Nominated Nairobi Member of County Assembly (MCA) Joyce Muthoni Kamau has sparked fresh debate over the future of healthcare in the capital after proposing that the health function be transferred from the Nairobi City County Government to the Government of Kenya.
Kamau made the proposal on Tuesday while contributing to debate on the State of the County Address delivered by Governor Johnson Sakaja on February 11, 2026.
She argued that Nairobi’s health sector is “limping” and urgently requires a comprehensive overhaul, saying national government intervention could restore efficiency and improve service delivery in public hospitals and health centres across the city.
“As the whip said also about the health sector, that is not working, I request the President to also incorporate the health sector so that it can also be transferred to the side for it to function,” Kamau told the Assembly.
Her remarks come just days after an agreement was signed at State House Nairobi on February 17 outlining areas of collaboration between the national and county governments. Although the agreement explicitly states that it “does not constitute a transfer of functions,” it provides for structured cooperation in key sectors including refuse management, county roads, markets, housing and water services under Clause 3.2.
Kamau questioned the governor’s assurances to MCAs that there would be no transfer of county functions, noting that reports of the signing had emerged shortly after his address.
“He came into this House and assured us that there is no transfer of functions, but we have seen on the papers today that actually the signing of that deed is happening today. With that, I think there is no honesty in that,” she said.
The proposal has drawn mixed reactions within the Assembly, though several MCAs welcomed closer collaboration between City Hall and the national government, particularly in sectors they say have struggled under county management.
Lindi Ward MCA Ochieng Jera described the partnership as long overdue, terming it a major win for Nairobi residents. He expressed optimism that enhanced cooperation would accelerate service delivery, especially in waste management and infrastructure.
At the same time, Jere praised Governor Sakaja’s administration for strides made in the education sector, citing county-funded support for students from disadvantaged backgrounds.
“I am very happy because now Nairobi students will be able to continue their education without disruption,” he said.
Kayole Ward MCA Jeremiah Themendu commended the governor’s efforts to strengthen revenue collection but called for tougher action against individuals accused of misusing public funds. He emphasized that Nairobi’s locally generated revenue must be safeguarded and prudently managed to benefit residents.
The unfolding debate reflects growing concern among elected leaders over service delivery in the capital and signals a potentially broader conversation about the balance of responsibilities between county governments and the national administration nearly a decade after the advent of devolution.
