Nairobi Hospitals in Crisis: Stalled Projects and Funding Shortfalls Plague Healthcare

The Public Accounts Committee (PAC) of the Nairobi City County Assembly has uncovered a critical situation at Mutuini and Mbagathi County Hospitals, characterized by stalled projects, extreme overcrowding, and severe funding shortages. Chege Mwaura, the committee chair and Ngara Ward Representative, outlined the challenges during a recent site visit.

“We are here at Mbagathi County Hospital for a fact-finding exercise,” Mwaura said. “The Auditor General had raised concerns regarding congestion and several stalled projects. We have confirmed that congestion has intensified, tripling in recent times.”

The PAC’s investigation revealed several causes behind the hospitals’ overwhelmed capacities. Mwaura cited delays in remittances from the Social Health Authority (SHA) and outstanding debts from the now-defunct National Health Insurance Fund (NHIF) as major setbacks to hospital operations. He also pointed out the lack of financial support from the Nairobi County Revenue Fund.

“Everything the hospital has managed to achieve has been through its internally generated revenue,” he noted.

A major concern raised by the committee was the number of incomplete county-initiated projects.

“All the stalled projects are county-run initiatives; none were started by the hospital,” Mwaura emphasized.

The PAC plans to engage City Hall officials to seek accountability for the delays and to push for the release of necessary funds to complete the projects.

Mwaura also called for a change in the county government’s approach to managing healthcare.

“Rather than contracting management companies for environmental services, the county should prioritize support for level 5 hospitals,” he argued, pointing out the imbalance between hospital-driven initiatives and county-led projects.

He specifically mentioned the stalled microwave incinerator project, which is 70% complete, and a delayed transformer installation as examples of critical infrastructure suffering from funding issues. With the current power supply inadequate, the hospital is forced to rely on costly diesel generators. Mwaura advocated for greater autonomy for county-level 5 hospitals, similar to the operational model between Mbagathi Hospital and the national government.

“The transformer project has been stalled for about a year, requiring just 21 million Kenyan Shillings to complete,” he noted.

Mwaura also criticized Governor Johnson Sakaja’s proposed healthcare initiatives, arguing that they do not address urgent needs.

“We’re seeing misplaced priorities in the governor’s health projects,” he said. “Even at Mama Lucy Kibaki Hospital, there’s no financial support coming from City Hall.”

Financial strain at Mbagathi Hospital is worsened by substantial debts owed by SHA and the defunct NHIF.

“Currently, SHA owes Mbagathi Hospital 107 million shillings, while the defunct NHIF owes 305 million,” Mwaura revealed. “This is a public hospital, and these debts cripple its only revenue streams. Without timely reimbursements, hospitals are forced into unsustainable charity.”

Mwaura stressed that similar financial challenges affect other county hospitals, including Mama Lucy, Pumwani, and Mutuini.

Power outages at Mbagathi are not only due to unpaid Kenya Power bills but also to the expanded hospital services sharing an already strained grid with surrounding communities like Kibra.

“We’re expanding services in theatres, radiology, the lab, and the ICU,” Mwaura explained.

The hospital’s frequent reliance on diesel generators significantly increases its operating costs.

Mwaura also touched on patient waivers, explaining that while the governor often issues them on humanitarian grounds, waivers are frequently requested by senators and county assembly members to assist vulnerable patients.

The PAC’s findings point to systemic challenges across Nairobi’s public healthcare facilities. Their forthcoming report will offer a full analysis of the issues and propose reforms, including addressing stalled projects, bridging funding gaps, and granting level 5 hospitals greater financial independence.

The committee also visited Mutuini Health Facility, where construction of a new wing initiated by the Nairobi Metropolitan Services (NMS) has similarly stalled.