Why Reuben Kigame wants national govt to take firm grip of health decisions
By Faith Lagat, January 18, 2026Renowned gospel musician, human rights activist, and 2027 presidential aspirant Reuben Kigame has reignited debate on the governance of Kenya’s health sector by calling for full national government control of health services.
National control versus devolution debate
In an X post dated January 18, 2026, Kigame argued that healthcare decisions should be centralised, saying counties are not adequately prepared to manage the sector.
“Thinking of Kenya‘s health sector, we need to consider factors beyond the challenges behind SHA and SHIF. My personal opinion is that all health service decisions should be under and controlled by the national government. Counties do not seem ready and equipped to handle health matters, not to mention all the unnecessary politics that go with it,” he stated.
His remarks come against the backdrop of Kenya’s devolved system of governance established under the 2010 Constitution, which transferred responsibility for most health services to county governments.
While devolution was intended to bring services closer to communities, it has also been marked by disparities in service delivery, frequent industrial unrest, and uneven capacity across counties.
Concerns over health reforms and service delivery
Kigame’s comments also intersect with ongoing public debate surrounding the rollout of the Social Health Authority (SHA) and the Social Health Insurance Fund (SHIF), which replaced the National Hospital Insurance Fund (NHIF). The transition has faced implementation challenges, including delays in payments to healthcare providers, system inefficiencies, and public confusion over registration and benefits.
By urging Kenyans to look beyond SHA and SHIF, Kigame shifted focus to broader structural questions about who should ultimately be responsible for healthcare decision-making. His position reflects concerns raised by sections of the public who argue that fragmented management has weakened accountability and coordination in the sector.
Recent developments illustrate the complexity of the current system. On January 2, 2026, SHA Chief Executive Officer Mercy Mwangangi announced that the authority had invited Expressions of Interest from qualified overseas healthcare providers to offer specialised services not available locally.
The move, anchored in the Social Health Insurance Act No. 16 of 2023, allows beneficiaries access to advanced treatment abroad under defined funds, including SHIF and the Emergency, Chronic and Critical Illness Fund.
Kigame’s broader critique of the health sector
Kigame has previously expressed concern about the direction of Kenya’s health system. In a December 28, 2025, post, he warned of what he termed the “weaponisation of the health sector by our government in conjunction with global players”, claiming neglect of hospitals and questionable policy decisions.
He also raised consumer safety issues, stating, “Products in our supermarkets, chemicals in our soils, fast foods and other consumer products are killing our people,” and added, “Also, not all vaccines are good for us.”