County governments are putting about 60 percent of their budgets into healthcare, Council of Governors Vice Chair Muthomi Njuki has said, highlighting the growing financial responsibility counties have taken on in providing health services under devolution.
Speaking on Wednesday during the second day of the Kenya Health Summit at the Kenyatta International Convention Centre (KICC), Njuki said healthcare had emerged as the most important function among those assigned to county governments.
“Initially, health used to receive more or less the same equal funding with the other sectors in the revolved units, but today every county spends or allocates approximately 60% of its total budget to health, and that tells you that in all the devolved functions that we give the devolved units, health is at the top.”
His remarks come as counties prepare to receive a larger share of nationally raised revenue in the 2026/27 financial year.
The National Treasury has proposed Sh420 billion as the equitable share for the 47 counties in the 2026/27 financial year, an increase from Sh415 billion allocated in 2025/26.
The equitable share remains the main source of funding for county governments and is distributed among the 47 counties using an approved revenue-sharing formula.
When additional allocations are included, the total transfers to counties are expected to rise to about Sh484.69 billion in 2026/27. The additional funding includes conditional allocations as well as financing from development partners.
Njuki said the growing amount of county resources directed towards healthcare showed how important the function had become since the introduction of devolution.
However, national health-sector targets point to a broader picture of health financing. The Kenya Health Sector Strategic Plan 2023–2027 targets government health allocations reaching 13.56 per cent of total government budgets in 2026/27 and rising to 15 percent by 2027/28.
The plan also targets all 47 counties allocating at least 30 percent of their health budgets to development expenditure.
Njuki attributed progress in the health sector to reforms carried out over the past four years, saying they had also strengthened cooperation between the national and county governments.
“We started with the reforms that we had with the four laws that were passed, which has been the brainchild of the Kenya Kwanza government and the leadership of His Excellency the President. Those four laws brought the reform that we needed today to bring us where we are.”
He identified the Social Health Authority (SHA) and community health promoters (CHPs) as key parts of the changing healthcare system.
“I cannot figure out a country without SHA. I cannot figure out a country without the CHPs that we have today.”
Njuki also pointed to cooperation between the national and county governments in efforts to reduce maternal and newborn deaths.
He said maternal and perinatal death surveillance and response, which was initially carried out on a smaller scale by counties, had since been taken up nationally and coordinated across the country.
“The efforts of both the national and the county government that brings the synergy to ensure that mothers don't lose lives or even lose the newborns is critical, and is a product of that synergy that we have between the levels of government.”
The national government has continued to provide additional funding to counties for health programmes. For the 2026/27 financial year, Treasury has proposed Sh3.235 billion for community health promoters and another Sh1.759 billion to clear outstanding basic salary arrears for health workers.
Njuki said counties would continue working with the Ministry of Health as the ongoing reforms are implemented, with governors committed to improving coordination between the two levels of government.
He said governors would support and strengthen the coordination started by the ministry to ensure the reforms lead to better health services and improved outcomes for Kenyans.
The remarks point to the growing financial and administrative role counties play in healthcare, while also showing the continued need for national government funding to support health services that were transferred to counties under devolution.