The Mess in County Govt Health Sector: A Crisis in the Making

From collapsing hospitals to striking doctors, lack of essential medicines, and rampant corruption, the healthcare system in most counties has become a shadow of its intended purpose. While governors boast of new hospitals and ambulances, the people at the grassroots—expectant mothers, the elderly, and accident victims—are left to suffer in silence.

At the heart of the crisis is the continuous standoff between county governments and healthcare workers. Doctors and nurses go months without pay, pushing them to strike repeatedly. In places like Embu, Kisumu, and Vihiga, hospitals have been shut down due to unresolved salary arrears.

“I have not been paid for four months, yet I am expected to show up and treat patients,” says one Dr. Wanjiku, a medical officer in a county referral hospital. “We work under extreme conditions, and when we complain, we are threatened with dismissal.”

The irony? Governors and health executives continue to draw fat salaries while hospitals struggle with basic operations. Patients are often turned away or forced to buy medicine from private pharmacies because county hospitals lack stock.

A closer look at most county budgets reveals a worrying trend: billions allocated for health services often disappear without a trace. Auditor General reports have repeatedly flagged misappropriation of health funds, yet little action is taken.

Take, for example, a county that allocated KSh. 500 million for the construction of a modern ICU facility. Five years later, the project remains a ghost structure, while critically ill patients are referred to Nairobi or Eldoret for treatment.

“The corruption in county health departments is shocking,” says a whistleblower from one of the procurement offices. “Tender cartels inflate costs, purchase expired drugs, or divert funds meant for essential services.”

For patients, the nightmare is real. Public hospitals in most counties are stretched beyond their limits. With doctors on strike or resigning in frustration, clinical officers and nurses are left to handle overwhelming cases.

In some level four hospitals, a single doctor attends to over 50 patients in a day. Maternity wards are overcrowded, forcing women to give birth on benches. Oxygen cylinders run out, dialysis machines are broken, and ambulances are used more for political campaigns than emergencies.

Despite the crisis, some counties have shown that a functioning health system is possible. Makueni and Kisii counties have been praised for implementing universal healthcare programs, where residents can access treatment affordably. The question is, why can’t all counties replicate this?

The solution lies in accountability. Health CSs, governors, and county health executives must be held responsible for every shilling allocated to health services. Medical staff need better pay and working conditions to prevent brain drain. More importantly, the people must demand better.

As Kenya moves towards the 2027 elections, voters must scrutinize leaders who promise improved healthcare. Because, at the end of the day, a failed health system means lives are lost—deaths that could have been prevented.

Devolution was meant to be a blessing, not a curse. But unless county governments fix the mess in healthcare, the suffering of ordinary Kenyans will only deepen. And while governors give speeches about "milestones," the sick continue to queue in long, hopeless lines, waiting for a healthcare system that works.