Devolution status: Why counties are struggling to run health systems

Vice-Chairperson Mutahi Kahiga during an interview at his COG office in Nairobi on April 22, 2025. [Boniface Okendo, Standard]

Devolution was a people-driven mandate enshrined in Kenya’s Constitution, which placed health among its flagship devolved functions. Yet, more than a decade later, doubts persist over whether the sector is firmly secured under county governments or gradually reverting to the national government control.

While some counties have built strong health systems, others still grapple with glaring gaps.