Emergency medical care in many parts of the country is falling short, leaving patients exposed to serious risks when they need help the most. Recent audit reports show that county governments are struggling to provide timely and effective emergency response, with delays that often turn treatable conditions into fatal situations.
According to the findings by Auditor General Nancy Gathungu, emergency services across counties are weakened by poor planning, limited resources, and lack of coordination.
The audits, covering the financial years from 2017/2018 to 2024/2025, reveal that many patients wait far too long before receiving urgent medical attention, both in cities and rural areas.
A major concern is the state of ambulances. Nearly a third of ambulances across the country are not operational, making it difficult to transport patients quickly during emergencies.
In some counties, ambulances are grounded due to lack of fuel, missing equipment, or shortage of trained staff. Counties such as Uasin Gishu, Nyandarua, Isiolo, Tharaka Nithi, Kisumu, Tana River, and Garissa are among those affected.
The situation is made worse by outright shortages, with Nairobi lacking 30 ambulances, Kiambu 11, Busia seven, and Mombasa five.
The audits also point to the absence of a coordinated national emergency dispatch system. Most counties rely on outdated communication methods, with no real-time tracking of ambulances and, in many cases, no toll-free emergency contact lines.
As a result, response times fall well below international standards, which recommend ambulance arrival within 15 to 20 minutes. In some regions, patients wait between one and two hours. Data from eight counties show that only Machakos met the recommended dispatch time, while others recorded delays of up to 60 minutes.
“Of 269 ambulances reviewed, 34 per cent were non-functional, with many lacking basic life-support supplies,” the audits show. Gathungu warned that response times of up to 60 minutes often lead to loss of life.
Hospitals are also ill-prepared to handle emergencies. Only nine per cent of Level 4 hospitals audited had proper accident and emergency units, and none had separate paediatric emergency sections. Most Level 4 hospitals lacked essential equipment such as piped oxygen, ventilators, and intensive care units. Staffing levels were critically low, with nurse-to-patient ratios far above recommended standards.
A previous audit released in June 2024 linked weak ambulance services and poor referral systems to high maternal and newborn deaths. Reviews of 146 cases showed that many deaths were caused by delays in accessing ambulances or during transfers between health facilities.
The Auditor General has urged counties to urgently establish fully functional emergency departments in Level 4 and 5 hospitals, staffed with trained personnel and properly equipped. Without these reforms, the reports warn, preventable deaths will continue to occur.
