In Kenya, Open Contracting Improves Efficiency & Curbs Corruption

With citizens’ lives on the line and government spending at record highs, ensuring accountability to citizens is imperative to maintaining trust and effectively managing KEMSA’s procurement in response to COVID-19. Open procurement data can help in improving the efficiency of emergency procurement and support civil society groups to detect corruption and monitor the effectiveness of service delivery.

“This level of transparency and through the use of technology will go a very long way in ensuring that we have the confidence of our people that those placed in institutions are able to manage the resources of the Kenyan taxpayer plus our development partners in an open and transparent manner” – President Uhuru Kenyatta

Much can be learned from Makueni County in Kenya, a county that publishes and uses open, accessible, and timely information on government contracting to engage citizens and businesses. The Makueni Open Contracting Portal is an interactive site built by Development Gateway (DG) that provides detailed information on each step of the tender, award, and contract implementation process at the county level. These steps are now recorded within the interactive Makueni Open Contracting Portal – making information available for citizens at each step of the process. The county plans to go a step further to publish all implementation data such as community monitoring reports, also known as PMC reports and supplier payment vouchers.

The goal of the portal is to improve the efficiency of public procurement management and support the delivery of higher-quality goods, works, and services for residents of Makueni County through enhanced citizen feedback.

What We Learned from Makueni County

Lesson 1: Public Data Improves Efficiency

The primary role of the Ministry of Health and KEMSA in Kenya during an emergency situation is to provide citizens timely, affordable, and efficient supplies and services. Digitizing and publishing procurement data will provide the Ministry insights on whether funding and services are reaching intended beneficiaries. 

Publishing procurement data will also encourage better monitoring from relevant state and non-state actors. The Ministry of Health and KEMSA will have the opportunity to aggregate non-state actors’ feedback and state actor insights. This feedback will enable them to make data-driven decisions that will improve service delivery to citizens, promote efficient allocation of resources and ultimately saving costs.

DG has developed interactive M&E dashboards to support analysis currently used by Makueni County. The series of charts and visualizations provide helpful data insights – such as top suppliers that received contracts and the percentage of awards that go toward the Access to Government Procurement Opportunities (AGPO), which requires tenders to be awarded to women, youth, and people with disabilities.

Since the start of the use of the Makueni open contracting portal in 2019, improved resource utilization and efficiency in procurement has been identified by the County leadership. Governor Kivutha Kibwana cited that the County has saved Kes. 30,000,000 from the Roads department as a result of using the portal.

Lesson 2: Building Trust is Essential to Combating Corruption

The complexity of emergency responses such as COVID-19 requires cooperation between the private sector, national, and county government to ensure timely delivery of supplies. KEMSA publishing data will promote feedback and engagement of business and citizens further building trust and collaboration. Publishing procurement data also equips civil society and citizens with the information needed to help combat corruption. For example, reporting counterfeits, frauds, and scams – which has been a key corruption issue identified globally in COVID-19 response procurement, particularly PPEs.

DG has implemented its corruption risk dashboard in Makueni, which uses high powered analytics and global research to identify risk profiles for potential corruption in procurement. KEMSA can adopt the corruption risk dashboard as a red-flagging tool to assist in identifying procurement activities that merit in-depth auditing of corruption risk – including fraud, collusion, and process rigging – over time. These analytics will allow the organization to address cases of corruption before taxpayer money is lost.

Lastly, publishing Beneficial ownership data can enable governments to quickly perform minimal standards of due diligence on companies they are buying goods and services from. As well as reducing the immediate risk of corruption, beneficial ownership data provides a valuable trail for future audit.

Development Gateway: An IREX Venture (DG) is pleased to announce the publication of a research manuscript on Mortality from Tobacco Use in Kenya. This research was carried out as part of the Tobacco Control Data Initiative (TCDI) activities in Kenya and is part of a broader report on Morbidity and Mortality from Tobacco Use in Kenya and the Economic Costs. Data from this research is available on the TCDI Kenya dashboard, which aims to supply decision-makers in government, members of civil society, and academia with improved access to country-specific data to better inform tobacco control policy. 

This is the second of three manuscripts which seek to break down the research report’s findings. The first, published in November 2023, explored the prevalence, patterns, and factors associated with tobacco use among patients with tobacco-related illnesses such as cancers, cardiovascular disease, chronic respiratory disease and diabetes.

This blog highlights some key findings in the manuscript from the research carried out in Kenya in 2021 on morbidity and mortality from tobacco use in Kenya and the economic costs thereof. 

Why research on Mortality from Tobacco Use in Kenya?

In Kenya, about 12,000 individuals die from tobacco smoking each year. Tobacco smoking is a risk factor for numerous diseases, including chronic respiratory diseases, cardiovascular diseases, various cancers, and diabetes. Tobacco use results in disability and death and imposes significant economic costs on Kenya’s health system and economy. In 2020, Kenyan tobacco control stakeholders requested domestically collected and analyzed data on mortality arising from tobacco use in Kenya to assist decision-makers make and implement tobacco control policies.

Key findings from the research

All-cause mortality data of deaths that occurred in Kenyan health facilities at sub-county, county and national levels between 2012 and 2021 was systematically reviewed from hospital medical records. Deaths arising among persons 35 years and older from five types of tobacco-related illnesses (respiratory diseases, diabetes mellitus, malignant cancers, tuberculosis, and cardiovascular diseases) were identified, and the fraction of deaths attributable to tobacco smoking was calculated. 

Between 2012 and 2021, Kenya experienced 60,228 deaths attributed to tobacco-related diseases (respiratory diseases, diabetes mellitus, malignant cancers, tuberculosis, and cardiovascular diseases) among adults aged 35 years and older. The age of 35 years is significant as these are classified as premature deaths that occur when people are still economically productive. 

Out of the 60,228 observed deaths,  9,943 (16.5%) were attributed to tobacco smoking.

Out of the 9,943 deaths attributable to tobacco smoking, 8.7% were women, and 91.3% were men, primarily because men smoke more than women. The major contributors to mortality included respiratory diseases (41%), malignant cancers (31%), tuberculosis (13%),  cardiovascular diseases (9%) and diabetes mellitus (6%). 

Among respiratory infections, pneumonia and influenza (86%) predominated, surpassing COPD (13%) and bronchitis/emphysema (1%). The year 2020 witnessed a significant twofold increase in pneumonia and influenza deaths, attributed to COVID-19. 

Noteworthy cancers with the highest deaths included larynx cancer (71%), lung cancer (60 and oropharyngeal cancer (51%). Cerebrovascular diseases (87%) emerged as the primary cardiovascular cause of death, followed by ischemic heart diseases (10%) and other arterial diseases (3%).

To address the significant impact of tobacco-related diseases on mortality in Kenya, a multifaceted approach to intervention is needed, including:

1. Progressively and regularly increasing tobacco taxes and enforcing smoke-free policies in public spaces to reduce tobacco consumption and exposure to secondhand tobacco smoke.  
2. Comprehensive public awareness campaigns, utilizing various media channels to emphasize the association between tobacco use and diseases highlighted in the study findings.
3. School-based programs to educate the younger population about the dangers of tobacco, aiming to deter initiation. 
4. Training of healthcare providers to offer effective smoking cessation counseling during routine visits, and access to cessation resources should be improved.

The final manuscript from the research report will focus on the economic burden of treating tobacco-related illnesses, to be published in the coming months. If you would like to learn more about TCDI and explore country-specific data, kindly visit www.tobaccocontroldata.org.