Public health is worse off under county governments

A health worker during a nationwide vaccination campaign to administer the Measles-Rubella and Typhoid Conjugate Vaccine to children aged 9 months to 14 years at Mutuini Sub-County Hospital, on July 16, 2025. [Kanyiri Wahito, Standard]

The devolution of health services, heralded as a bold democratic experiment under the 2010 Constitution, has yielded mixed outcomes. While localised governance has improved infrastructural visibility and political responsiveness in some counties, the case of public health paints a far grimmer picture: One of fragmentation, professional attrition, and resurgent disease burdens.