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Let’s fix rather than replace key systems
Social Health Authority signage at Mutuini Hospital in Dagoretti South Sub-County, Nairobi, on August 27, 2025.
Kenya’s approach to reform has become increasingly reactive. When public systems begin to falter, the response is often to discard them and introduce new ones, rather than address the underlying weaknesses. This tendency, now evident across key sectors, risks entrenching instability instead of delivering lasting solutions.
The transition from the National Hospital Insurance Fund (NHIF) to the Social Health Authority (SHA) reflects this challenge. Although intended to improve access and efficiency, SHA’s rollout has been marked by confusion and operational difficulties. Many of these issues mirror the very weaknesses that affected NHIF.
A similar pattern is evident in the education sector.
The Competency-Based Education (CBE) was introduced to modernise learning and equip students with practical skills. However, its implementation has faced inconsistencies, inadequate preparation and shifting policy direction.
Frequent systemic overhauls erode public trust, as citizens begin to perceive reforms as temporary and unreliable. When people are unsure whether a system will remain in place long enough to function effectively, their willingness to engage with it diminishes. Replacing systems entails significant financial costs, including the loss of existing infrastructure and institutional knowledge. These costs often place additional strain on public resources.
Moreover, constant transitions create environments in which accountability is difficult to enforce. New systems typically involve new procurement processes, administrative structures and contractual arrangements. Without robust safeguards, these transitions can become vulnerable to mismanagement and corruption. Stability, by contrast, allows for stronger oversight and more effective enforcement of regulations.
Strengthening institutions requires patience, consistency, and a focus on incremental improvement. Addressing inefficiencies, enhancing transparency and ensuring proper implementation are often less visible than launching new initiatives, but they are far more impactful in the long term.
By focusing on strengthening rather than constantly reinventing its institutions, Kenya can achieve more durable and meaningful development.
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Donfred Okoth, Maseno University
