Fresh Amendments on Health Bill Gives lifeline to Nairobi Hospital CEOs

Chief Executive Officers (CEOs) of Nairobi’s Level 5 county hospitals are set to benefit from fresh amendments to the Nairobi City County Health Services Bill, which seek to formally establish their positions in law and provide a clear framework for their appointment and tenure.

The latest amendments adopted by the Nairobi County Assembly introduce a new Clause 14A, creating the office of the Chief Executive Officer of a County Hospital for every Level 5 health facility in the county.

Under the proposed law, every County Hospital (Level 5) will have a CEO who will serve as the chief administrative officer of the hospital.

The CEO must be an officer in the County Public Service and will be appointed competitively by the County Public Service Board.

The amendments further provide that successful candidates will serve a three-year term, renewable once for a final three-year term, subject to satisfactory performance and terms set by the County Public Service Board.

To qualify for 0appointment, a candidate must possess a degree from a university recognized in Kenya in health sciences, health systems management, hospital administration, business administration, public administration, or another relevant field.

The proposed law also requires candidates to have at least 10 years of relevant experience in health services management or public administration, among other qualifications reflected in the amendments.

The Assembly also approved amendments to Clause 13(5) by replacing the words “shall not be eligible” with “shall be eligible” and substituting the word “unless” with “if”, effectively broadening eligibility for appointment.

Similarly, Clause 13(6) was amended by deleting the word “not” after the word “shall” and replacing “unless” with “if”, changes that further align the appointment provisions with the new governance framework.

Additionally, the Assembly amended the composition of the relevant board by replacing one of the membership provisions to require one person with experience in human resource and/or administration.

The amendments are expected to strengthen governance in Nairobi’s public hospitals by providing legal certainty on the appointment, qualifications, tenure and responsibilities of hospital chief executives, while enhancing professionalism and accountability in the management of county health facilities.

Commenting on the changes,Mutuini Level IV Chief Executive Officer Dr. Martin Wekesa Wafula welcomed the move, noting that it gives a clear path for the positions and allow the county to plan.

The Nairobi City County Health Services Bill, 2025 was sponsored by Kilimani MCA Moses Ogeto, who said the proposed legislation seeks to establish a comprehensive legal framework for the delivery, regulation and management of health services across the county in line with the Constitution.

Ogeto argued that despite Nairobi being home to millions of residents and hosting referral facilities serving patients from across the country, the county has operated for years without a standalone law to guide the management of its public health facilities, governance structures and service delivery.

He said the Bill is designed to improve access to quality healthcare by providing clear governance structures for county hospitals, strengthening accountability, standardising health services and ensuring every ward has access to properly equipped health facilities. The legislation also seeks to align Nairobi’s health sector with the county’s constitutional mandate of providing health services.

During debate on the Bill, Ogeto noted that Nairobi’s daytime population exceeds 5.7 million people, placing enormous pressure on existing health facilities. He said the reforms are intended to ensure the county builds and equips health facilities across all wards while creating a legal framework that supports efficient and professional management of public hospitals

Ogeto has maintained that the legislation is intended to transform Nairobi’s public health system by creating predictable governance structures, improving service delivery and enhancing accountability in the management of county health facilities. The latest amendments introducing fixed-term Chief Executive Officers for Level 5 hospitals form part of that wider reform agenda.