Nyikal says strategic health programmes affected by budget cuts

National Assembly Health Committee Chairperson James Nyikal has said that strategic health programmes like HIV, Malaria, TB and blood have been a target of unilateral budget cuts in supplementary budgets, causing severe stockout of critical commodities.

Dr Nyikal, who made a presentation before the National Assembly Budget Appropriation Committee, warned that supplementary budget cuts have hampered the government's ability to meet the agreed-upon co-financing/counterpart funding for donor-funded projects.

He said postgraduate medical trainees undertaking specialist training in Kenyatta National Hospital, Moi Teaching and Referral Hospital, and Kenyatta University Teaching, Referral and Research Hospital continue to receive salaries from respective counties despite providing clinical services and undergoing training within institutions managed and funded by the national government.

“The Health Committee further observed that national referral facilities currently lack structured staff establishments and dedicated payroll provisions for postgraduate trainees, despite being the primary centres for specialist training and clinical mentorship in the country,” said Nyikal.

He told the committee chaired by Alego Usonga MP Samuel Atandi that the current arrangement has imposed a financial burden on county governments, created disparities in remuneration and sponsorship and contributed to delays in salary payments and training coordination challenges.

The Ministry of Health owes Kenya Medical Supplies Authority (Kemsa) Sh1.9 billion with the pending bills emanating from warehousing and distribution of donated commodities like. cancer commodities and other healthcare equipment.

Notably Kemsa has no budget to cater for these warehousing and distribution expenses.

Nyikal recommended that the Health Cabinet Secretary within 30 days, submits a Cabinet Memorandum seeking the revocation of the recurrent budget cuts imposed on agencies under the Ministry of Health, particularly where the affected allocations relate to personnel emoluments and statutory payroll obligations.

“He said that upon approval of the Cabinet Memorandum, the National Treasury should reinstate the affected recurrent budget provisions in order to restore agencies’ capacity to meet salary commitments, statutory remittances, and other essential operational obligations,” said Nyikal.

He recommended that in the next 90 days, the Education Cabinet Secretary in consultation with his Health counterpart, the Commission for University Education (CUE) and professional regulatory bodies, initiates amendments to the Universities Act, 2012, particularly Section 5A on the functions of the CUE, to provide for mandatory joint accreditation and regulation of medical and health-related programmes by CUE and relevant health sector regulators.

Nyikal said that the health sector’s Sh175.56billion budgetary allocation for the 2026/27 financial year will enable the implementation of the Health Policy, Health Regulations, Management of National Referral Health Facilities and Technical assistance to counties.

He noted that this comprises Sh141.97 billion and Sh33.56 billion allocations to recurrent and development expenditures respectively with this allocation reflecting a Sh10.67 billion increase compared to 2025/26 financial year (approved supplementary I allocation of Sh164.87billion).

“Reductions in recurrent budget allocations by the National Treasury have adversely affected agencies under the State Department of Medical Services, given that these funds primarily support personnel emoluments and related operational obligations,” said Nyikal.

Consequently, agencies have increasingly depended on their limited Appropriations-in-Aid (A-I-A) revenues to bridge the funding gap, leading to delays in statutory remittances and salary obligations, while exposing the institutions to potential KRA penalties and legal liabilities.

Nyikal said told the committee chaired by Alego Usonga MP that the Health Committee observed with concern that the Social Health Authority has faced significant challenges in effecting timely and equitable reimbursements to both public and private healthcare facilities.

The Seme MP said that Public health facilities have been disproportionately affected by delayed reimbursements, despite these funds constituting a critical source of Appropriations-in-Aid (AIA) used to support operations, procurement of medical supplies, and payment of essential services.

“The Health Committee noted that the persistent delays in processing and settling claims have severely disrupted service delivery in public healthcare facilities, leading to operational constraints, accumulation of pending bills, shortages of essential commodities, and increased financial distress across the public health system,” said Nyikal.