President William Ruto has called for the inclusion of members of the public in hospital management boards to strengthen accountability and ensure healthcare funds are spent on essential services.
Speaking during a church service at ACK Kapsabet Church on Sunday, October 18, 2026, the President said public participation in hospital management would help prevent the misuse of funds and improve service delivery in public health facilities.
Ruto proposed a management structure similar to that used in public schools, where community representatives work alongside government officials and other stakeholders to oversee operations.
He argued that hospital boards should include doctors, government representatives, county officials and members of the public to improve oversight of expenditure.
Ruto Raises Concerns Over Use of SHA Funds
The President expressed concern that some hospitals were spending money received through the Social Health Authority (SHA) on infrastructure projects instead of prioritising medicines and other essential medical supplies.
He cited cases in which health facilities allegedly used funds to construct gates or install cabro paving rather than purchase medicines needed by patients.
Ruto said hospitals receiving money directly from the government had a responsibility to ensure the funds were used to meet patients' immediate healthcare needs.
He stressed that purchasing medicines and essential medical commodities should take priority over non-urgent infrastructure improvements.
President Wants Public Involved in Hospital Management
Ruto said including members of the public on hospital management boards would help strengthen accountability and give communities a greater role in monitoring how healthcare resources are used.
Under the proposed model, community representatives would work alongside medical professionals and government officials to oversee hospital operations and expenditure.
The President drew comparisons with public schools, where boards of management include parents, community representatives and other stakeholders.
He argued that a similar approach in the health sector could help ensure public resources are directed towards improving patient care.
However, the proposal would require an appropriate implementation framework, particularly because county governments are responsible for managing county health services.
SHA Funding and Hospital Accountability
The remarks come as Kenya continues implementing reforms in healthcare financing through the Social Health Authority.
Under the current arrangements described by the President, funds are being sent directly to individual health facilities, increasing the responsibility of hospital management boards to oversee expenditure.
Ruto said the new approach should ensure that resources reach their intended beneficiaries and support the availability of essential medical supplies.
The government has been pursuing changes intended to improve access to healthcare and strengthen the management of public health facilities.
Nairobi Hospitals Under New Management Framework
The President's proposal also comes amid changes in hospital governance, including Nairobi County's Health Services and Management Act, 2026.
The law provides greater financial and operational autonomy for Level Five county hospitals while maintaining oversight requirements and providing for hospital management boards.
The broader debate centres on how public hospitals can manage their finances effectively while ensuring transparency and accountability.
Ruto's proposal seeks to give members of the public a more direct role in monitoring hospital spending, with the stated aim of improving access to medicines and strengthening healthcare services across the country.