KERUGOYA — In a bright, tiled corridor of the Kerugoya County Referral Hospital, a group of officials from Tharaka Nithi and Taita Taveta counties pause to admire the newborn unit. It is spotless. Well-equipped. And, they say, a model of what county health care should look like.
They are here for a reason.
Kirinyaga County has quietly become a frontrunner in Kenya’s public health sector, thanks in large part to a financing approach that gives hospitals more control over their own revenue. Known as the Facility Improvement Fund (FIF), the model allows public hospitals to keep money they generate and use it for everyday operations, rather than waiting for long bureaucratic approvals from Nairobi.
“The difference is visible,” said Franklin Mawira, Member of County Assembly for Chogoria Ward in Tharaka Nithi. “From the newborn unit to the psychiatry wing, services here are not only functioning they’re ahead of what many national facilities can offer.”
The visiting team toured the 341-bed Kerugoya facility, which now houses a modern intensive care unit, high-dependency unit, operating theatres and digital monitoring systems. The delegation said it came not just to observe but to take lessons home.
“This is the future,” said Violet Mkamburi, Taita Taveta’s Chief Officer for Health. “We’re preparing to build a level five hospital. What we’ve seen here gives us a blueprint everything from infrastructure design to financial autonomy.”
A Break from the Old Model
Under FIF, hospitals appoint independent boards that oversee how revenue is spent whether on repairs, supplies, or staffing gaps. That autonomy means fewer delays, and quicker responses to patient needs.
Daniel Kibinga, the MCA for Ngariama Ward in Kirinyaga, said the local assembly played a crucial role by passing laws that support FIF. “The board doesn’t have to wait for approval from Nairobi,” he said. “If something breaks, they fix it. That’s how a hospital should run.”
Health experts say the system is not perfect, but it’s a clear improvement over older models that often left hospitals waiting months for basic supplies. According to Dr Mwendia Mutema, Head of Infectious Diseases at the hospital, the model is already paying off.
“Our recurrent services are stable now,” he said. “FIF helps us meet the rising demand for affordable, quality health care.”
National Attention
Seven counties including Turkana, Laikipia, Nyeri, and Bomet have already sent delegations to Kirinyaga to observe the changes firsthand. Governor Anne Waiguru, who has championed the model since taking office, said the interest from other regions shows the health reforms are delivering.
“When we opened the new medical complex, we aimed to offer services our people were travelling to Nairobi for,” Waiguru told reporters. “Now we are doing it here.”
She added that the county had invested heavily in both infrastructure and systems. A hospital-wide digital management tool helps track patient data, manage stock, and flag gaps in services in real time.
That technology, combined with local autonomy over funds, has made a visible impact. According to a recent survey by Infotrak, Kirinyaga now ranks third in the country for overall health sector performance.
Lessons and Limits
Still, not everyone can replicate Kirinyaga’s model overnight. Smaller counties may lack the administrative capacity or initial investment needed to set up similar systems. Others face political or logistical hurdles.
But those who’ve made the trip say the lessons are clear.
“Seeing it in action is different from reading about it in reports,” said Mkamburi. “We’re leaving with a checklist of what to implement.”
As the officials wrapped up their visit, one thing was clear: in a country still struggling with gaps in health care, Kirinyaga has given others something to aspire to and perhaps, a path to follow.
