Aasai

Kenyas Ministry of Health was created to be a national hub of equitable health policy, professional collaboration, and inclusivity across the more than 18 cadres that form our healthcare system. But instead, Afya House has become a fortress dominated by Medical Officers, who hold a disproportionate number of influential positions and are using their power to shape policy and resource distribution in their own interest.

Just look at the top of the Ministrys leadership pyramid: the Director General, Dr. Patrick Amoth; the Principal Secretary, Dr. Ouma Oluga; and senior departmental figures like Dr. Matendechere, Deputy Director. All are Medical Officers. While their qualifications are not in dispute, the concern arises when this dominance translates into policymaking that benefits only one cadre, leaving out equally critical health professionals like Clinical Officers, Nurses, Laboratory Technologists, Nutritionists, Radiographers, Community Health Assistants, and more.

This lopsided representation has already shown its effects. During the 2024 nationwide healthcare strike that involved multiple cadres, only Medical Officers issues were fully addressed. Their UHC salaries were harmonized according to SRC rates, while Clinical Officers and Nurses under the same UHC program were left out. Again in April 2025, UHC Medical Officers were confirmed into Permanent and Pensionable (PNP) terms and paid five years gratuity. The rest—including Clinical Officers and Nurses who have toiled for equal or more service years—were ignored.

It is this same biased machinery that is now pushing the controversial Quality Healthcare Bill 2025, which proposes centralized control over licensing, clinical practice, and health workforce regulation under a narrow lens. If passed, the bill would effectively reduce Clinical Officers autonomy and limit patient access to essential services they provide. Specialized Clinical Officers trained in ophthalmology, anesthesia, reproductive health, pediatrics, oncology, forensic medicine, and other fields could be locked out of roles they are fully qualified to serve in.

The fear among Clinical Officers is justified. Their scope of training now spans degrees, Masters, and even PhDs, yet they face systemic marginalization not because of competency, but because of cadre politics. Many Clinical Officers scored As and A- grades and chose Bachelor of Clinical Medicine over traditional medicine degrees, often due to passion, cost, or accessibility. They are not inferior alternatives—they are parallel professionals driving Kenyas health system forward, especially in primary and underserved settings.

The Ministry of Health must not continue to function as an exclusive club. The dominance of one cadre is unhealthy for sector-wide policymaking. We must restructure Afya House to reflect the full diversity of the health workforce. Key policy boards and leadership positions should include representation from all major cadres. Otherwise, Kenya risks continuing down a path where healthcare is fragmented, workforce morale is low, and Universal Health Coverage remains a dream.

Let this be a national conversation. The call is simple: restructure the Ministry of Health to ensure inclusive and representative leadership. Clinical Officers, Nurses, and all cadres deserve a seat at the table—not just as implementers, but as architects of Kenyas healthcare future.

#EqualRepresentationMoH

#RespectAllHealthCadres

#SayNoToHealthMonopolies