Quick Answer
Health is a shared function. County governments run most health facilities and deliver day-to-day services, while the national government sets health policy, regulates the sector and runs national referral hospitals.
Key facts
- County governments run most health facilities.
- The national government sets policy and runs referral hospitals.
- County health is a devolved function under the Constitution.
- Both levels are funded partly through the national budget.
What counties do
Under devolution, county health services are a county function. Counties run dispensaries, health centres and county and sub-county hospitals, employ much of the health workforce, and manage primary and county-level care.
What the national government does
The national level keeps policy and oversight: setting national health policy, regulating medicines and professionals, managing national referral hospitals (the most specialised), and coordinating programmes such as immunisation.
Why the split sometimes causes friction
Because money and staff sit at the county level but policy and some funding sit nationally, disputes over funding, staffing and strikes are common. Knowing which level is responsible helps you direct a complaint to the right office.
Why this matters to you
When a clinic lacks medicine or staff, the responsibility usually lies with your county government — not the national Ministry. Knowing the split tells you which leader to hold to account.
Frequently asked questions
Is health a county or national function?
Both — counties run facilities and services; the national level sets policy and runs referral hospitals.
Who runs my local dispensary?
Your county government.
Who runs national referral hospitals?
The national government.
Sources & references
- Constitution of Kenya 2010, Fourth Schedule — klrc.go.ke
- Ministry of Health — health.go.ke