,361,62 5,694,927 6,000,000 6,500,000 6,800,000 7,000,00
Services Travellers travellers 2 0
screened for

223
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

notifiable
diseases

Vaccinated Number of 249,600 23,440 30,000 35,000 40,000 45,000

travellers travellers issued
with vaccination
certificates as per
travel
requirements

Trade facilitation Number of tonnes 1,460,00 2,214,892 2,500,000 2,800,000 3,000,000 3,300,00
of cargo cleared 0 0
as per health
requirements at
POEs

Sanitary Number of 265,000 423, 989 500,000 700,000 700,000 700,000

conveyances conveyances
inspected and
issued with
disinfection/disinf
ection certificates

Digitization of Number of POEs N/A N/A 23 23 23 23

government implementing
services digitized services

Number of food N/A N/A 4000 4000 4000 4000

handlers
medically
examined at the
POEs

224
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

SP 1.4- Kenya Nuclear Development of a Number of draft 0 0 3 10 10 10

Radiation Regulatory national nuclear nuclear power
Safety and Authority power programme
Nuclear programme regulations
Security infrastructure developed

Number of 0 0 0 2 2 2
nuclear security
regulations
developed

Strengthening Cumulative 10 10 20 60 80 100

nuclear security percentage of
and non- enforcement
proliferation of officers qualified
nuclear materials and able to
respond to
nuclear security
events

Cumulative 20 20 30 70 80 90
percentage of
nuclear safety and
security detection
at ports of entry

Proportion of 100 100 100 100 100 100

category I and II
radiation facilities
complying with
physical

225
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

protection
measures

Safety of Number of draft 0 0 0 2 2 2

radioactive regulations on
devices and radiation devices
materials and sources

Percentage of 50 50 50 100 100 100

radiation
contamination
tests performed
on consumer
products

Percentage of 70 70 80 100 100 100

compliant
radiation facilities

Percentage of 20 20 50 90 100 100

development and
implementation
of the national
radiation workers
database

Proportion of 0 0 20 30 40 60
environmental
radiological
mapping and
characterization
of High

226
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Background
Radiation Areas

Number of 0 0 25 25 25 25
persons who have
completed the
International
Atomic Energy
Agency
postgraduate
educational
certificate in
radiation
protection

Radioactive waste Percentage of 10 10 30 60 80 100

management radioactive waste
collected and
conditioned at the
central
radioactive waste
processing
facility

Safety of Number of 0 0 0 1 1 1
electromagnetic electromagnetic
radiation radiation safety
regulations
developed

Number of 100 2 47 315 N/A N/A

hospitals mapped

227
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

SP 1.5 Primary Health Primary care as hubs for the

Primary Services Division networks PHC Networks
Health Care operationalized
Number of 47 19 150 315 N/A N/A
functional
primary care
networks (PCNs)

Monitoring and Number of PCNs N/A N/A N/A 315 315 315
Evaluation of adhering to the
Functionality of set standards as
PCNs per PCN
guidelines

Payment of Number of CHPs N/A N/A 100,000 100,000 100,000 100,000

stipend paid
(Ksh.2,500) to
CHPs

SP 1.6 Health Division of Health Health promotion Number of N/A N/A 3 5 5 5

Promotion Promotion and policies/ policies/strategies
and Advocacy on strategies and and guidelines
Education Lifestyle guidelines on developed
health advocacy
(SBCC)
developed

Health promotion Number of N/A N/A 10 15 12 10

M&E tools to the counties with
counties health promotion
disseminated M&E tools

228
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

National Health Cumulative 1 0 1 2 3 4

Promotion Summits ending
summit convened with a national
Presidential
declaration on a
target health
behavior change

Commemoration World Health N/A N/A 30 35 40 50

of World Health Days
Days commemorated

Social Listening Social Listening N/A N/A N/A 1 N/A N/A

and Infodemic and Infodemic
Tracking Tracking package
developed and
disseminated Number of N/A N/A N/A 10 30 47
counties with
tracking with
social listening
tools

Division of Health messages Number of health 1 1 20 20 20 20

Information, developed education
Education and materials
Communication developed
(IEC)
Printing press Number of N/A N/A 2 2 3 4
refurbished machines
refurbished

229
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Call center Percentage of call N/A N/A 40 60 80 100

operationalized center
operationalization

Functional Percentage of N/A N/A 40 60 80 100

WhatsApp WhatsApp
Chatbot Chatbot
operationalization

World Health Number of world N/A N/A 30 35 40 50

days IEC health days
materials materials
developed developed

School Health School Health Number of N/A N/A N/A 1,000 10,000 100,000
Programme Promotion School Health
Sensitization promoters trained
Package
developed
Number of N/A N/A N/A 47 47 47
School Health
promotion skills
lab established

Number of N/A N/A N/A 1 5 47

School health
surveys carried
out

Programme 2: Health resource development and innovation

Programme Outcome: Enhanced health human resources for quality healthcare

230
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

SP 2.1 Kenya Medical Health workers Number of 18,250 25,889 17,200 18,370 19,750 20,250
Capacity Training College and professionals students enrolled
Building and trained Number of CHAS 1,000 3,519 700 4,500 5,500 6,500
Training trained
Proportion of 98 95 99 98 98 98
health
professionals(coh
ort) certified
No. of evidence 9 20 10 12 13 15
based policies
developed
Number of 6 10 5 5 6 7
Curriculums
reviewed
SP 2.2 Kenya Institute of New biomedical No. of peer N/A N/A 34 35 35 35
Research and Primate Research knowledge reviewed
innovation on generated scientific
Health and health publications
interventions for No. of people 25 52 52 50 50 50
human diseases trained on
biomedical
knowledge and
skills
No. of candidate 6 6 6 7 8 8
drugs and
vaccines tested
No. of N/A N/A N/A 2 2 2
bacteriophages
(phages) isolated
for treatment of

231
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

multidrug
resistant bacteria
Snakebite rescue No. of victims 120 265 265 270 275 275
& intervention successfully
services rescued from
snake bites
No. of snake N/A N/A N/A 4 4 4
venom profiled
for anti-venom
development
No. of anti- N/A N/A 2 2 2 2
venom generated
for preclinical
testing
Ecosystem health No. of 2 5 5 7 10 10
& Conservation community
of non-human outreach
primates for education forums
research conducted on
ecosystem health
& primate
conservation
No. of colony 25 46 40 40 40 40
bred non-human
primates
Disease Bio No. of humans N/A N/A 300 300 300 300
surveillance using samples at
one health wildlife, livestock
approach for early interface tested
warning and No. of vector- N/A N/A 1500 1500 1500 1500
preventive health borne samples at

232
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

high-risk
interface tested
SP 2.3 Health Public Health MOUs developed Number of N/A N/A 3 4 5 6
Professional Sector MOUs developed
services Coordination &
IGR Guidelines to N/A N/A 3 4 5 6
operationalize
MOUs

Ratification and Number of N/A N/A N/A 1 2 3

domestication of treaties ratified
treaties and domesticated

Coordination of Number of N/A N/A 11 12 13 14

international meetings
Health related coordinated
meetings
Number of health 4 2 4 4 4 4
sector
intergovernmenta
l forums held

Proportion of 10 5 10 10 10 10
resolutions from
IGF implemented

National Action National Action N/A N/A N/A 1 N/A N/A

Plan on Health Plan on Health
Security 2024- Security 2024-
2028 developed 2028

National Action Reviewed N/A N/A N/A N/A N/A 1

Plan on Health National Action
Plan on Health

233
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Security 2024- Security 2024-

2028 reviewed 2028

State Party self- Number of State N/A N/A N/A 1 1 1

assessment Party self-
conducted assessments

Division of Global Healthcare Number of health N/A N/A 20 200 235 200
Health Security workers trained workers trained
on Global Health
Security

Programme 3: Health Policy Standards and Regulations

Programme Outcome: Strengthened quality health standards and regulations

SP:3.1 Health Kenya Health Compliance to set Percentage of 20 22 30 36 42 50

Standards Professions norms and health facilities
and Quality Oversight standards of inspected for
Authority training and compliance to
health care norms and
services standards of
healthcare
delivery
Percentage of 50 0 50 70 85 100
Health profession
training
institutions
assessed for
compliance to
norms and
standards of

234
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

training

Number of 500 998 1500 2000 2600 3200

unregulated
health
professionals
registered

Patient Percentage of 100 100 100 100 100 100

Complaints and complaints and
Disputes from disputes received
Regulatory and handled
Bodies and
Aggrieved Parties
resolved

Kenya Health Enhance Percentage N/A N/A N/A 40 60 80

Human Resource efficiency and uniform norms
Advisory Council quality of care and standards for
(KHHRAC) master register
for all health
practitioners
developed

Percentage master N/A N/A 55 60 80 100

register for all
health
practitioners
developed

Availability/qualit Number of HWs 100 100 100 150 150 150

y and use of trained on iHRIS

235
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

health workforce Number of 100 100 100 150 150 150

data HCWs trained
on NHWA

Number of HWs 100 100 100 150 150 150

implementing
iHRIS

Number of HWs 100 100 100 150 150 150

implementing
NHWA

Number of faith 0 0 30 60 80 100

based and private
health facilities
implementing
NHWA

Efficient Number of HWs 100 100 100 150 150 150

management of trained on WISN
health workforce
Number of N/A N/A 0 350 400 450
facilities where
WISN has been
carried out

Number of N/A N/A 0 350 400 450

facilities
implementing
WISN

No of Framework N/A N/A N/A 1 N/A N/A

for Management
of Specialist

236
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Management of health care

health care workers
professionals Developed

No of guidelines N/A N/A N/A 1 N/A N/A

developed to
implement
Kenya health
workforce
migration policy

KHHRAC KHHRAC
Strategic Plan Strategic Plan N/A N/A N/A 1 N/A N/A
developed

Kenya Medical Competent Health Number of 900 912 912 930 950 970
Practitioners and Professionals Medical and
Dentist Council dental Officer
Interns placed

Number of new 1,300 1,325 1,325 1,350 1,400 1,450

Medical, Dental
and Community
Oral Health
Officers
practitioners
registered.

Number of 10,200 10,638 11,960 12,550 13,050 13,650

Medical, Dental
and Community
Oral Health
Officers

237
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

practitioners with
active annual
practice licenses.

Number of health 7,000 7,124 8,000 9,000 10,000 11,000

facilities with
active annual
operating
licenses.

Compliance to set Number of 2,720 3,560 3,560 3,710 3,900 4,150

standards of compliance
training and inspections
healthcare carried out
services
Proportion of 40 100 100 100 100 100
Medical, dental
internship and
specialist training
centers inspected.

Continuous Number of new N/A N/A 0 15 20 30

Professional accredited
Development Continuous
Professional
Development
(CPD) providers.

Nursing Council of Competent health Number of nurses 4,533 6,341 6,238 6,400 6,600 6,800
Kenya professionals and midwives
newly registered

238
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Number of 7,205 10,937 11,418 11,500 12,000 12,500

eligible
candidates
examined

Number of 6,400 19,249 10,000 11,000 11,500 12,000

eligible
candidates
Indexed

Percentage of 50 48.6 49 55 60 65
nurses and
midwives
retained

Compliance to set Proportion of 100 88.3 80 100 100 100

standards of training
training institutions that
institutions and are audited for
health facilities compliance

Proportion of N/A N/A 100 100 100 100

health facilities
audited for
compliance

Clinical Officers Clinical Officers Number of 3000 1799 2500 2500 2500 2500
Council Trained, Clinical Officers
Registered and trainees Indexed
Licensed
Number of 2500 2790 3000 3000 3000 3000
Clinical Officers
Registered

239
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Number of 23949 16764 15000 15000 15000 15000

Clinical Officers
Licensed

Public Health Competent Health Number of 1000 780 780 800 900 1000
Officers and Professionals candidates
Technicians Assessed
Council - Kenya
Number of 1000 720 720 750 800 850
interns placement

Number of 7000 7109 8,000 9,000 10,000 11,000

practitioners
licensed

Compliance to set Number of newly 5 2 2 3 5 5

standards of accredited
training and internship centers
healthcare
services Number of H/F 30 50 50 60 70 80
inspected for
compliance

Number of 10 5 5 10 10 10
training
institutions
inspected

Professional Number of newly 5 3 4 4 4 4

Development and CPD providers
Growth accredited

Counselors and Counselors and Number of N/A N/A 4000 4000 4000 4000
Psychologist Board Psychologist Counselors &

240
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Trained, Psychologist
Registered and trainees Indexed
Licensed Number of N/A N/A 5000 1500 1500 1500
Counselors &
Psychologist
Registered
Number of N/A N/A 5000 5000 5000 5000
Counselors &
Psychologist
Licensed
Compliance to set Number of N/A N/A 20 30 40 50
standards of clinical facilities
training and registered and
clinical practice licensed
Number of N/A N/A 35 35 40 40
training
institutions
inspected
Professional Number of N/A N/A 5 5 5 5
Development and institutions
Growth accredited to
offer CPD
Policies, rules and Number of N/A N/A 1 1 1 1
legislations, Available Rules
human resources & Regulation
instruments formulated
developed Number of N/A N/A 1 1 1 1
policies
developed
Number of N/A N/A 1 1 1 1
Human resource

241
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

instruments
developed
Occupational Occupational Number of N/A N/A N/A 150 250 300
Therapy Council of Therapy students students indexed
Kenya indexed

Compliance to set Number of N/A N/A 5 10 15 15

standards of clinical facilities
training and registered and
clinical practice licensed

Number of N/A N/A 1 3 5 5

training
institutions
inspected

Occupational Number of N/A N/A 200 1000 1500 1500

Therapists Occupational
Registered and Therapists
Licensed Registered and
licensed

Standards of Number of N/A N/A N/A 1 N/A N/A

Practices for Standards of
occupational Practices for
Therapy occupational
Therapy

Policies, rules and Number of N/A N/A 1 1 1 1

legislations, Available Rules
human resources & Regulation
formulated

242
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

instruments Number of N/A N/A 1 1 1 1

developed policies
developed

Number of scopes 0 0 1 2 3 4
of practice
developed

Number of N/A N/A 1 N/A N/A N/A

Human resource
instruments
developed

Continuous Number of new N/A N/A 2 5 10 10

Professional accredited
Development Continuous
Professional
Development
(CPD) providers.

Physiotherapy Physiotherapy Number of 100 80 150 200 250 300

Council of Kenya facilities physiotherapy
inspected facilities
inspected

Scope of practice Number of scopes 0 0 3 5 7 9

developed of practice
developed

National Quality Access to Quality Proportion of 100 93 100 100 100 100
Control Laboratory drugs and medical medical drugs
devices tested for quality,

243
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

safety of the
citizens

Proportion of Proportion of 100 100 100 100 100 100

medical devices medical devices
tested for quality, tested for quality,
safety of the safety of the
citizens citizens.

Laboratory % of the 30 0 30 80 100 N/A

constructed and laboratory
equipped completed

Research on Number of 50 75 100 120 120 120

health products research activities
and technologies
and their effects
on the
environment
Methods of Number of N/A N/A 5 5 5 5
analysis for HPTs method
Developed/verifie Developed/valida
d/validated ted/verified

Health Records Accredited HRIM Number of N/A N/A 20 30 50 70

and Information training training
Managers Board institutions institutions
regulated accredited and
regulated
% of training N/A N/A 50 100 100 100
institutions who
have adopted the

244
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

standard
curriculum
Roll of master Number of HRIM N/A N/A 3000 4000 5000 6000
register for HRIM professionals
professionals entered in the
established register
% of HRIM N/A N/A 50 70 80 100
professional
registered,
licensed and
entered in the roll
register
Policies and Number of policy N/A N/A 3 5 6 7
regulatory documents
framework for developed
HRIM developed Number of N/A N/A 20 30 50 70
institutions using
the board’s
policies
Pharmacy and Marketing Numbers of new 10000 8000 8000 10500 11000 11500
Poisons Board Authorization product
(Product registrations as
Registration) well as audited
and approved
Manufacturing
Sites

Pharmacists and Number of 1000 800 1000 1200 1500 2000

pharmaceutical Practitioners
technologists Registered and
licenced licensed per year.

245
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Market Number of Joint 24 24 36 36 36 36

Surveillance and inspections done
Regulatory across the country
Inspections

Clinical Trials Number of new 50 42 50 55 60 65

conducted applications and
studies done per
year

Trade Affairs Number of 32000 30000 33000 33000 34000 35000

conducted approved import
and export
permits.

Kenya Medical Medical Number of 1,000 755 1,200 1,367 1,500 1855
Laboratory Laboratory students indexed
Technicians and science students
Technologists indexed
Board
Eligible Number of 1,600 1,287 1,700 1,012 800 1000
candidates candidates
examined for examined
MLS licensure
examinations

Medical Number of 1,500 1,283 1,300 1,114 640 710

Laboratory Medical Lab
Technologists Technologists
registered registered

246
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Renewed licenses Number of MLS 13,000 12,348 15,000 13,913 16,400 17,000
for Laboratory licenses issued
Technologists

Medical Number of labs 4,100 3,667 4,500 4,623 5,012 6,200

Laboratory registered
facilities
registered

Medical Number of 4,100 2,614 3,500 3,407 4,100 5,850

Laboratory laboratory
facilities Licensed facilities licensed

IVDs Vendor Number of IVDs 200 119 161 192 292 360
companies / vendor companies
manufacturers / manufacturers
registered registered

IVDs Vendor Number of IVDs 100 70 83 89 99 200

companies / registered
manufacturers
registered

SP 3.2 Health Division of Quality Kenya Quality of Kenya Quality of 1 0 1 N/A N/A N/A
Policy and assurance, health Health Care Health Care
Regulations worker and patient Authority Authority in place
safety established

Division of Health Health Norms and Number of 1 0 1 1 1 1

Standards Standards/Guideli Norms and
nes developed Standards
developed

247
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Number of 1 2 1 1 1 1
Guidelines
developed
Division of Coordination of Number of Bills 2 3 2 2 2 2
Legislation/Regula operationalization /Regulations
tion of the Health Act, developed
2017

Division of HRH policy, HRH policy and NA NA 1 1 N/A N/A

Professional Strategy and Strategy
Standards Guidelines developed
developed,
disseminated, and Health NA NA 0 1 N/A N/A
monitored professionals’
Migration policy
developed

Training and Middle and senior N/A 2 2 2 2 2

capacity building management
training at
National defense
College

Programme 4: General Administration

Programme Outcome: Effective governance and administration strengthened

SP4.1: General Enhanced safety Number of 100 NA 50 100 0 0

General administration and security CCTV installed
Administratio in Afya House
n and Human and Afya Annex
Resource Campuses

248
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

management Number of 500 20 400 80 NA NA

and biometric logs
development installed

Sensitization of Number of NA NA 8 5 3 NA
staff on HIV Strategies
Prevention and developed
NCDs; citizen
service delivery Number of staff N/A NA 500 800 1000 1000
charter/process; sensitized on each
resolution of package
public
complaints;
Alcohol and drug
abuse; disability,
gender, road
safety
mainstreamed

ICT Services Information Number of N/A N/A 2 2 2 2

Communication Information
Technology (ICT) Communication
Systems Technology(ICT)
deployed Systems
deployed

Workplace Workplace N/A N/A 1 0 0 0

Digitalization and Digitalization and
Automation Automation
Strategy 2023- Strategy
2027 developed document
developed

249
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Human Resource HealthCare Number of health 9,308 8,706 1,159 1,275 1,466 1,759
Management & workers recruited care workers
Development recruited
division
Health care Number of Health 130 121 261 411 611 861
workers trained workers trained
in different
specialties across
the country

Public Information Number of press N/A N/A N/A 20 40 60

Communication sharing on releases, media
Services projects, briefing and
programs engagement
policies, events official
statements, media
briefings, social
media/ website
posts

Number of N/A N/A 30 100 150 300

articles
published/photos/
videos

Educational Number of N/A N/A N/A 5000 6000 7000

Materials profiles, t-shirts,
brochures, fact
sheets,
infographics,
posters, banners

250
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Social media Number of social N/A N/A 20 100 160 200

campaigns media campaigns
and social media
reach

Public Number of public N/A N/A 1 1 1 1

Communication communication
plan plan

Records Integrated Number of N/A N/A 40 60 100 150

Management Records records Digitized
Services Management Real time access
System & retrieval of
implemented records

ISO Certification Percentage ISO N/A N/A 30 70 N/A N/A

Certification
Management Percentage N/A N/A 45 65 N/A N/A
Policy developed completion
Records
Management
Policy
Record Percentage level N/A N/A 30 70 N/A N/A
Management Unit of establishment
established of Records
Management Unit

Supply Chain Updated List Of Updated List Of N/A N/A 1 1 1 1

Management Unit Registered Registered
Suppliers Suppliers

251
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Annual Annual N/A N/A 1 1 1 1

Procurement Plan Procurement Plan

Asset inventory Asset register N/A N/A 1 1 1 1

Percentage of N/A N/A 100 100 100 100

obsolete/surplus
assets disposed

SP4.2: Finance division Absorption of Absorption Rate 100 89 100 100 100 100
Financing financial
and planning resources
allocated

Quarterly budget Number of 4 4 4 4 4 4

performance budget reports
reports submitted submitted

Tax Exemption Tax exemption Number of tax 1 0 2 2 2 2

Unit application exemption
process of DA1 application
and Master list process digitized
digitized

Tax exemption Number of tax 400 420 420 500 550 650
applications exemption
recommended applications
recommended

Central Planning & Capital projects Number of capital 4 4 4 4 4 4

Projects monitored projects
Monitoring Unit monitoring
progress reports

252
Programme Delivery Unit Key Outputs Key Target Actual Target Target Target Target
Performance 2022/23 Achievement (Baseline) 2024/25 2025/26 2026/27
Indicators 2022/23 2023/24

Counties health Number of N/A N/A 300 330 360 390

department officers trained
officers trained on
planning,
budgeting, and M
&E

Surveys Number of N/A N/A 2 2 2 2

surveys
conducted

MOH Facts and MOH Facts and 1 1 1 1 1 1

Figures booklet Figures booklet
developed

Directorates, Number of N/A N/A 300 330 360 390

SAGAs/ officers sensitized
regulatory bodies
sensitized on
planning,
budgeting and M
&E

253
 3.1.3. Programmes by Order of Ranking
For allocation of resources, the eight programmes in Sector will be prioritized according to their
impact towards the population health and well-being. The programmes as ordered per their rank
are as follows:
a) State Department of Medical Services
i. National Referral and Specialized Services
ii. Curative and Reproductive, Maternal, Neo-natal, Child and Adolescent Health
(RMNCAH) Services
iii. Health Research and Innovation
iv. General Administration
b) State Department of Public Health and Professional Standards
i. Preventive and promotive Health services.
ii. Health resource development and innovation.
iii. Health Policy standards and regulations; and
iv. General Administration.

4. Resource Allocation Criteria

The following will be considered during the allocation of resources to the various programmes:
a) Programmes that enhance value chain and linkage to BETA priorities;
b) Cabinet Decisions;
c) Linkage of Programme with priorities of the Medium Term Plan IV of the Kenya Vision
2030;
d) Completion of on-going projects, stalled projects and payment of verified pending bills;
e) Degree to which a programme addresses job creation and poverty reduction;
f) Degree to which a programme addresses the core mandate of the Ministry of Health;
g) Programmes that support mitigation and adaptation of climate change;
h) Cost effectiveness, efficiency and sustainability of the programme;
i) Requirements for furtherance and implementation of the Constitution; and
j) Consideration for newly established Institutions.

254
2. ANALYSIS OF SECTOR AND SUB-SECTOR RESOURCE REQUIREMENT VERSUS ALLOCATION
The Sector’s requirements are KSh. 371,850.80 million, KSh. 411,377.11 million and KSh. 456,780.56 million respectively compared
to an allocation of KSh. 147,598.89 million, KSh. 156,407.66 million and KSh. 160,927.84 million in FYs 2024/25, 2025/26, 2026/27.
This translates to shortfall of KSh. 224,251.92 million, KSh. 254,969.45 million and KSh. 295,852.72 million during the budget period.

1. SECTOR AND SUB-SECTOR RECURRENT REQUIREMENTS /ALLOCATIONS (AMOUNT KSH. MILLIONS)

The Sector’s requirements are KSh. 131,405.80. million, KSh.148,928.51 million and KSh. 168,345.64 million respectively compared
to an allocation of KSh. 87,324.19 million, KSh. 91,930.16 million and KSh.95,303.50 million in FYs 2024/25, 2025/26, 2026/27
respectively as presented in Table 3.3.

Table 3.1: Sector and Sub-sector Recurrent Requirements /Allocations (Amount KSh. Millions)

VOTE ECONOMIC APPROVED REQUIREMENT ALLOCATION

CLASSIFICATION ESTIMATES
2023/24 2024/25 2025/25 2026/27 2024/25 2025/25 2026/27
HEALTH SECTOR
GROSS 80,627.50 131,405.80 148,928.51 168,345.64 87,324.19 91,930.16 95,303.50
AIA 25,185.00 28,246.24 29,557.64 30,644.64 30,397.00 30,387.00 30,387.00
NET 55,442.50 103,159.56 119,370.88 137,701.00 56,927.19 61,543.16 64,916.50
Compensation to 13,578.50 25,010.89 37,683.53 50,347.09 14,027.96 15,953.27 16,432.22
Employees
Grants and Transfers 63,605.36 75,562.90 78,879.50 83,484.00 70,896.49 73,510.31 76,300.10
Other Recurrent 3,443.20 16,390.73 17,490.97 19,193.80 2,399.74 2,466.58 2,571.18
of Which 0.00 0.00 0.00
Utilities 178.00 248.66 291.00 326.00 203.00 208.00 213.00
Rent 25.70 6.50 7.00 7.50 5.70 5.70 5.70
Insurance 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Subsidies 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Gratuity 103.00 103.00 103.00 103.00 103.00 103.00 103.00

255
VOTE ECONOMIC APPROVED REQUIREMENT ALLOCATION
CLASSIFICATION ESTIMATES
2023/24 2024/25 2025/25 2026/27 2024/25 2025/25 2026/27
Contracted Guards 88.60 115.18 132.46 142.00 88.60 88.60 88.60
and Cleaners services
Others. 3,047.90 15,917.39 16,957.51 18,615.30 2,004.46 2,096.30 2,162.48
1082 STATE DEPARTMENT FOR MEDICAL SERVICES
Gross 110,738.17 71,909.94
63,053.50 77,945.06 94,964.72 66,833.95 69,281.90
AIA 21,764.04 22,367.00
19,536.00 20,317.44 21,130.14 22,377.00 22,367.00
NET 88,974.12 49,542.94
43,517.50 57,627.62 73,834.58 44,456.95 46,914.90
Compensation to 48,175.38 8,962.62
employees 9,175.00 22,963.85 35,575.08 8,691.96 8,824.67
Grants and 59,883.00 61,119.10
Transfers 52,106.00 52,448.00 56,774.00 56,399.49 58,681.31
Other Recurrent 1,828.22
1,772.50 2,533.21 2,615.64 2,679.79 1,742.50 1,775.92
of which;
Utilities 286.00 153.00
153.00 218.66 256.00 153.00 153.00
Rent 5.70
5.70 6.50 7.00 7.50 5.70 5.70
Insurance -
- - - - - -
Subsidies -
- - - - - -
Gratuity 103.00 103.00
103.00 103.00 103.00 103.00 103.00
Contracted Guards& 142.00 88.60
Cleaning Services 88.60 115.18 132.46 88.60 88.60
others 2,141.29 1455.64 1474.52
1,422.20 2,089.87 2,117.18 1,392.22
1083 STATE DEPARTMENT FOR PUBLIC HEALTH AND PROFESSIONAL STANDARDS
GROSS 57,607.48 23,393.56
17,574.00 53,460.74 53,963.80 20,490.24 22,648.26

256
VOTE ECONOMIC APPROVED REQUIREMENT ALLOCATION
CLASSIFICATION ESTIMATES
2023/24 2024/25 2025/25 2026/27 2024/25 2025/25 2026/27
AIA 8,020.00
5,649.00 7,928.80 8,427.50 8,880.60 8,020.00 8,020.00
NET 48,726.88 15,373.56
11,925.00 45,531.94 45,536.30 12,470.24 14,628.26
Compensation to 7,469.60
Employees 4,403.50 2,047.04 2,108.45 2,171.71 5,336.00 7,128.60
Grants and Transfers 23,601.00 15,181.00
11,499.36 23,114.90 22,105.50 14,497.00 14,829.00
Other Recurrent 16,514.02 742.96
1,670.70 13,857.52 14,875.33 657.24 690.66
of Which
Utilities 60.00
25.00 30.00 35.00 40.00 50.00 55.00
Rent
20.00
Insurance
-
Subsidies
-
Gratuity
-
Contracted Guards
and Cleaners services -
Others . 16,474.02 687.96
1,625.70 13,827.52 14,840.33 612.24 640.66

257
3.2.2SECTOR AND SUB-SECTOR DEVELOPMENT REQUIREMENTS/ALLOCATIONS (AMOUNT
KSH. MILLION)

Table 3.4: Sector and Sub-Sector Development Requirements /Allocations (Amount KSh. Millions)

APPROVED BUDGET
ALLOCATION
DESCRIPTION 2023/24 REQUIREMENT ALLOCATION
2024/25 2025/25 2026/27 2024/25 2025/25 2026/27
HEALTH SECTOR

Gross 60,559.40 240,445.00 262,448.60 288,434.92 60,274.70 64,477.50 65,624.34

GOK 39,100.34 216,282.00 232,887.00 253,268.00 38,815.50 42,118.00 43,318.34

Loans 13,291.56 16,308.60 20,000.00 22,000.00 13,291.50 13,292.00 13,292.00

Grants 8,167.50 8,058.40 8,511.00 12,561.00 8,167.70 8,167.50 8,167.00

Local AIA - - - -
VOTE 1082: STATE DEPARTMENT FOR MEDICAL SERVICES

Gross 53,539.06 231,490.00 252,010.60 277,312.92 55,113.20 59,777.50 61,175.00

GOK 35,980.00 209,023.00 225,000.00 245,000.00 36,242.00 39,553.00 40,669.00

Loans 12,091.56 15,898.60 20,000.00 22,000.00 13,291.50 13,292.00 13,292.00

Grants 5,467.50 6,568.40 7,010.00 11,312.00 5,579.70 6,032.50 6,367.00

Local AIA - - - - - - -
VOTE 1083: STATE DEPARTMENT FOR PUBLIC HEALTH AND PROFESSIONAL STANDARDS

Gross 7,020.34 8,955.00 10,438.00 11,122.00 5,161.50 4,700.00 4,449.34

GOK 3,120.34 7,259.00 7,887.00 8,268.00 2,573.50 2,565.00 2,649.34

Loans 1,200.00 410.00 - - - - -

Grants 2,700.00 1,490.00 1,501.00 1,249.00 2,588.00 2,135.00 1,800.00

Local AIA - - - - - - -

258
Table 3.5: Analysis of Programmes and Sub-Programmes (Current and Capital) Resource Requirements (Amount KSh. Millions)

Programme Approved Estimates Projection (Requirements)

2023/24 2024/25 2025/26 2026/27
Current Capital Total Current Capital Total Current Capital Total Current Capital Total

STATE DEPARTMENT FOR MEDICAL SERVICES

Programme 1 – National Referral and Specialized Services

SP1.1 -
National 39,544.02 4,447.90 43,991.92 44,069.95 54,672.66 98,742.61 46,102.02 62,901.58 109,003.60 47,135.05 81,430.00 128,565.05
Referral
Services
SP 1.2 - -
Specialized - 3,795.14 3,795.14 - 9,550.50 9,550.50 9,550.50 9,550.50 9,550.50 9,550.50
Medical
Equipment
SP1.3 –
National Blood 129.10 - 129.10 722.33 1,500.00 2,222.33 747.42 2,000.00 2,747.42 752.51 2,500.00 3,252.51
Transfusion
Service
SP1.4 - Health
Products and 2,478.00 428.00 2,906.00 924.82 500.00 1,424.82 1,025.00 550.00 1,575.00 1,025.19 600.00 1,625.19
Technologies

Total
Expenditure 42,151.12 8,671.04 50,822.16 45,717.10 66,223.16 111,940.26 47,874.44 75,002.08 122,876.52 48,912.75 94,080.50 142,993.25
Programme 1

Programme 2 - Curative & Reproductive Maternal New Born Child Adolescent Health (RMNCAH)
SP2.1 -
Communicable 982.87 6,156.71 7,139.58 1,110.94 5,000.00 6,110.94 1,211.87 5,200.00 6,411.87 1,312.82 5,500.00 6,812.82
disease
prevention &
control
SP2.2 - Non
Communicable 728.54 442.81 1,171.35 467.45 2,110.00 2,577.45 789.75 2,143.00 2,932.75 1,003.06 2,166.09 3,169.15
Disease
Control
SP2.3 -
RMNCAH 287.39 7,058.50 7,345.89 35.30 2,900.00 2,935.30 36.30 2,950.00 2,986.30 37.53 3,000.00 3,037.53
SP2.4-
Immunization - 4,684.18 4,684.18 41.21 16,570.75 16,611.96 42.30 17,066.22 17,108.52 43.43 17,576.54 17,619.97

259
 Programme Approved Estimates Projection (Requirements)
2023/24 2024/25 2025/26 2026/27
Current Capital Total Current Capital Total Current Capital Total Current Capital Total

Total
Expenditure 1,998.80 18,342.20 20,341.00 1,654.90 26,580.75 28,235.65 2,080.22 27,359.22 29,439.43 2,396.83 28,242.63 30,639.47
Programme 2
Programme 3 - Health Research and Development
SP3.1 - Health
Innovations 5,894.25 807.00 6,701.25 545.00 1,370.00 1,915.00 860.00 1,581.10 2,441.10 1,145.00 1,892.53 3,037.53
SP3.2 –
Medical 2,966.00 349.00 3,315.00 3,830.00 620.00 4,450.00 4,319.00 635.60 4,954.60 4,830.00 651.67 5,481.67
Research
Total
Expenditure 8,860.25 1,156.00 10,016.25 4,375.00 1,990.00 6,365.00 5,179.00 2,216.70 7,395.70 5,975.00 2,544.20 8,519.20
Programme 3
Programme 4 - General Administration

SP 4.1 -
General 31.50 12,235.31 12,266.81 16,908.81 - 16,908.81 29,532.29 - 29,532.29 42,145.02 - 42,145.02
Administration
& Human
Resource
Management &
Development
SP4.2 -
Finance and 435.55 - 435.55 183.81 - 183.81 185.05 - 185.05 186.32 - 186.32
Planning

SP4.3 -Social
Protection in 7,217.89 - 7,217.89 9,105.44 144,420.00 153,525.44 10,113.72 147,432.60 157,546.32 11,122.25 152,445.58 163,567.82
Health

Total
Expenditure 7,684.94 12,235.31 19,920.25 26,198.06 144,420.00 170,618.06 39,831.06 147,432.60 187,263.66 53,453.58 152,445.58 205,899.16
Programme 5

Total
Vote 1082 69,518.89 41,666.55 111,185.44 77,945.06 239,213.91 317,158.97 94,964.72 252,010.60 346,975.31 110,738.17 277,312.92 388,051.08

STATE DEPARTMENT FOR PUBLIC HEALTH AND PROFESSIONAL STANDARDS

Programme 1 - Preventive and Promotive Services

260
 Programme Approved Estimates Projection (Requirements)
2023/24 2024/25 2025/26 2026/27
Current Capital Total Current Capital Total Current Capital Total Current Capital Total

SP1.1 -
Communicable 79.54 4,300.00 4,379.54 2,217.54 8,755.00 10,972.54 2,850.15 10,438.00 13,288.15 3,007.42 11,122.00 14,129.42
Disease
Control
SP1.2 - Disease
Surveillance 164.58 - 164.58 1,265.00 - 1,265.00 1,374.65 - 1,374.65 1,484.05 - 1,484.05
and Response
SP 1.3 : Public
Health Services 1,121.44 1,260.00 2,381.44 1,352.00 200.00 1,552.00 1,505.00 - 1,505.00 1,640.00 - 1,640.00

SP1.4 -
Radiation 274.00 - 274.00 1,100.00 - 1,100.00 1,210.00 - 1,210.00 1,331.00 - 1,331.00
Safety and
Nuclear
Security
SP1.5 -
Primary Health 69.87 - 69.87 6,404.00 - 6,404.00 6,550.00 - 6,550.00 7,204.00 - 7,204.00
Care

Total
Expenditure 1,709.44 5,560.00 7,269.44 12,338.54 8,955.00 21,293.54 13,489.80 10,438.00 23,927.80 14,666.48 11,122.00 25,788.48
Programme 1

Programme 2 - Health Resource Development and Innovation

SP2.1 -
Capacity 8,863.00 1,416.00 10,279.00 13,391.00 1,585.00 14,976.00 11,473.00 1,580.00 13,053.00 11,890.00 1,295.00 13,185.00
Building and
Training
SP2.2 -
Research and 73.80 44.34 118.14 1,780.20 66.00 1,846.20 1,833.00 - 1,833.00 1,917.00 - 1,917.00
Innovation on
Health
SP2.3 - Health
Profession 4,601.53 - 4,601.53 15,720.00 15,720.00 16,289.00 - 16,289.00 16,807.00 - 16,807.00
Services

Total
Expenditure 13,538.33 1,460.34 14,998.67 30,891.20 1,651.00 32,542.20 29,595.00 1,580.00 31,175.00 30,614.00 1,295.00 31,909.00
Programme 2

Programme 3 - Health Policy, Standards and Regulations

261
 Programme Approved Estimates Projection (Requirements)
2023/24 2024/25 2025/26 2026/27
Current Capital Total Current Capital Total Current Capital Total Current Capital Total

SP3.1 -Health
Standards and 1,702.67 - 1,702.67 6,703.00 - 6,703.00 7,215.00 - 7,215.00 8,392.00 250.00 8,642.00
Quality
Assurance
SP3.2 - Health
Policy and 101.30 - 101.30 1,950.00 1,950.00 2,030.00 2,030.00 2,205.00 2,205.00
Regulations

Total
Expenditure 1,803.97 - 1,803.97 8,653.00 - 8,653.00 9,245.00 - 9,245.00 10,597.00 250.00 10,847.00
Programme 3

Programme 4 - General Administration & Support Services

SP 4.1 : - - -
General 453.42 - 453.42 1,493.00 1,493.00 1,536.00 1,536.00 1,635.00 1,635.00
Administration
& Human
Resource
Management
and
Development
SP 4.2 : - - -
Finance and 68.46 - 68.46 200.00 200.00 220.00 220.00 240.00 240.00
Planning

Total
Expenditure 521.88 - 521.88 1,693.00 - 1,693.00 1,756.00 - 1,756.00 1,875.00 - 1,875.00
Programme 4

Total
Vote 1083 17,573.61 7,020.34 24,593.95 53,575.74 10,606.00 64,181.74 54,085.80 12,018.00 66,103.80 57,752.48 12,667.00 70,419.48

262
Table 3.5: Analysis of Programmes and Sub-Programmes (Current and Capital) Resource Allocation (Amount KSh. Millions)

Programme Approved Budget Allocation

2023/24 2024/25 2025/26 2026/27
Current Capital Total Current Capital Total Current Capital Total Current Capital Total

STATE DEPARTMENT FOR MEDICAL SERVICES

Programme 1 – National Referral and Specialized Services

SP1.1 - 5,576.65
National 39,544.02 4,447.90 43,991.92 42,806.97 48,383.62 44,064.52 5,548.30 49,612.82 45,338.46 3,010.00 48,348.46
Referral
Services
SP 1.2 9,551
Specialized - 3,795.14 3,795.14 - 9,550.50 50.00 9,893.00 9,943.00 51.50 7,109.00 7,160.50
Medical
Equipment
SP1.3 – 237.49 1000
National Blood 129.10 - 129.10 1,237.49 243.16 1,000.00 1,243.16 249.43 1,200.00 1,449.43
Transfusion
Service
SP1.4 - Health 4,015 310
Products and 2,478.00 428.00 2,906.00 4,324.70 5,279.26 150.00 5,429.26 5,300.13 160.00 5,460.13
Technologies

Total 47,059 16,437 63,496 49,637 16,591 66,228 50,940 11,479 62,419
Expenditure 42,151.12 8,671.04 50,822.16
Programme 1

Programme 2 - Curative & Reproductive Maternal New Born Child Adolescent Health (RMNCAH)
SP2.1 - 1,077 4,950 6,027 5997 7136.5
Communicable 982.87 6,156.71 7,139.58 1,098.99 7,095.99 1,150.45 8,286.95
disease
prevention &
control
SP2.2 - Non 2,040 2,258
Communicable 728.54 442.81 1,171.35 217 215.35 150.00 365.35 225.59 350.00 575.59
Disease
Control
SP2.3 - 2,810 2,841 2118.7 1524
RMNCAH 287.39 7,058.50 7,345.89 31 31.63 2,150.33 31.81 1,555.81
SP2.4- 9,852 9,893
Immunization - 4,684.18 4,684.18 41 42.21 13,243.00 13,285.21 42.38 18,242.40 18,284.78

263
 Programme Approved Budget Allocation
2023/24 2024/25 2025/26 2026/27
Current Capital Total Current Capital Total Current Capital Total Current Capital Total

Total 1,367 19,652 21,019 1,388 21,509 22,897 1,450 27,253 28,703
Expenditure 1,998.80 18,342.20 20,341.00
Programme 2
Programme 3 - Health Research and Development
SP3.1 - Health 150 852 1,002
Innovations 5,894.25 807.00 6,701.25 354.00 800.00 1,154.00 403.00 1,000.00 1,403.00
SP3.2 – 3,307 600 3,907
Medical 2,966.00 349.00 3,315.00 3,272.32 537.00 3,809.32 3,446.00 637.00 4,083.00
Research
Total 3,457 1,452 4,909 3,626 1,337 4,963 3,849 1,637 5,486
Expenditure 8,860.25 1,156.00 10,016.25
Programme 3
Programme 4 - General Administration and Support Services

SP4.1 – 3,104 0 3,104

General 31.50 12,235.31 12,266.81 3,287.81 - 3,287.81 3,409.85 - 3,409.85
administration
& Human
Resource and
Planning
SP4.2 - 180.71 0 181
Finance and 435.55 - 435.55 228.59 - 228.59 234.30 - 234.30
Planning

SP4.3 -Social 7,886 15,998 23,884

Protection in 7,217.89 - 7,217.89 8,835.43 15,676.20 24,511.63 9,399.00 19,408.60 28,807.60
Health
Total 11,171 15,998 27,169 12,352 15,676 28,028 13,043 19,409 32,452
Expenditure 7,684.94 12,235.31 19,920.25
Programme 5

Total 63,053 53,539 116,593 67,003 55,113 122,116 69,282 59,778 129,059
Vote 1082 69,518.89 41,666.55 111,185.44

STATE DEPARTMENT FOR PUBLIC HEALTH AND PROFESSIONAL STANDARDS

Programme 1 - Preventive and Promotive Services

SP1.1 - 4,188.00
Communicable 79.54 4,300.00 4,379.54 321.30 4,509.30 339.63 3,985.00 4,324.63 372.31 4,049.34 4,421.65

264
 Programme Approved Budget Allocation
2023/24 2024/25 2025/26 2026/27
Current Capital Total Current Capital Total Current Capital Total Current Capital Total

Disease
Control
SP1.2 - Disease -
Surveillance 164.58 - 164.58 197.18 197.18 205.29 - 205.29 212.66 - 212.66
and Response
SP 1.3 : Public 63.00
Health Services 1,121.44 1,260.00 2,381.44 254.43 317.43 1,896.55 - 1,896.55 2,082.42 - 2,082.42

SP1.4 - -
Radiation 274.00 - 274.00 272.00 272.00 281.00 - 281.00 290.00 - 290.00
Safety and
Nuclear
Security
SP1.5 - -
Primary Health 69.87 - 69.87 113.10 113.10 150.19 - 150.19 171.30 - 171.30
Care

Total 4,251.00
Expenditure 1,709.44 5,560.00 7,269.44 1,158.01 5,409.01 2,872.66 3,985.00 6,857.66 3,128.69 4,049.34 7,178.03
Programme 1

Programme 2 - Health Resource Development and Innovation

SP2.1 - 700.00
Capacity 8,863.00 1,416.00 10,279.00 9,302.00 10,002.00 9,565.00 715.00 10,280.00 9,841.00 400.00 10,241.00
Building and
Training
SP2.2 - 85.50
Research and 73.80 44.34 118.14 226.00 311.50 237.00 237.00 248.00 - 248.00
Innovation on
Health
SP2.3 - Health -
Profession 4,601.53 - 4,601.53 3,953.57 3,953.57 4,035.70 - 4,035.70 4,124.73 - 4,124.73
Services

Total 785.50
Expenditure 13,538.33 1,460.34 14,998.67 13,481.57 14,267.07 13,837.70 715.00 14,552.70 14,213.73 400.00 14,613.73
Programme 2

Programme 3 - Health Policy, Standards and Regulations

265
 Programme Approved Budget Allocation
2023/24 2024/25 2025/26 2026/27
Current Capital Total Current Capital Total Current Capital Total Current Capital Total

SP3.1 -Health 75.00

Standards and 1,702.67 - 1,702.67 4,878.07 4,953.07 4,930.33 4,930.33 4,989.02 - 4,989.02
Quality
Assurance
SP3.2 - Health
Policy and 101.30 - 101.30 202.46 202.46 208.73 208.73 215.19 215.19
Regulations

Total 75.00
Expenditure 1,803.97 - 1,803.97 5,080.54 5,155.54 5,139.05 - 5,139.05 5,204.21 - 5,204.21
Programme 3

Programme 4 - General Administration & Support Services

SP 4.1 : 50.00
General 453.42 - 453.42 611.75 661.75 634.78 634.78 675.92 675.92
Administration
& Human
Resource
Management
and
Development
SP 4.2 :
Finance and 68.46 - 68.46 159.24 159.24 165.06 165.06 171.11 171.11
Planning

Total 50.00
Expenditure 521.88 - 521.88 770.99 820.99 799.84 - 799.84 847.03 - 847.03
Programme 4

Total 5,161.50
Vote 1083 17,573.61 7,020.34 24,593.95 20,491.11 25,652.61 22,649.26 4,700.00 27,349.26 23,393.66 4,449.34 27,843.00

266
Table 3.6: Programmes and Sub-Programmes by Economic Classification (Amount KSh. Millions)

APPROVED BUDGET REQUIREMENT ALLOCATION

2023/24 2024/25 2025/25 2026/27 2024/25 2025/26 2026/27
STATE DEPARTMENT FOR MEDICAL SERVICES
Programme 1. National Referral and Specialized Services

Current Expenditure 47,059.16 45,717.10 47,874.44 48,912.75 49,636.94 50,939.52 52,306.18

21 Compensation to Employees 1,120.10 1,120.10 1,120.10 1,120.10 1,177.82 1,213.15 1,249.55

22 Use of Goods and Services 906.91 1,418.00 1,470.06 1,502.93 906.91 906.91 906.91

24 Interest - - - - - - -

25 Subsidies - - - - - - -
Current transters to Govt
26 Agencies 44,758.50 42,900.00 45,000.00 46,000.00 47,278.56 48,545.81 49,876.07

27 Social Benefits 103.00 103.00 103.00 103.00 103.00 103.00 103.00

28 Other Expense - - - - - - -

31 Non-financial Assets 170.65 176.00 181.28 186.72 170.65 170.65 170.65

32 Financial Assets - - - - - - -

Capital Expenditure 16,437.15 66,223.16 75,002.08 94,080.50 16,591.30 11,479.00 10,224.00

21 Compensation to Employees - - - - - - -

22 Use of Goods and Services 1,000.00 1,500.00 2,000.00 2,500.00 1,000.00 1,200.00 1,350.00

24 Interest - - - - - - -

25 Subsidies - - - - - - -
Capital transters to Govt
26 Agencies 13,072.49 62,288.16 70,494.03 88,997.21 13,226.64 10,279.00 8,874.00

27 Social Benefits - - - - - - -

28 Other Expense - - - - - - -

31 Non-financial Assets 2,364.66 2,435.00 2,508.05 2,583.29 2,364.66 - -

32 Financial Assets - - - - - - -

Total Expenditure for Programme 1 63,496.31 111,940.26 122,876.52 142,993.25 66,228.24 62,418.52 62,530.18

267
Programme 2: Curative & Reproductive Maternal New Born Child Adolescent Health RMNCAH

Current Expenditure 1,366.68 1,654.90 2,080.22 2,396.83 1,388.18 1,450.23 1,556.37

21 Compensation to Employees 97.61 97.61 97.71 98.01 101.61 104.66 107.80

22 Use of Goods and Services 101.57 107.29 110.51 113.82 101.57 101.57 101.57

24 Interest - - - - - - -

25 Subsidies - - - - - - -
Current transters to Govt
26 Agencies 1,167.50 1,450.00 1,872.00 2,185.00 1,185.00 1,244.00 1,347.00

27 Social Benefits - - - - - - -

28 Other Expense - - - - - - -

31 Non-financial Assets - - - - - - -

32 Financial Assets - - - - - - -

Capital Expenditure 19,651.89 26,580.75 27,359.22 28,242.63 21,508.70 27,252.90 28,639.00

21 Compensation to Employees 55.24 55.24 55.24 55.24 55.24 55.24 55.24

22 Use of Goods and Services 3,226.81 5,345.00 5,505.35 5,670.51 5,198.28 7,776.43 8,125.53

24 Interest - - - - - - -

25 Subsidies - - - - - - -
Capital transters to Govt
26 Agencies 14,264.00 19,010.00 19,590.00 20,279.90 15,984.67 19,150.72 20,187.72

27 Social Benefits - - - - - - -

28 Other Expense - - - - - - -

31 Non-financial Assets 2,105.84 2,170.51 2,208.63 2,236.98 270.51 270.51 270.51

32 Financial Assets - - - - - - -

Total Expenditure for Programme 2 21,018.57 28,235.65 29,439.43 30,639.47 22,896.88 28,703.13 30,195.37
Programme 3. Health Research and Innovations

268
Current Expenditure 3,457.00 4,375.00 5,179.00 5,975.00 3,457.00 3,849.00 4,108.18

21 Compensation to Employees - - - - - - -

22 Use of Goods and Services - - - - - - -

24 Interest - - - - - - -

25 Subsidies - - - - - - -
Current transters to Govt
26 Agencies 3,457.00 4,375.00 5,179.00 5,975.00 3,457.00 3,849.00 4,108.18

27 Social Benefits - - - - - - -

28 Other Expense - - - - - - -

31 Non-financial Assets - - - - - - -

32 Financial Assets - - - - - - -

Capital Expenditure 1,452.00 1,990.00 2,216.70 2,544.20 1,337.00 1,637.00 2,400.00

21 Compensation to Employees - - - - - - -

22 Use of Goods and Services - - - - - - -

24 Interest - - - - - - -

25 Subsidies - - - - - - -
Capital transters to Govt
26 Agencies 600.00 1,100.00 1,300.00 1,600.00 537.00 537.00 800.00

27 Social Benefits - - - - - - -

28 Other Expense - - - - - - -

31 Non-financial Assets 852.00 890.00 916.70 944.20 800.00 1,100.00 1,600.00

32 Financial Assets - - - - - - -

Total Expenditure for Programme 3 4,909.00 6,365.00 7,395.70 8,519.20 4,794.00 5,486.00 6,508.18
Programme 4: General Administration

Current Expenditure 11,170.64 26,198.06 39,831.06 53,453.58 12,351.83 13,043.15 13,939.22

21 Compensation to Employees 7,957.27 21,746.14 34,357.27 46,957.27 7,412.53 7,506.86 7,605.28

269
 22 Use of Goods and Services 480.87 499.37 514.35 529.78 450.87 484.29 536.59

24 Interest - - - - - - -

25 Subsidies - - - - - - -
Current transters to Govt
26 Agencies 2,723.00 3,723.00 4,723.00 5,723.00 4,478.93 5,042.50 5,787.85

27 Social Benefits - 217.95 224.49 231.22 - - -

28 Other Expense - - - - - - -

31 Non-financial Assets 9.50 11.60 11.95 12.31 9.50 9.50 9.50

32 Financial Assets - - - - - - -

Capital Expenditure 15,998.00 144,420.00 147,432.60 152,445.58 15,676.20 19,408.60 19,912.00

21 Compensation to Employees - - - - - - -

22 Use of Goods and Services 400.00 420.00 432.60 445.58 550.00 750.00 920.00

24 Interest - - - - - - -

25 Subsidies - - - - - - -
Capital transters to Govt
26 Agencies 15,598.00 144,000.00 147,000.00 152,000.00 15,126.20 18,658.60 18,992.00

27 Social Benefits - - - - - - -

28 Other Expense - - - - - - -

31 Non-financial Assets - - - - - - -

32 Financial Assets - - - - - - -
Total Expenditure for
Programme 4 27,168.64 170,618.06 187,263.66 205,899.16 28,028.03 32,451.75 33,851.22
STATE DEPARTMENT FOR PUBLIC HEALTH AND PROFESSIONAL STANDARDS

Programme 1 - Preventive and Promotive Services

Current Expenditure 1,709 12,338.54 13,489.80 14,666.48 1,158.01 2,872.66 3,128.69

Compensation to Employees 246 2,047.04 2,108.45 2,171.71 568.87 2,218.59 2,412.29

Use of Goods and Services 233 8,969.50 9,923.34 10,818.77 191.14 241.07 288.30

270
 Grants and other Transters 1,231 1,322.00 1,458.00 1,676.00 398.00 413.00 428.10

Other Recurrent - - - - - - -

Capital Expenditure 4,200 8,955.00 10,438.00 11,122.00 4,251.00 3,985.00 4,049.34

Acquisition of Non-Financial
Assets - - - - - -
Capital transters to Govt
Agencies 4,200 8,755.00 10,088.00 10,722.00 4,188.00 3,985.00 4,049.34

Other Development 200.00 350.00 400.00 63.00 - -

Total Expenditure for
Programme 1 5,909 21,293.54 23,927.80 25,788.48 5,409.01 6,857.66 7,178.03

Programme 2 - Health Resource Development and Innovation

Current Expenditure 13,538 30,891.20 29,595.00 30,614.00 13,481.57 13,837.70 14,213.73

Compensation to Employees 4,275 14,118.30 14,541.85 14,978.11 3,771.00 3,884.13 4,000.65

Use of Goods and Services 324 1,101.70 1,123.15 1,120.89 127.57 93.57 63.07

Grants and other Transters 8,937 15,671.20 13,930.00 14,515.00 9,583.00 9,860.00 10,150.00
Other Recurrent 2

Capital Expenditure 1,460 - - - 785.50 715.00 400.00

Acquisition of Non-Financial
Assets - - -
Capital transters to Govt
Agencies 1,460 785.50 715.00 400.00

Other Development - - - - - -
Total Expenditure for
Programme 2 14,999 30,891.20 29,595.00 30,614.00 14,267.07 14,552.70 14,613.73

Programme 3 - Health Policy, Standards and Regulations

Current Expenditure 1,703 8,653.00 9,245.00 10,597.00 5,080.54 5,139.05 5,204.21

Compensation to Employees 193 119.46 123.04 126.73 483.00 497.49 512.41

Use of Goods and Services 83 2,296.84 2,282.46 2,915.27 80.54 84.56 88.79

Grants and other Transters 1,419 6,236.70 6,839.50 7,555.00 4,517.00 4,557.00 4,603.00
Other Recurrent 8

271
 Capital Expenditure - - - 250.00 75.00 - -
Acquisition of Non-Financial
Assets - - - - - -
Capital transters to Govt
Agencies - - 250.00 75.00 - -

Other Development - - -
Total Expenditure for
Programme 3 1,703 8,653.00 9,245.00 10,847.00 5,155.54 5,139.05 5,204.21

Programme 4 - General Administration & Support Services

Current Expenditure 406 1,693.00 1,756.00 1,875.00 770.99 799.84 847.03

Compensation to Employees 188 203.52 209.63 215.91 513.00 528.39 544.24

Use of Goods and Services 218 1,489.48 1,546.37 1,659.09 257.99 271.45 302.79
Grants and other Transters
Other Recurrent 48

Capital Expenditure - - - - 50.00 - -

Acquisition of Non-Financial
Assets 50.00 - -
Capital transters to Govt
Agencies - - -

Other Development - - -
Total Expenditure for Programme
4 406 1,693.00 1,756.00 1,875.00 820.99 799.84 847.03
Total
Vote 23,017 62,530.74 64,523.80 69,124.48 25,652.61 27,349.26 27,843.00

Table 3.7: Analysis of Recurrent Resource Requirements Vs allocation for SAGAs (Amount KSh. Millions)

Remarks
2023/24 Requirement Allocation
Economic Classification
Approved
2024/25 2025/26 2026/27 2024/25 2025/26 2026/27
Estimates
SUMMARY FOR ALL SAGAs

272
 Remarks
2023/24 Requirement Allocation
Economic Classification
Approved
2024/25 2025/26 2026/27 2024/25 2025/26 2026/27
Estimates
STATE DEPARTMENT FOR MEDICALSERVICES
1 KENYATTA NATIONAL HOSPITAL
20,529 20,529 20,529 20,373.0 20,962.0 21,581.0
GROSS 20,529
8,508 8,592 9,022 8,592.0 8,592.0
AIA 9,473 8,592.0
12,021 11,937 11,507 11,781.0 12,370.0 12,989.0
NET 11,056
13,478 14,320 14,893 14,017.1 15,160.9
Compensation to Employees 15,489 14,577.8
7,051 8,592 9,022 6,463.0 6,536.0
Other Recurrent of which 9,472 6,496.0
750 831 906 780.0 843.6
Insurance 988 811.2
263 394 429 273.5 295.8
Utilities 468 284.5
Rent - - - - - - -
Subscriptions to International Organizations - - - - - - -
Subscriptions to Professional Bodies - - - - - - -
171 186 203 177.8 192.4
Contracted Professionals (Guards & Cleaners) 221 185.0
23 94 102 23.9 25.9
Gratuity 112 24.9
5,844 7,086 7,381 5,207.7 5,178.3
Others 7,683 5,190.5
MWAI KIBAKI HOSPITAL - KENYATTA
2. NATIONAL HOSPITAL
1,381 2,886 3,051 1,379.0 1,418.0 1,459.0
GROSS 4,399
593 599 629 599.0 599.0
AIA 660 599.0
788 2,287 2,422 780.0 819.0 860.0
NET 3,739
788 1,880 1,955 814.0 881.0
Compensation to Employees 3,204 847.0
593 1,006 1,096 565.0 578.0
Other Recurrent of which 1,195 571.0
16 193 210 5.0 7.0
Insurance 229 6.0
44 111 121 59.0 99.0
Utilities 131 76.0

273
 Remarks
2023/24 Requirement Allocation
Economic Classification
Approved
2024/25 2025/26 2026/27 2024/25 2025/26 2026/27
Estimates
Rent - - - - - - -
Subscriptions to International Organizations - - - - - - -
Subscriptions to Professional Bodies - - - - - - -
27 29 32 28.0 30.0
Contracted Professionals (Guards & Cleaners) 34 29.0
43 89 97 - - -
Gratuity 106
463 584 636 473.0 442.0
Others 695 460.0
3. MAMA MARGARET UHURU HOSPITAL
1,031 2,005 2,128 1,031.0 1,055.0 1,081.0
GROSS 2,346
531 536 563 536.0 536.0
AIA 591 536.0
500 1,469 1,565 495.0 519.0 545.0
NET 1,755
551 1,155 1,201 573.0 620.0
Compensation to Employees 1,336 596.0
480 850 927 458.0 461.0
Other Recurrent of which 1,010 459.0
- 85 93 85.0 101.0
Insurance 101 92.7
21 68 74 68.0 81.0
Utilities 81 74.0
Rent - - - -
Subscriptions to International Organizations - - - -
Subscriptions to Professional Bodies - - - -
12 22 24 22.0 26.0
Contracted Professionals (Guards & Cleaners) 26 24.0
- 12 15 12.0 15.0 18.0
Gratuity 18
447 663 721 271.0 235.0
Others 784 253.4
4. MOI TEACHING AND REFERRAL HOSPITAL
12,774.0 14,296.0 15,237.2 13,049.8 14,835.1
GROSS 16,760.9 13,910.5
3,785.0 4,164.0 4,580.4 4,164.0 5,038.4
AIA 5,038.4 4,580.4
8,989.0 10,132.0 10,656.8 8,885.8 9,796.6
NET 11,722.5 9,330.1

274
 Remarks
2023/24 Requirement Allocation
Economic Classification
Approved
2024/25 2025/26 2026/27 2024/25 2025/26 2026/27
Estimates
8,989.0 10,132.0 10,656.8 10,132.0 11,722.5
Compensation to Employees 11,722.5 10,656.8
3,785.0 4,164.0 4,580.4 2,917.8 3,112.6
Other Recurrent of which 5,038.4 3,253.7
394.0 433.0 476.3 433.0 433.0
Insurance 523.9 433.0
180.0 198.0 217.8 198.0 198.0
Utilities 239.6 198.0
4.0 4.0 4.4 4.0 4.0
Rent 4.8 4.0
Subscriptions to International Organizations - - - - - - -
Subscriptions to Professional Bodies - - - - - - -
Contracted Professionals (Guards & Cleaners) - - - - - - -
18.0 20.0 22.0 20.0 20.0
Gratuity 24.2 20.0
3,189.0 3,509.0 3,859.9 2,262.83 2,457.59
Others 4,245.9 2,598.71
KENYATTA UNIVERSITY TEACHING,
5. RESEARCH AND REFERRAL HOSPITAL
5,106.6 8,865.0 9,751.5 6,744 7,046
GROSS 10,726.7 6,891
2,120.6 3,800.0 3,800.0 3,800 3,800
AIA 3,800.0 3,800
2,986.0 5,065.0 5,951.5 2,944 3,246
NET 6,926.7 3,091
2,544.0 5,065.0 5,571.5 2,944 3,246
Compensation to Employees 6,128.7 3,091
2,562.6 3,800.0 4,180.0 3,800 3,800
Other Recurrent of which 4,598.0 3,800
308.0 405.0 445.5 405 405
Insurance 490.1 405
238.0 242.0 266.2 242 242
Utilities 292.8 242
Rent - - - - - -
Subscriptions to International Organizations - - - - - -
28.0 30.0 33.0 30 30
Subscriptions to Professional Bodies 36.3 30
285.0 318.0 349.8 318 318
Contracted Professionals (Guards & Cleaners) 384.8 318
192.0 641.0 705.1 641 641
Gratuity 775.6 641

275
 Remarks
2023/24 Requirement Allocation
Economic Classification
Approved
2024/25 2025/26 2026/27 2024/25 2025/26 2026/27
Estimates
1,511.0 2,164.0 2,380.4 2,164 2,164
Others 2,618.4 2,164
GATUNDU LEVEL V HOSP- KENYATTA
6. UNIVERSITY TEACHING, RESEARCH AND
REFERRAL HOSPITAL-GATUNDU
- 825.0 907.5 - - -
GROSS 998.3
- 275.0 302.5 - - -
AIA 332.8
- 550.0 605.0 - - -
NET 665.5
- 341.0 341.0 - - -
Compensation to Employees 375.1
- 484.0 566.5 - - -
Other Recurrent of which 623.2
- 36.3 39.9 - - -
Insurance 43.9
- 85.8 94.4 - - -
Utilities 103.8
Rent - - - - - -
Subscriptions to International Organizations - - - - - - -
- 2.2 2.4 - - -
Subscriptions to Professional Bodies 2.7
- 30.8 33.9 - - -
Contracted Professionals (Guards & Cleaners) 37.3
- 24.2 26.6 - - -
Gratuity 29.3
- 304.7 369.3 - - -
Others 406.2
MATHARI NATIONAL TEACHING AND
7. REFERRAL HOSPITAL
- 4,200.0 5,823.0 - - -
GROSS 6,114.0
- 200.0 220.0 - - -
AIA 250.0
- 4,000.0 5,603.0 - - -
NET 5,864.0
- 3,000.0 4,303.0 - - -
Compensation to Employees 4,518.0
- 1,200.0 1,300.0 - - -
Other Recurrent of which 1,596.0
- 136.0 180.0 - - -
Insurance 200.0

276
 Remarks
2023/24 Requirement Allocation
Economic Classification
Approved
2024/25 2025/26 2026/27 2024/25 2025/26 2026/27
Estimates
- 32.0 45.0 - - -
Utilities 50.0
Rent - - - - - - -
Subscriptions to International Organizations - - - - - - -
Subscriptions to Professional Bodies - - - - - - -
- 80.0 110.0 - - -
Contracted Professionals (Guards & Cleaners) 125.0
Gratuity - - - - - - -
- 952.0 1,190.0 - - -
Others 1,221.0
8. KENYA MEDICAL SUPPLIES AUTHORITY
3,990.0 5,747.6 5,944.6 5,263 5,294
GROSS 6,191.8 5,273
3,570.0 4,847.6 4,944.6 4,858 4,848
AIA 5,191.8 4,848
420.0 900.0 1,000.0 405 446
NET 1,000.0 425
1,338.9 1,100.0 1,210.0 1,100 1,271
Compensation to Employees 1,270.5 1,210
2,651.1 4,647.6 4,734.6 4,163 4,023
Other Recurrent of which 4,921.3 4,063
170.0 270.0 297.0 270 327
Insurance 327.0 297
31.0 40.0 44.0 40 48
Utilities 48.4 44
45.0 30.0 30.0 30 30
Rent 30.0 30
Subscriptions to International Organizations - - - - - - -
5.0 6.0 7.0 6 7 8
Subscriptions to Professional Bodies 8.0
129.0 386.0 387.9 386 396
Contracted Professionals (Guards & Cleaners) 395.7 388
Gratuity - - - - - - -
2,271.1 3,916.0 3,969.0 3,431 3,214
Others 4,112.0 3,297
NATIONAL AIDS CONTROL
9. COUNCIL/NATIONAL SYNDEMIC CONTROL
COUNCIL
967.0 1,417.0 1,554.0 987.0 1,128.0
GROSS 1,835.0 1,036.0

277
 Remarks
2023/24 Requirement Allocation
Economic Classification
Approved
2024/25 2025/26 2026/27 2024/25 2025/26 2026/27
Estimates
AIA - - - - - - -
967.0 1,417.0 1,554.0 987.0 1,128.0
NET 1,835.0 1,036.0
494.0 517.0 578.0 517.0 594.0
Compensation to Employees 594.0 578.0
473.0 900.0 976.0 450.0 534.0
Other Recurrent of which 1,241.0 437.0
54.0 60.0 63.0 54.0 69.3
Insurance 69.3 63.0
60.0 69.0 69.0 60.0 75.9
Utilities 75.9 69.0
77.0 80.0 83.0 77.0 91.3
Rent 91.3 83.0
5.0 5.0 5.0 5.0 5.0
Subscriptions to International Organizations 5.0 5.0
2.0 2.0 2.0 2.0 2.0
Subscriptions to Professional Bodies 2.0 2.0
27.0 28.0 29.0 27.0 32.0
Contracted Professionals (Guards & Cleaners) 32.0 29.0
99.0 99.0 100.0 99.0 120.0
Gratuity 120.0 100.0
149.0 557.0 625.0 146.0 138.5
Others 845.5 107.0
10. NATIONAL CANCER INSTITUTE OF KENYA
200.5 850.0 1,232.0 200.5 219.5
GROSS 1,525.0 208.5
0.5 0.5 0.5 0.5 0.5
AIA 0.5 0.5
200.0 849.5 1,231.5 200.0 219.0
NET 1,524.5 208.0
45.0 350.0 460.0 60.0 66.0
Compensation to Employees 540.0 55.0
155.5 500.0 772.0 140.0 153.5
Other Recurrent of which 985.0 153.5
2.0 20.0 42.0 5.0 5.0
Insurance 54.0 3.0
6.0 30.0 75.0 11.0 15.0
Utilities 120.0 10.0
12.0 35.0 45.0 12.0 12.0
Rent 45.0 12.0
- - - - 3.0 3.0
Subscriptions to International Organizations 3.0

278
 Remarks
2023/24 Requirement Allocation
Economic Classification
Approved
2024/25 2025/26 2026/27 2024/25 2025/26 2026/27
Estimates
- - - - 1.0 1.0
Subscriptions to Professional Bodies 1.0
- - - - 5.0 5.0
Contracted Professionals (Guards & Cleaners) 5.0
- 10.0 10.0 - -
Gratuity 10.0
135.5 405.0 600.0 103.0 121.5
Others 756.0 128.5
11. KENYA BIOVAX INSTITUTE LTD
150.0 634.0 951.0 354.0 403.0
GROSS 1,273.0 403.0
AIA - - - - - - -
210.0 634.0 951.0 354.0 403.0
NET 1,273.0 403.0
151.0 389.0 507.0 194.0 275.0
Compensation to Employees 678.0 270.0
59.0 245.0 444.0 160.0 128.0
Other Recurrent of which 595.0 133.0
18.0 48.0 53.0 34 45.0
Insurance 100.0 40.0
6.0 25.0 25.0 10 15.0
Utilities 30.0 13.0
10.0 35.0 38.0 34 38.0
Rent 40.0 38.0
- 1.0 2.0 2 3.0
Subscriptions to International Organizations 3.0 3.0
1.0 1.5 2.0 1.5 3.0
Subscriptions to Professional Bodies 2.5 2.0
2.0 3.0 4.0 5 7.0
Contracted Professionals (Guards & Cleaners) 5.0 8.0
22.0 45.0 64.0 3.5 12.0
Gratuity 88.0 10.0
- 86.5 256.0 70 5.0
Others 326.5 19.0
12. KENYA MEDICAL RESEARCH INSTITUTE
3,307.0 4,049.9 4,539.4 3,272.0 3,705.0
GROSS 5,050.4 3,425.0
220.0 220.0 220.0 220 220 220
AIA 220.0
3,087.0 3,829.9 4,319.4 3072 3226 3485
NET 4,830.4

279
 Remarks
2023/24 Requirement Allocation
Economic Classification
Approved
2024/25 2025/26 2026/27 2024/25 2025/26 2026/27
Estimates
2,713.0 3,095.0 3,489.0 2727 2870 3029
Compensation to Employees 3,895.0
594.0 954.9 1,050.4 545 555 676
Other Recurrent of which 1,155.4
16.0 70.0 77.0 50 70 75
Insurance 84.7
101.0 176.0 193.6 101 120 140
Utilities 213.0
2.0 20.0 22.0 10 15 17
Rent 24.2
3.0 5.0 5.0 3 3 5
Subscriptions to International Organizations 5.5
Subscriptions to Professional Bodies - - - - 1 1 2
52.0 80.0 88.0 54 55 62
Contracted Professionals (Guards & Cleaners) 96.8
76.0 86.0 94.6 76 80 92
Gratuity 104.1
344.0 518.0 569.8 250 211 283
Others 626.8
NATIONAL HOSPITAL INSURANCE
13. FUND/SOCIAL HEALTH AUTHORITY
94,914.1 100,609.0 106,645.5 100,609.0 113,044.2
GROSS 113,044.2 106,645.5
94,914.1 100,609.0 106,645.5 100,609.0 113,044.2
AIA 113,044.2 106,645.5
NET - - - - - - -
6,219.4 6,592.5 6,988.1 6,592.5 7,407.4
Compensation to Employees 7,407.4 6,988.1
Other Recurrent of which - - - - - - -
647.3 670.1 693.8 670.1 718.5
Insurance 718.5 693.8
14.8 16.3 17.9 16.3 19.7
Utilities 19.7 17.9
298.4 307.4 316.6 307.4 326.1
Rent 326.1 316.6
5.3 5.3 5.3 5.3 5.3
Subscriptions to International Organizations 5.3 5.3
17.0 18.7 20.6 18.7 22.7
Subscriptions to Professional Bodies 22.7 20.6
131.7 144.9 159.4 144.9 175.3
Contracted Professionals (Guards & Cleaners) 175.3 159.4

280
 Remarks
2023/24 Requirement Allocation
Economic Classification
Approved
2024/25 2025/26 2026/27 2024/25 2025/26 2026/27
Estimates
18.8 18.8 18.8 18.8 18.8
Gratuity 18.8 18.8
87,561.1 92,834.9 98,425.0 92,834.9 104,350.4
Others 104,350.4 98,425.0
GoK Grants 1,723.0 1,723.0 2,020.0 1,723.0 2,020.0
2,020.0 2,020.0
Health Insurance Subsidy Program for Orphans 1,423.0 1,423.0 1,720.0 1,423.0 1,720.0
Vulnerable Children-BETA 1,720.0 1,720.0
Health Ins. Subsidy Program for Older Ppl & 300.0 300.0 300.0 300.0 300.0
Persons w/Disability-BETA 300.0 300.0
GOK GRANT TRANSFER TO COUNTIES
14. UNDER COMMUNITY HEALTH
VOLUNTEERS
GoK Grant
Community Health Volunteers - BETA 1,000.0 3,000.0 4,000.0 2,584.0 2,700.0
5,000.0 2,700.0
15. KENYA BOARD OF MENTAL HEALTH
GoK Grant
Kenya Board of Mental Health 50.0 50.0 49.0 55.0
52.0

STATE DEPARTMENT FOR PUBLIC HEALTH AND PROFESSIONAL STANDARDS

1. KENYA MEDICAL TRAINING COLLEGE
GROSS 8,863 13,391 11,473 11,890 9,302 9,565 9,841
AIA 3,840 4,040 4,240 4,440 4,040 4,040 4,040
NET 5,023 9,351 7,233 7,450 5,262 5,525 5,801
Compensation to Employees 4,519 7,023 7,233 7,450 4,855 5,001 5,151
Other Recurrent of which 4,344 6,368 4,240 4,440 4,447 4,354 4,470
Insurance 660 700 730 750 700 720 740
Utilities 150 162 175 185 162 170 185
Rent 4 5 5 6 5 5 6
Subscriptions to International Organizations 0 0 0 0 0 0 0
Subscriptions to Professional Bodies 0 0 0 0 0 0 0
Contracted Professionals (Guards & Cleaners) 367 444 464 500 444 464 490
Gratuity 80 11 30 40 11 30 40
Others 3,083 5,046 2,836 2,959 3,125 2,965 3,009

281
 Remarks
2023/24 Requirement Allocation
Economic Classification
Approved
2024/25 2025/26 2026/27 2024/25 2025/26 2026/27
Estimates
KENYA MEDICAL PRACTITIONERS AND
2. DENTISTS’ COUNCIL
GROSS 850 1,345 1,360 1,375 855 879 905
AIA 355 365 375 385 365 365 365
NET 495 980 985 990 490 514 540
Compensation to Employees 341 375 380 385 375 380 385
Other Recurrent of which 509 970 980 990 480 499 520
Insurance 28 40 43 47 40 42 45
Utilities 4 5 6 7 4 5 5
Rent 5 6 7 8 4 5 6
Subscriptions to International Organizations 1 1 1 1 1 1 1
Subscriptions to Professional Bodies 3 1 1 1 1 1 1
Contracted Professionals (Guards & Cleaners) 3 4 5 6 3 4 4
Gratuity 19 25 27 28 20 22 25
Others 446 888 890 892 407 419 433
KENYA HEALTH PROFESSIONS OVERSIGHT
3. AUTHORITY
GROSS 66 486 636 790 70 73 75
AIA 15 20 20 20 20 20 20
NET 51 466 616 770 50 53 55
Compensation to Employees - 105 207 310 0 0 0
Other Recurrent of which 66 381 429 480 - 0 0
Insurance - 2 4 6 3 5 6
Utilities 1 2 2 2 2 2 2
Rent 3 4 4 5 4 4 5
Subscriptions to International Organizations - - - - 2 2 2,42
Subscriptions to Professional Bodies 0 1 1 1 1 1 1
Contracted Professionals (Guards & Cleaners) 1 1 1 2 1 1 2
Gratuity - 31 64 96
Others 60 339 352 368 57 57 59
KENYA NUCLEAR REGULATORY
4. AUTHORITY
GROSS 274 1,100 1,210 1,331 272 281 290

282
 Remarks
2023/24 Requirement Allocation
Economic Classification
Approved
2024/25 2025/26 2026/27 2024/25 2025/26 2026/27
Estimates
AIA 100 100 110 121 100 100 100
NET 174 1,000 1,100 1,210 172 181 190
Compensation to Employees 30 360 396 436 156 164 172
Other Recurrent of which 244 740 814 895 116 117 118
Insurance 6 7 8 8 10 11 11
Utilities 7 10 11 12 5 6 6
Rent 22 30 33 36 30 32 32
Subscriptions to International Organizations - - - - 0 0 0
Subscriptions to Professional Bodies - - - - 0 0 0
Contracted Professionals (Guards & Cleaners) 7 9 10 11 9 10 10
Gratuity - - - - 0 0 0
Others 202 684 752 828 62 58 59
KENYA INSTITUTE OF PRIMATE
5. RESEARCH
GROSS 73.8 1,780.20 1833 1917 226 237 248
AIA 0 2.5 3.5 2.5 3 3 3
NET 73.8 1,777.70 1,829.50 1,914.50 223 234 245
Compensation to Employees - 380 418 418 0 0 0
Other Recurrent of which 73.8 1,400.20 1413 1499 76 80 84
Insurance - 44.6 47 50.2 0 0 0
Utilities 73.8 14.5 15 15.5 76 80 84
Rent - 0 0 0
Subscriptions to International Organizations - 14.6 14 15 0 0 0
Subscriptions to Professional Bodies - 4 4 4.5 0 0 0
Contracted Professionals (Guards & Cleaners) - 119 100 80 0 0 0
Gratuity - 19 21 23 0 0 0
Others - 1184.5 1212 1333 0 0 0
PUBLIC HEALTH OFFICERS AND
6. TECHNICIANS COUNCIL (PHOTC)
GROSS - 218 250 300 50 51 52
AIA - 30 40 60 30 30 30
NET - 188 210 240 20 21 22

283
 Remarks
2023/24 Requirement Allocation
Economic Classification
Approved
2024/25 2025/26 2026/27 2024/25 2025/26 2026/27
Estimates
Compensation to Employees - 40 70 70 10 15 15
Other Recurrent of which - 178 181 231 40 36 37
Insurance - 10 20 40 3.2 3.5 3.5
Utilities - 31 35 54 10 12 14
Rent - 8 10 10 3 5 5
Subscriptions to International Organizations - 1 1 1 1 1 1
Subscriptions to Professional Bodies - 0 1 1 0.1 0.1 0.1
Contracted Professionals (Guards & Cleaners) - 5 10 10 2 3 3
Gratuity - 10 15 15 5 5 5
Others - 113 89 100 16 6 5
KENYA HEALTH HUMAN RESOURCE
7. ADVISORY COUNCIL
GROSS 69 500 624 708 - - -
AIA - - - - - - -
NET 69 500 624 708 - - -
Compensation to Employees 24 282 383 442 - - -
Other Recurrent of which 45 218 241 266 - - -
Insurance - 3 4 5 - - -
Utilities 2 3 4 4 - - -
Rent 7 15 17 18 - - -
Subscriptions to International Organizations - 2 2 2 - - -
Subscriptions to Professional Bodies - 2 2 2 - - -
Contracted Professionals (Guards & Cleaners) - 3 3 4 - - -
Gratuity - 18 20 23 - - -
Others 36 172 188 208 - - -
8. TOBACCO CONTROL BOARD
GROSS 786 876 975 1,082 861 862 864
AIA 756 831 915 1,007 831 831 831
NET 30 45 60 75 30 31 33
Compensation to Employees
Other Recurrent of which 30 45 60 75 861 862 864

284
 Remarks
2023/24 Requirement Allocation
Economic Classification
Approved
2024/25 2025/26 2026/27 2024/25 2025/26 2026/27
Estimates
Insurance - - - - - - -
Utilities - - - - - - -
Rent - - - - - - -
Subscriptions to International Organizations - - - - - - -
Subscriptions to Professional Bodies - - - - - - -
Contracted Professionals (Guards & Cleaners) - - - - - - -
Gratuity - - - - - - -
Others 30 45 60 75 - - -
KENYA NATIONAL PUBLIC HEALTH
9. INSTITUTE
GROSS 34 107 126 200 34 35 37
AIA - - - - 0 0 0
NET 34 107 126 200 34 35 37
Compensation to Employees - - - - - - -
Other Recurrent of which 34 107 126 200 34 35 37
Insurance - - - - - - -
Utilities - - - - - - -
Rent - - - - - - -
Subscriptions to International Organizations - - - - - - -
Subscriptions to Professional Bodies - - - - - - -
Contracted Professionals (Guards & Cleaners) - - - - - - -
Gratuity - - - - - - -
Others 34 107 126 200 0 0 0
10. NURSING COUNCIL OF KENYA

GROSS 503 920 1,040 1,140

751 758 765
AIA 418 620 690 740
620 620 620
NET 85 300 350 400
131 138 145
Compensation to Employees 116 170 173 193
170 173 193
Other Recurrent of which 387 750 867 947
581 585 572

285
 Remarks
2023/24 Requirement Allocation
Economic Classification
Approved
2024/25 2025/26 2026/27 2024/25 2025/26 2026/27
Estimates
Insurance 25 30 35 40
30 35 40
Utilities 18 40 45 50
40 45 50
Rent - - - -
- - -
Subscriptions to International Organizations - - - -
- - -
Subscriptions to Professional Bodies 3 5 7 9
5 7 9
Contracted Professionals (Guards & Cleaners) 341 675 780 848
506 498 473
Gratuity
Others
11. CLINICAL OFFICERS COUNCIL
GROSS - 557 607 662 132 132 132
AIA - 132 144 156 132 132 132
NET - 425 463 506 20 60 80
Compensation to Employees - 100 109 119 - - -
Other Recurrent of which - 457 498 543 15 30 40
Insurance - 37 41 45 - - -
Utilities - 1 1 1 - - -

Rent - - - - - -
-
Subscriptions to International Organizations - - - - - -
-
Subscriptions to Professional Bodies - 0 0 0 - - -
Contracted Professionals (Guards & Cleaners) - 34 37 40 5 30 40

Gratuity - - - - - -
-
Others - 385 419 457 - - -
OCCUPATIONAL THERAPY COUNCIL OF
12. KENYA (OTC)
GROSS - 100 110 120 24 24 25
AIA - 14 15 16 14 14 14
NET - 86 95 104 10 10 11
Compensation to Employees - 12 13 13 1 1 1

286
 Remarks
2023/24 Requirement Allocation
Economic Classification
Approved
2024/25 2025/26 2026/27 2024/25 2025/26 2026/27
Estimates
Other Recurrent of which - 88 98 107 23 23 24
Insurance - - - - - - -
Utilities - 0 0 0 0 0 0
Rent - 1 1 1 0 0 0
Subscriptions to International Organizations - 0 0 0 0 0 0
Subscriptions to Professional Bodies - - - - - - -
Contracted Professionals (Guards & Cleaners) - 86 95 105 21 23 24
Gratuity
Others
NATIONAL CONTROL QUALITY
13. LABARATORY
GROSS 65 399 427 532 0 0 0
AIA 24 76 86 96 0 0 0
NET 41 322 341 436 0 0 0
Compensation to Employees 17 201 302 402 0 0 0
Other Recurrent of which 48 198 125 130 0 0 0
Insurance - - - - 0 0 0
Utilities 5 8 8 8 0 0 0
Rent - - - - 0 0 0
Subscriptions to International Organizations - 1 1 1 0 0 0
Subscriptions to Professional Bodies - 1 1 1 0 0 0
Contracted Professionals (Guards & Cleaners) - 3 3 3 0 0 0
Gratuity - - - - 0 0 0
Others 44 186 112 117 0 0 0
COUNSELLORS AND PSYCHOLOGIST
14. BOARD
GROSS - 112 123 136 30 31 32
AIA - 10 11 12 10 10 10
NET - 102 112 123 20 21 22
Compensation to Employees - 20 22 24 15 15 15
Other Recurrent of which - 92 101 111 15 16 17
Insurance - 15 17 18 2 2 2

287
 Remarks
2023/24 Requirement Allocation
Economic Classification
Approved
2024/25 2025/26 2026/27 2024/25 2025/26 2026/27
Estimates
Utilities - 2 2 2 2 2 2
Rent - 1 1 1 1 1 1
Subscriptions to International Organizations - - - - 0 0 0
Subscriptions to Professional Bodies - - - - 0 0 0
Contracted Professionals (Guards & Cleaners) - - - - 0 0 0
Gratuity - - - - 0 0 0
Others - 74 81 90 10 11 12
15. PHARMACY AND POISONS BOARD
GROSS - 2,100 2,287 2,500 1,691 1,670 1,670
AIA - 1,670 1,757 1,800 1,670 1,670 1,670
NET - 430 530 700 21 80 100
Compensation to Employees - 145 150 160 166 230 360
Other Recurrent of which - 3,767 4,112 4,490 1,546 1,520 1,510
Insurance - 60 75 95 40 75 95
Utilities - 9 9 10 12 15 20
Rent - 11 11 15 18 20 22
Subscriptions to International Organizations - - - - - - -
Subscriptions to Professional Bodies - - - - - - -
Contracted Professionals (Guards & Cleaners) - 65 67 70 75 80 85
Gratuity - 1,811 1,975 2,150 - - -
Others - 1,811 1,975 2,150 0 0 0
16. PHYSIOTHERAPY COUNCIL OF KENYA
GROSS 0 79 84 89 40 42 46
AIA 0 18 21 25 20 22 26
NET 0 61 63 64 20 20 20
Compensation to Employees 0 43 44 45 16 17 20
Other Recurrent of which 0 36 40 44.00 24 25 26
Insurance 0 0 0 0 0 0 0
Utilities 0 2 2 2 2 2 2
Rent 0 0.30 0.33 0.363 1 1 1
Subscriptions to International Organizations 0 0 0 0 0 0 0

288
 Remarks
2023/24 Requirement Allocation
Economic Classification
Approved
2024/25 2025/26 2026/27 2024/25 2025/26 2026/27
Estimates
Subscriptions to Professional Bodies 0 0 0 0 0 0 0
Contracted Professionals (Guards & Cleaners) 0 0.155 0.16 0.165 1 1 1
Gratuity 0 0.30 0.6 1.2 1 1 1
Others 0 33.4 37.0 40.3 19 20 21

289
CHAPTER FOUR: CROSS-SECTOR LINKAGES, EMERGING ISSUES/
CHALLENGES

The purpose of this chapter is to highlight the linkages that exist within and without the Health
Sector, emerging issues, and challenges that impact on the efficiency of operations aimed at attaining
the best standards of healthcare.

The Constitution of Kenya 2010 establishes two distinct and interdependent levels of governments
consisting of the national and 47 county governments with specific functions. These two levels must
conduct their service provision through consultation and cooperation in order to effectively deliver
their mandates.

The multi-sectoral approach in healthcare provision is critical in addressing the various social
determinants of health that lie outside the control of the health system. It is therefore critical to
maintain and enhance actions across multiple Sectors to ensure the gains made through the expansion
of healthcare services are not eroded.
In implementing its mandate, the health sector interacts with key stakeholders as outlined in the
Health Sector Partnership Framework 2018-2030, resulting in the efficient delivery of health
services, optimal utilization of resources, and accountability. Kenya has a robust health system that
has evolved over the years from a centralized system at independence, graduating to a decentralized
and currently devolved system with Counties having the mandate of ensuring healthcare services are
provided to all. Private health sector, Faith Based Organizations, and Non-Governmental
Organizations provide health services at delivery points that range from communities to referral
hospitals.
Key Ministries Departments and Agencies (MDAs) have been identified as enablers for UHC, as
they facilitate the moving of services closer to the people, in the spirit of citizen-centeredness. The
MDAs provide complimentary services that are key to a healthy population, these include, access to
safe water, diverse food of optimal quality, and quality education that results in improved quality of
life, including cash transfer and employment. These MDAs include; Labour and Social Protection,
Water and Sanitation, Energy, ICT, Education, and Agriculture, among others.
There is also an increasing complexity of government operations aimed at meeting the diverse needs
of an ever-growing population, who are living longer, and thus more prone to non-communicable
diseases. There are also more modern treatments and interventions that require advanced capacity to
operate. The ever-changing environment marked by emerging diseases, globalization, digitization,
and climate change is having direct impacts on health.

290
1. CROSS-SECTOR LINKAGES
The multi-sectoral approach in health care provision is critical in addressing the various social
determinants of health that lie outside the control of the health system. It is therefore critical to
maintain and enhance actions across multiple Sectors to ensure the gains made through the expansion
of healthcare services are not eroded.

In implementing its mandate, the health sub-sector interacts with key stakeholders outlined in the
Health Sector Partnership Framework 2020-2030, resulting in the efficient delivery of health
services, optimal utilization of resources, and accountability. Kenya has a robust health system that
has evolved over the years from a centralized system at independence, graduating to a decentralized
and currently devolved system with Counties having the mandate of ensuring healthcare services are
provided to all. Private health sector, Faith Based Organizations, and Non-Governmental
Organisations provide health services at delivery points that range from dispensaries to hospitals.

Key Ministries Departments and Agencies (MDAs) have been identified as enablers for UHC, as
they facilitate the moving of services closer to the people, in the spirit of patient-centeredness. The
MDAs provide complimentary services that are key to a healthy population, these include; access to
safe water, diverse food of optimal quality, and quality education that results in improved quality of
life, including cash transfer and employment. These MDAs include; Public service, Education,
Agriculture, Roads, Water, Energy, and ICT among others.

There is also an increasing complexity of government operations aimed at meeting the diverse needs
of an ever-growing population, who are living longer, and thus more prone to non-communicable
diseases. There are also more modern treatments and interventions that require advanced capacity to
operate. The ever-changing environment marked by emerging diseases, globalization, digitization,
and climate change is having direct impacts on health.

2. SECTORAL LINKAGES WITHIN THE SECTOR

The Kenya Health Policy (KHP) 2014-2030 provides a framework for the attainment of the highest
possible standards of health in a manner responsive to the health needs of the population. Further,
the Health Sector Partnership and Coordination Framework is a framework to better coordinate all
health sector players and enablers and align efforts towards improving the health of all Kenyans.
The Government has continued to invest in the health sector to facilitate the well-being of its citizens
by availing quality healthcare services closer to the people; ensuring sustainability of the Nation’s
human capital base required for sustainable economic growth. This is attained through a
collaborative way by both the National and County Governments.
The collaboration is through policy and strategy formulation, planning, information sharing,
legislation, resource mobilization, programme implementation, setting of standards, capacity
building, and monitoring and evaluation. The intra-sectoral linkage therefore enhances the
realization of the sub-sector mandate on the right to health for all Kenyans.

291
4.3 INTER SECTORAL LINKAGES AND STAKEHOLDERS
Social determinants of health in a population go beyond health-related interventions, and often
involve other non-health related determinants like education, poverty, access to clean water, food
security, and infrastructural development among others. In this regard cross-sectoral relations are
key in moving towards a healthy population. This section looks at ways that the health sector
collaborates with other sectors of the economy.

The sector has categorized stakeholders with various roles under four groups:
1. State actors (Departments and Agencies, County Governments);
2. Non-state actors (implementing partners, FBOs, NGOs, CSOs, Private sector);
3. External actors (Development partners); and
4. Clients (individual, household, community).

The linkages/partnership with stakeholders mainly focuses on issues that impact and contributes to
improved health care, quality of life, and productivity leading to the country's economic growth.
The various stakeholders play different roles which are complementary and synergistic at all levels
of health care.

The various stakeholders in the Sector and their contribution to healthcare delivery are shown in
the table below:

S/No. Sector Area of Description Gaps/Remarks

Collaboration
1. Social Provision of The Health Sector is Continued engagement
Protection, employment/Labour working towards a healthy will ensure labour
Culture and force to improve labour force in the country related disputes do not
Recreation access to quality and to improve health hinder provision of
health services labour relations. health services.

Occupational Health There is an occupational The is need for

and Safety health and safety Act to enhanced partnerships
ensures a healthy on occupational health
workforce. and safety

The sector contributes

towards development’
review, and monitoring
implementation of policies
and legislation on labour
laws
Social Insurance for The launch of Universal Transition from input
Health Health Coverage (UHC) financing to output
with a model of social based financing through
insurance that will improve a social health insurance

292
S/No. Sector Area of Description Gaps/Remarks
Collaboration
health care service access
without extra financial
pressure through a
progressive and explicit
benefits package to which
all Kenyans will be
protected from potential
catastrophe arising from
health care services.

Special focus is given to

the poor and vulnerable in
the population.
2. Environment Hygiene behaviour Implementation of the Proper management of
Protection, and Environmental Environmental Sanitation waste continues to be a
Water and Sanitation and Hygiene Policy 2016- challenge to the
Natural 2030, envisions community.
Resources and motivates all Kenyans
Water and to improve their hygiene
Sanitation behaviour and
environmental sanitation to
free them from suffering ill
health caused by poor
sanitation.

Radiation Safety Radioactive materials have There is need for

a wide application enhanced
including health diagnostic radiation safety
and treatment equipment.
The Ministry of
Environment in
collaboration with the
sector implements radiation
safety requirements to
ensure safe use and
disposal of radioactive
materials.
Water supply Water supply to health Supply of clean water
facilities and proper management
of waste continues to
be a challenge to the
community.

School Health There is a consigned school The government will

Programmes health policy and continue to strengthen
293
S/No. Sector Area of Description Gaps/Remarks
Collaboration
implementation guidelines. the School Health
With an aim of providing a Programmes
healthy, safe and friendly
environment for all learners
in Kenya. The schools are
used as service delivery
points for health care
services such as
vaccinations, micronutrient
supplementation
3. Energy, Nuclear Power Development of Complexity in Global
Infrastructure Programme regulations and review of regulation of nuclear
and ICT pre-feasibility reports for energy.
Information, nuclear power
Communication programmes. This will
and Digital inform decisions on the
Economy health safety and viability
of nuclear power

Working with Energy on 800 CHVs trained on

household air pollution uptake of clean cooking
under strategic objective 5 solutions that will train
in the KHSSP on reduction the household. Primary
risk factors. With the Health care bill for
Ministry of Energy compensation of CHP an
working to develop advantage to motivate
household air pollution the CHPs to keep up this
strategy with an aim to initiative.
accelerate uptake of clean
cooking fuel and
technologies. Rapid
situation analysis on clean
cooking including for
health facilities in 35
counties.
Information The Ministry of Health in The Ministry will
Communication collaboration with the leverage ICT for
Technology Ministry of ICT undertook digital transformation in
connectivity of Hospital health service delivery.
Network infrastructure at 2
Level six, 15 Level five &
29 Level four Hospitals
totalling to 46 which
included a Local Area
294
S/No. Sector Area of Description Gaps/Remarks
Collaboration
Network (LAN) and links
to the government National
level. The MoICTDE has a
balance of installing 327
Level 4 Hospitals, and
KNH (L6)
Optic Fiber Backbone The country targets to
Infrastructure (NOFBI). A connect all health
total 137 Hospitals facilities totaling 6,091
connected to NOFBI to the Optic Fiber
Backbone Infrastructure
(NOFBI
4. Public Finance The funding levels and Allocation of 15% of the
Administration timely disbursement of budgets to health inline
and funds highly determine the Abuja
International efficiency and Declaration
Relations effectiveness of running the
sector.
Bilateral agreements The sector has entered into MOUs on health
a bilateral agreement cooperation
between Kenya and several signed for execution
Countries i.e., South
Africa; Cuba; United
Kingdom of Great Britain
and Northern Ireland
among others to enhance
cooperation in the sector in
an effort by the Kenyan
government to further
improve quality and access
to primary health care. The
MoUs are on Cooperation
in strengthening disease
prevention, epidemic
surveillance, preparedness,
and control, and emergency
health service; HR
exchange, HR capacity
building in medical
training colleges under
national government,
Knowledge exchange on
UHC and diseases of
public health importance,
Health Tourism; and
295
S/No. Sector Area of Description Gaps/Remarks
Collaboration
Disease surveillance,
response and control of
emerging and re-emerging
diseases.
5. Education Training institutions The education sector Harmonize the different
programmes are geared professional training
towards improving curriculum across all
efficiency in core service health training
delivery of accessible, institutions.
equitable and quality
education and training. The
sector plays a key role in
health research which helps
in the generation of new
health interventions which
are critical in the provision
of solutions to existing and
emerging health
challenges.

Kenya National The sector plays a key role KNQA will coordinate
Qualifications in harmonising of training, and harmonise
Authority (KNQA) assessment and quality education, training,
& Commission of assurance of all assessment, and quality
University qualifications in both assurance of all
Education public and private qualifications awarded
institutions in the country to
In addition, through the improve quality and
Commission of University international
Education, the sector comparability.
facilitates the accreditation The Commission to
of institutions offering regularly update the
university level medical public of new
courses in the country. developments in the
higher education
scenario as well as make
public pronouncements
to caution on those
institutions which have
not been mandated by
the Commission to offer
university-level
education in the country

296
S/No. Sector Area of Description Gaps/Remarks
Collaboration
6. Governance, Security, Law The constitution of Kenya Existing laws provide
Justice, Law guarantees provisions on the framework under
and Order State Department for the right to the highest which all collaboration
Interior, State Law quality of healthcare and of health matters across
office and the the sector will continue different sectors are
Judiciary to provide service handled
delivery as outlined in
chapter four. The sector
can help in deterring
behaviours related to
violence and injury;
addressing the traumas
that victims face and how
those perpetuate crime and
reducing adverse childhood
experiences and psycho
trauma.
The sector will continue to
implement the Health Act,
2017 and develop/review
Health Bills to address the
existing gaps and work
closely with other
government agencies in
implementing the laws
7. General Industry The availability, Promote locally
Economic and accessibility, quality and generated products to
Commercial pricing of medicines, transform the economy
Affairs vaccines and other and solve HPTs issues.
health products and
technologies (HPT) is a
key component and
challenge to the success of
UHC.
The Government has
therefore committed to
building its capacity for the
production/
manufacturing of Health
Products Technologies
(HPTs) that will include
human vaccines,
therapeutics and
biomedical products with
the long term measure to
297
S/No. Sector Area of Description Gaps/Remarks
Collaboration
become self-sufficient in
pharmaceutical and vaccine
needs.
The sector - -
collaborates with
KEBS on food
fortification,
particularly
industrial level
surveillance and
enforcement.
8. Agriculture, Agriculture and Through the Bottom Strengthen agriculture
Rural and livestock and Economic Transformation sector to generate
Urban fisheries production Agenda (BETA), the nutritious foods and in
Development for food and priorities include Crop adequate quantities and
nutrition security Production, Livestock quality contributing
Fisheries. These are critical to national food and
Food safety and the to ensure the rights to nutrition security.
resultant effects to adequate food of
health acceptable quality as
enshrined in article 43 of
the constitution.

The priority value chains

under the Food Security
Pillar in BETA maize,
beef, irish potatoes,
indigenous poultry, sweet
potatoes, mutton, pulses ,
goat meat, bananas, fish,
dairy, pork.

Plans underway to review

the food and security
policy to make it have a
food systems approach.
Distribution of free
vegetable seeds 5 types to
223,000 households, in 11
counties, subsidized
fertiliser for maize and
other commodities per
farmers, 6000 to 3500, 14
counties especially in high
maize production areas.
298
S/No. Sector Area of Description Gaps/Remarks
Collaboration
Farmer registration to
know types of crop
production and patterns, to
guide on extension and
subsidisation.

Extension being done at

ward level, 4000 wards,
agripreneurs, have been
employed to handle
production and handling
farmers in cooperatives.
Farmer cooperatives being
formed at ward level. The
national government is
conducting supervision to
ensure roll out is seamless
and carried out.
Food safety
Livestock systems,
antibiotics use and
antimicrobial resistance are
closely linked. Interactions
between human beings and
animals can result in
zoonotic diseases - one
health approach is
important in addressing
these among other
challenges.
Crop Improvement The use of biotechnology, Implementation of
and Management to in particular Genetically Monitoring Framework
increase food Modified Crops (GMCs), for BT Maize
security have proved to increase the
maize yield as well as
reduce yield losses caused
by pests. The sector in
collaboration with other
stakeholders has
developed a Monitoring
Framework for BT Maize.
Food safety Food safety remains a
critical pillar to food and
nutrition security. The
sector collaborates with
299
 S/No. Sector Area of Description Gaps/Remarks
Collaboration
agriculture and livestock
sectors to ensure that food
availed to the Kenyan
populace is safe and of
good quality.

4.4 EMERGING ISSUES

Emerging health issues are those that pose either a threat or relief from threat to the overall health
of the population. They can be an increased visibility in a long-standing health issue that continues
to obstruct the public health goal of reducing morbidity, mortality and disability.

The following are some of the emerging health issues that need to be considered:
i. Artificial intelligence technology provides an opportunity to enhance the quality and
efficiency of health services provision;
ii. Climate change related calamities pose a great risk to the state of public health in the
country. The recent re-emergence of disease implicates the resilience of micro-organisms
to climatic conditions. Further, drought persistence has led to increased cases of
malnutrition as well as increase in WASH related diseases such as cholera, trachoma and
vector borne diseases;
iii. Emergence of novel health products and technologies posing human capacity and
regulatory challenges within the existing legislative framework;
iv. The health sector has positioned Kenya as a medical tourism hub through state of the art
facilities and skilled healthcare professionals. This call for need to undertake research on
procedures like cosmetic surgery, modern dental care and traditional medicine to ensure
quality and safety.
v. Emerging and re-emerging Diseases (Hemorrhagic fever, airborne viral epidemics, polio)
due to increased cross border travels and the reality heather to unforeseen-security
threats;
vi. Declining donor funding by development for strategic programs like TB, Malaria, Family
Planning, nutrition and immunization. This has been occasioned by the Kenya being
debased to Lower middle-income status and therefore need to progressively increase the
domestic allocations to cater for these programmes in order to maintain the gains made;
vii. Re-emergence of neglected tropical diseases e.g. elephantiasis, kalaazar including Multi
Drug resistant infectious agents.

4.5 CHALLENGES
The following are the challenges in the health sector;

300
i. Low awareness on the health insurance benefit package among the beneficiaries and
healthcare providers, with associated low uptake of health insurance due to apathy and poor
socio-economic status of many Kenyans;
ii. Weak health systems and Inadequate health infrastructure for provisioning of health services
during the pandemics;
iii. Inadequate Human Resource for Health especially specialized cadres and low absorption of
skilled health professional into the active workforce and recurring health workers unrest
impacting negatively provision of quality health care services;
iv. Inadequate budgetary provision for key health products resulting in unpredictable/uneven
supply of essential commodities (mainly, HIV, Malaria, TB and Nutrition, family planning
and NCD) due to declining donor funding and increasing cost of health products.
v. Sub optimal prioritization, overlapping and conflict of interest in health research for
informing health policies and interventions and service provision leading to different
stakeholders supporting the same service provision or program;
vi. Slow categorization of newly formed SAGAs thus delaying the execution of their mandates;
vii. Low level of digitization of the health records system and health supply chain where health
facilities continue to manage and report health and commodities data manually;

viii. Rising cases of communicable diseases such as HIV, TB and malnutrition, NCD such as
cancer and diabetes; and

ix. Inadequate resources for mental health services and research.

301
CHAPTER FIVE: CONCLUSION

The Health Sector in Kenya aims to provide an efficient and high quality health care system with
the best standards by year 2030 as enshrined in the Bill of Rights in the Constitution of Kenya 2010.
The Sector takes cognizance of the opportunities and challenges in establishing strong health
systems that are responsive to the population under the current constitution that creates two levels
of government and delineates health care provision to the counties.

Substantial investments have been made by the Government to advance accessible, affordable, and
high-quality healthcare, with a strong focus on equity. Focus has been towards establishing
Universal Health Coverage (UHC) through publicly funded primary healthcare, creating a seamless
universal health insurance system, and allocating resources to cover a wide range of healthcare
services, including preventive, promotional, curative, rehabilitative, and palliative care.

During the period under review, the sector recorded significant milestones attributable to increased
prioritization and augmented funding for healthcare services. Safety programs for both patients and
healthcare workers have been implemented across all levels of healthcare to ensure the delivery of
high-quality services in secure healthcare environments. There have been considerable achievements
in the areas of infrastructural development and equipping of health facilities with modern equipment.
Notably, there has been commendable progress in quality of service in specialized health care
services in referral hospitals and research and innovation with a number of locally manufactured
HPTs. These achievements have been made possible through the adoption of a multi-sectoral
approach.

Despite these accomplishments, the sector continues to grapple with various challenges. These
challenges relate to inadequate funding, limited resources, human resource shortages, the persistent
issue of rising medical costs alongside low insurance enrollment and regulatory challenges for novel
and re-emerging products. As a result, the sector has not fully met the expectations of the public.

To address these challenges and enhance access to essential, high-quality healthcare services for
underserved, marginalized, and vulnerable populations, in line with the UHC Policy, several critical
actions are necessary. These actions involve strengthening adherence to established healthcare
standards, fostering collaboration and involvement across multiple sectors, promoting domestic
resource mobilization, investing in healthcare innovations and local production of healthcare
products and technologies, fortifying legislative and regulatory frameworks within the healthcare
sector.

The government's healthcare strategy places significant emphasis on Preventive health and health
promotion interventions, to align and support the Bottom Up Economic Transformation Agenda
(BETA). Therefore, the sector recognizes the essential nature of a multi-sectoral approach in
addressing the various determinants of health. It intends to collaborate with both government and

302
non-government entities, including Ministries, Departments, Agencies, County Governments, Faith-
Based Organizations, Non-Governmental Organizations, Civil Society groups, the Private Sector,
external stakeholders, and patients, to achieve the goal of delivering high-quality healthcare services.
The adoption of a multi-sectoral approach is viewed as fundamental and rational in addressing the
numerous factors influencing health that extend beyond the healthcare system's control.

303
CHAPTER SIX: RECOMMENDATIONS

Maximizing health outputs and outcomes with the available resources remains the major focus for
the Sector during this Medium-Term Expenditure Framework. The sector has noted several
emerging issues and challenges that have faced the sector during the review period. To realize the
targeted outputs/outcomes and overcome the sector challenges, the following recommendations are
made:

i. There is need to provide social protection to citizens against the catastrophic cost related to
accessing health services through accelerating the implementation of the social health
insurance acts enacted in 2023 to address out-of-pockets costs, enhance access to quality
healthcare, bring services closer to households.
ii. Strengthen and expand the capacity on surveillance as part of preparedness including the use
of technology, analytics, infrastructure, human resource, cross-border and international
collaboration to enable early detection and guided response to potential public health
emergencies.
iii. Enhance Human Resource Capacity: Develop strategies to retain and attract skilled
healthcare professionals, through available structures to mitigate the impact of labor
immigration, labor unrest and improve the health workforce to population ratios and enhance
the technical and managerial skills of healthcare professionals through continuous capacity
development to ensures access to specialized services.
iv. Increase Resource Allocation: Increase budgetary provisions and ring-fence allocations to
reduce donor dependency for the sector to adequately address the health requirement
resource gaps in essential commodities and enable effective implementation of programs and
projects.
v. Provide adequate investment in research for health through performance-based grants to
local research institutes to promote technology and deliver innovative and sustainable health
care delivery solutions for the current and emerging health challenges including those
resulting from the effects of climate change.
vi. Strengthen Regulatory Frameworks: Review existing legal and policy frameworks to protect
the public and fulfil the health rights of all persons in Kenya to the progressive realization of
their right to the highest attainable standard of health. Further, this will ensure effective
regulation of health professionals, healthcare services, health products and technologies and
facilitate in a progressive and equitable manner, the highest attainable standards of health
service.
vii. Increase investments in digital data management and information systems: Invest in robust
health information systems to improve data collection, analysis, and utilization. Implement
electronic medical records, surveillance systems, and enhance data sharing mechanisms for
evidence-based decision-making.

304
viii. Health Promotion and Disease Prevention: Prioritize sector programs and campaigns aimed
at creating awareness for regular screening, access to treatment, palliative care and promoting
healthy behaviors.

305
ANNEXURES

ANNEX I: REFERENCE
The Constitution of Kenya,

Kenya Vision 2030,

Medium-Term Plan (2023-2027),

Post-COVID-19 Economic Recovery Strategy (PC-ERS)

Health Sector Policy Framework 2014-2030,

Bottom-up Economic Transformation Agenda (BETA).

306
 ANNEX II: COUNTY CONSULTATION PRIORITIES CONSIDERATIONS

STATE DEPARTMENT FOR MEDICAL SERVICES

S/NO County Issue Raised Proposed FY 2024/25 FY 2025/26 FY 2026/27

Intervention Health Sector
Intervention
1. Busia, Elgeyo Marakwet, Lack/Shortage of Timely delivery of Capitalization of Local manufacturing and Local manufacturing
Turkana, Machakos, drugs in Health drugs to Health KEMSA with a view to local procurement of HPT and local
Kilifi, Kwale, Lamu, facilities Facilities improve on their Order procurement of HPT
Mombasa, Tana River, Refill rate
Samburu, Kajiado,
Muranga
Nairobi

2. Bungoma, Kakamega Lack of inclusive Roll out Inclusive Rollout of Essential Rollout of Essential Rollout of Essential Health
Nandi, Vihiga NHIF Cover Cover Health Benefit Package Health Benefit Package Benefit Package under the
Elgeyo Marakwet, Trans under the SHIF under the SHIF SHIF
Nzoia, Turkana Low of awareness
Uasin Gishu, Homa Bay, on NHIF Cover Sensitization/awareness Sensitization/awareness Sensitization/awareness
Kericho, Kisumu, Nairobi, creation on Social Health creation on Social Health creation on Social Health
Siaya, Nyamira, Narok, Insurance Insurance Cover/Essential Insurance Cover/Essential
Nakuru, Nyandarua, Cover/Essential Health Health Benefit Package Health Benefit Package
Meru, Garissa, Kitui, Benefit Package
Makueni, Kilifi, Kwale,
TanaRiver
Wajir, Kajiado, Kiambu,
Muranga, Taita Taveta
3. Busia, Homa Bay, Lack of objectivity Objective Criteria in Institutionalization and Establishment of a Establishment of a
Kericho, Kisumu, in recruitment, selection and harmonization of centralized CHPs bureau centralized CHPs
Nairobi, Siaya, Bomet, training and remuneration of CHPs recruitment and bureau for
Kisii, Narok, Nyeri, Meru, equipping of remuneration of CHPs efficient
Kitui, Makueni, Community Health through the Primary management of
Machakos, Kilifi, Kwale, Promoters Health Care Act CHPs
Mombasa, Laikipia,
Samburu, Muranga, Taita
Taveta
307
S/NO County Issue Raised Proposed FY 2024/25 FY 2025/26 FY 2026/27
Intervention Health Sector
Intervention
Digitization of
management of CHPs for
transparency
4. kericho, kakamega, Ensuring that the Carry out an audit of Census already done. Audit the HCF on Audit the HCF on
Homabay, Siaya, Nairobi, HCF are aligned the HCF to determine Analysis of data is regular basis (proposing regular basis (proposing every
Bungoma, Kakamega and equipped where they fall underway to inform every 2 years)for 2 years)for
Nandi, Vihiga according to the action. Upgrade and compliance and compliance and
Elgeyo Marakwet, Trans level they are in downgrade HF levels upholding upholding
Nzoia, Turkana based on assessed standards as per standards as per
Uasin Gishu, Homa Bay, capacity. licensed levels. licensed levels
Kericho, Kisumu, Nairobi,
Siaya, Nyamira, Narok, Harmonized Health MOH to ensure Quality of MOH to ensure Quality of
Nakuru, Nyandarua, Facility assessment is Care of all services is Care of all services is ensured.
Meru, Garissa, Kitui, planned and underway ensured.
Makueni, Kilifi, Kwale, incorporating QOC
TanaRiver
Wajir, Kajiado, Kiambu,
Muranga, Taita Taveta
5. Siaya, Nairobi, Assessment of The PWDs need the Allocate resources for Rollout of Essential Rollout of Essential Health
Kisii,Kisumu,Nakuru, PWDs – charges cards and therefore it printing the cards for Health Benefit Package Benefit Package under the
Kitui, Machakos, for assessment and should be processed at distribution to the PWDS under the SHIF SHIF
Mombasa, Laikipia, treatment are not the national level to at no cost.
Kiambu affordable enable them access Offer PWD free services.
services in a timely PWD medical equipment
manner readily available eg
wheelchairs
No sign language
interpreters in hospital
6. Kericho, Nairobi, Lack of 24/7 Opening time for the MOH to consider change MOH to Quality of care MOH to Quality of care for all
Kakamega,Nakuru Health services dispensaries to be of Policy to ensure that for all which will address which will address the access
mashinani extended to weekends patients can access the access
and longer working Health care any time
hours
7. Nairobi,West Pokot, Linda mama Free maternity to be Linda Mama is still on To be integrated into the Tol be integrated into the
Nakuru,Garissa, Taita program to be re provided 4Billion Essential Health Benefit Essential Health Benefit
Taveta introduced/ free Package under the SHIF Package under the SHIF
maternity
308
S/NO County Issue Raised Proposed FY 2024/25 FY 2025/26 FY 2026/27
Intervention Health Sector
Intervention
8. Uasin Gishu, Vihiga, mental health, Enhance sensitization. Increase budget Enhance sensitization. Enhance sensitization.
Nairobi, Homabay, drug and substance programs on the allocation towards mental programs on the effects of programs on the effects of
Nyamira,Isiolo,Tharaka abuse,GBV effects of health programs and drugs and substance abuse drugs and substance abuse
Nithi,Kitui, Kwale, drugs and substance healthcare
Mombasa, Laikipia, professionals specializing
abuse
Marsabit,Samburu, Wajir, in mental.
Kiambu, Taita Taveta Establish new wellness
rehabilitation.
centers in the county

9. Busia, Kakamega, Inadequate Human Recruit more staff BETA has provided for BETA commitment to BETA commitment
Vihiga,Nandi, Resources for CHPs and the UHC staff recruit 20000 HCW in to recruit 20000
Bungoma,Elgeyo health (8600) phases HCW in phases
Marakwet,Turkana, Trans
Nzoia, Kericho, Kisumu, BETA commitment to
Homa Bay, Nairobi, recruit 20000 HCW in
Siaya, Nyamira, Narok, phases
Nakuru, Nyandarua,
Meru, Garissa, Kitui,
Makueni, Kilifi, Kwale,
Tana River
Wajir, Kajiado, Kiambu,
Muranga, Taita Taveta,
10. Kisumu, Siaya,Migori, Cancer Early detection, Increase allocations to Progressive increments in Progressive increments in
Narok,Embu,Isiolo,Kiriny treatment and care ensure the regional allocations allocations
aga,Meru, Kitu,Machakos, cancer centers.
Laikipia, Kisii Allocation of 155 B for
regional cancer center
and 50B for Kisii level 5
hospital

309
 STATE DEPARTMENT FOR PUBLIC HEALTH AND PROFESSIONAL STANDARDS
County Issue Raised Proposed FY 2024/25 FY 2025/26 FY 2026/27
Intervention Health Sector
Intervention
1 Busia, Elgeyo Marakwet, Environmental 1. Enforce public Empower Counties Empower Counties Empower Counties through
Turkana, Machakos, Health health Laws through technical through technical support, technical support, sensitization
Kilifi, Kwale, Lamu, support, sensitization sensitization and capacity and capacity building of
Mombasa, Tana River, inadequacies 2. Regular and capacity building of building of public health public health officers
Samburu, Kajiado, including water inspection in public health officers officers
Muranga schools
Nairobi pollution and poor
3. Clear drainage
waste management and solid wastes
around water
points/rivers

4. Provision of
medicine to
control and treat
the affected and
control the
bedbugs and the
jiggers

5. Mass indoor
insecticide
spraying
2 Bungoma, Kakamega Weak disease Scale up disease Provide Technical Provide Technical support Provide Technical support and
Nandi, Vihiga surveillance surveillance and support and Capacity and Capacity building of Capacity building of staff in
Elgeyo Marakwet, Trans systems eg takes response in all building of staff in the staff in the counties on the counties on disease
Nzoia, Turkana long to detect and epidemics including counties on disease disease surveillance and surveillance and
Uasin Gishu, Homa Bay, respond to schools surveillance and response
Kericho, Kisumu, Nairobi, epidemics in
Siaya, Nyamira, Narok, schools
Nakuru, Nyandarua,
Meru, Garissa, Kitui,
Makueni, Kilifi, Kwale,
TanaRiver
Wajir, Kajiado, Kiambu,
Muranga, Taita Taveta
310
3 Busia, Homa Bay, Frequent health Strengthen the Kenya Roll out policies to Roll out policies to ensure Roll out policies to ensure
Kericho, Kisumu, worker strikes Health Human ensure optimal staff optimal staff training, optimal staff training,
Nairobi, Siaya, Bomet, Poor welfare Resource Advisory training, distribution and distribution and scale up distribution and scale up staff
Kisii, Narok, Nyeri, Meru, among Health care Council scale up staff welfare staff welfare welfare
Kitui, Makueni, workers
Machakos, Kilifi, Kwale, Shortage of health
Mombasa, Laikipia, care workers
Samburu, Muranga, Taita Persistent Health
Taveta Workers industrial
actions

4 kericho, kakamega, Malnutrition and Provide more fortified Roll out capacity Roll out capacity building Roll out capacity building of
Homabay, Siaya, Nairobi food safety issues porridge for the building of county of county Nutrition staff county Nutrition staff to
malnourished children Nutrition staff to prevent to prevent and provide prevent and provide support to
eg severe Put mechanisms to and provide support to support to cases of cases of malnutrition
malnutrition cases ensure the fortified cases of malnutrition malnutrition
porridge is given to
and lack of the malnourished Implement policies on
adequate food children only food safety and roll out
Public awareness Implement policies on
safety standards food safety and roll out Implement policies on food
Public awareness safety and roll out Public
awareness
5 Nairobi,West Pokot, Sub-optimal Sensitization of Roll out of robust health Roll out of robust health Roll out of robust health
Nakuru,Garissa, Taita Health Promotion communities on education and promotion education and promotion education and promotion of
Taveta various health issues of health lifestyles in of health lifestyles in health lifestyles in conjunction
and education eg conjunction with all conjunction with all with all counties and other
lack of awareness Sensitization of the counties and other counties and other stakeholders
communities on the stakeholders stakeholders
on many health importance of
issues including delivering at the
hospitals
Health policies CHPs to be provided
and Laws with training on
midwifery services
Health education on
harmful cultural
practices

311
 Sensitization of the
communities on the
importance of
delivering at the
hospitals
CHPs to be provided
with training on
midwifery services

Sensitization on the
importance of
education especially
for the girl child

Enforcement of the
education of the girl
child

Additional funding for

youth friendly health
services to ensure the
services are available
and friendly and
easily accessible

6 Uasin Gishu, Vihiga, Lack of Training Development of Development and roll out Development and roll out Development and roll out of
Nairobi, Homabay, opportunities eg standards for students of standards for students of standards for students standards for students training
Nyamira,Isiolo,Tharaka lack of land to training and training and training and and placements/attachments
Nithi,Kitui, Kwale, construct placements/attachmen placements/attachments placements/attachments Development and
Mombasa, Laikipia, additional KMTC ts Development and Development and implementation of a
Marsabit,Samburu, Wajir, campuses implementation of a implementation of a framework on how Counties
Kiambu, Taita Taveta Counties to provide framework on how framework on how can provide land to facilitate
Students are land to construct Counties can provide Counties can provide land to construction of additional
allowed to conduct land to facilitate to to facilitate to KMYC Campuses
additional KMTCS
procedures construction of additional construction of additional
unsupervised. KMYC Campuses KMYC Campuses

312
7 Busia, Kakamega, Lack of optimal Regulatory agencies to Regulatory bodies should Regulatory bodies should Regulatory bodies should to
Vihiga,Nandi, standards/regulatio improve surveillance to open offices in each to open offices in each open offices in each county
Bungoma,Elgeyo of health safety of county county
Marakwet,Turkana, Trans n of HPT products products for human
Nzoia, Kericho, Kisumu, consumption
Homa Bay, Nairobi,
Siaya, Nyamira, Narok,
Nakuru, Nyandarua,
Meru, Garissa, Kitui,
Makueni, Kilifi, Kwale,
Tana River
Wajir, Kajiado, Kiambu,
Muranga, Taita Taveta,

313