The Kenya Medical Supplies Authority (KEMSA) Act 2013, lays the framework for procurement and supply of medical products or materials throughout the country. The implication is that the 47 county governments in Kenya depend on KEMSA for such supplies.
However, there have been complaints relating to sub-standard equipment supplied to hospitals, corrupt procurement dealings and delayed supplies to medical institutions across the country. This is the current state of affairs in the health sector despite the fact that the practice is not in harmony with the objects and principles of devolved government as enunciated in the Constitution of Kenya.
Since establishment of devolved government units, the health sector has undergone devolution, but KEMSA has questionably remained centralised. This situation has not only impeded equitable provision of medical services to the people but has also perpetuated corrupt dealings by some public servants and cartels at the top. Clearly, those resisting devolution of KEMSA appear to be promoting the monolithic practice which characterised the former Central Tender Board and now KEMSA, for the benefit of the few greedy individuals.
In a study commissioned by the World Bank and USAID (2014), who are key partners and financiers of KEMSA, it was noted that in the post-devolution KEMSA model, the cost of products to the counties include procurement, warehousing and distribution which comes to at least 8 per cent. This is a heavy cost being passed on to the county governments by the National Government for functions that can effectively be handled by the county governments themselves.
Another key lesson learnt from the study was that political goodwill is a pre-requisite for implementation of the various recommendations proposed in order to achieve devolution of KEMSA services. This is a clear indictment on the political leaders in national government who have made it their mission to frustrate devolution of these services. It is clear they have an interest in controlling procurement of medical supplies at the national level.
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When cartels assemble to decide on what to buy for hospitals across the 47 counties like the case of the medical equipment scandal, you can be sure Kenyans are being taken for a ride. Doubtlessly, the devolution or decentralisation of KEMSA will stop the perennial problem in the health sector by ensuring quality and effective management by the devolved units as well as quality provision of health services in the 47 counties.
Instructively, sentiments echoing the need for decentralization of KEMSA have been noted across the country in the recent past. It is in view of the aforesaid that KEMSA urgently needs to be fully decentralised for it to remain relevant.