Why PS Muthoni’s leadership in a strained health system earned her Star nomination

Public Health PS Mary Muthoni’s nomination for the Star Person of the Year award comes after a period in which the health sector has been under sustained pressure, facing reforms, integrity challenges, labour unrest and emerging disease threats. The Ministry of Health—under which Muthoni's department falls—is a docket that rarely enjoys calm.

Over the past year, it has had to manage structural changes while responding to crises that threatened to undermine public confidence in the system. For the PS, the task has been less about headline-making reforms and more about holding together institutions under strain.

The Public Health and Professional Standards docket is critical in preventive and promotive health services, as well as the policy on human resource development for healthcare workers, ensuring a skilled and competent workforce.

The department’s mandate extends to health education management, food quality, hygiene and nutrition policies, quarantine administration, radiation policy and immunisation policy and management. Her nomination reflects recognition of her steady leadership at a time when the sector was tested on several fronts.

SHIF SHIFT

Probably one of the most significant challenges she has faced is the transition from the National Hospital Insurance Fund to the Social Health Insurance Fund. The shift is central to the Kenya Kwanza government’s Universal Health Coverage agenda but has also been disruptive and politically sensitive. The transition has been opposed by the opposition and Kenyans who have often said SHIF is not working, either because of technical issues or delays in bill settlement.

Muthoni described the transition as necessary but complex, saying the focus has been to ensure that systems are stabilised while continuing to provide services.

"The transition into the Social Health Insurance Fund is a monumental, necessary reform to achieve true Universal Health Coverage. Any reform of this size has transitional challenges, but we have actively worked to address them," she told the Star in an interview.

"We have prioritised clear communication to the public and healthcare providers on how to navigate the new system while concurrently stabilising the ICT infrastructure to minimise disruptions to service delivery. The goal is to move beyond the legacy issues of the previous NHIF model and provide reliable, affordable health coverage."

The department also focuses on improving information technology infrastructure to minimise disruptions. Beyond financing reform, the health sector suffered a major integrity test in the wake of fraudulent claims exposed in SHIF. These raised concerns about governance and the protection of public money, which constituted one of the reasons for shifting from NHIF. Muthoni says the response required swift and firm action.

The ministry worked with investigative agencies including the EACC and the DCI. Audits were conducted and facilities implicated in fraud were suspended where necessary. Cases were forwarded for legal action. In the process, the MoH tried to shut avenues for abuse.

Claims verification systems were strengthened using enhanced data analytics, strengthening provider credentialing processes, while internal audit trails were reinforced to ensure accountability. This, she said, was to restore people's trust in the health insurance system so that funds put into the health purse actually reached the patients. The moment demanded firm leadership and not defensiveness in a sector long accused of corruption.

HUMAN RESOURCE MANAGEMENT

Another long-standing challenge affecting the public health sector is labour unrest. Strikes by health workers have disrupted services repeatedly over the years, often exposing weaknesses in human resource management and intergovernmental coordination—health is a devolved function.

Muthoni said the ministry has moved away from a crisis-driven response mechanism to structured engagement. Regular dialogue has been institutionalised with health worker unions and professional associations. The process brings together national and county governments, as well as the SRC.

The aim is to address issues that have been raised in collective bargaining agreements in a realistic and sustainable way within the limits of the national fiscal framework.

She added, "We are working on a coherent national Human Resources for Health strategy to improve career progression, the distribution of staff and working conditions throughout the country."

While the country was engrossed in reforms and labour talks, the public health threats did not take a break. The response to the outbreak of Mpox then tested disease surveillance and emergency preparedness.

Muthoni said the response drew on lessons from past health emergencies, including Covid-19. Community surveillance systems were activated early, case definitions issued and counties alerted on detection and reporting protocols and laboratory capacity enhanced to ensure rapid confirmation of cases.

She said quick turnaround in testing is important for containment. Such a response required coordination across counties and facilities at a time when the system was already stretched.

The PS also emphasised the government’s focus on disease prevention through the Eliminate Dirt, Home Health (Epuka Uchafu, Afya Nyumbani) initiative. The programme promotes sanitation, hygiene and positive household behaviour change.

The Strong Communities at the Grassroots (Jamii Imara Mashinani) programme is yet another initiative that the PS noted had played a key role in strengthening community engagement and bringing essential health and government services closer to Kenyans. Devolution has added another layer of complexity to the leadership in the public health sector.

While counties implement health services, it is still important to have national oversight to ensure that standards, policy and public health protection are upheld. Muthoni said collaboration is key to her approach. Structured forums provide the means for the ministry to align national policies with county-level implementation through the Intergovernmental Technical Committee on Health. Bottlenecks identified through joint review meetings are targeted and resolved.

One flagship area of cooperation has been the countrywide scaling-up of Community Health Promoters. CHPs constitute the first line of primary healthcare and link households to the health system and ensuring consistency across the 47 counties has required sustained coordination.

The ministry also co-chairs mechanisms managing donor-funded programmes, among them the Global Fund grants for HIV, tuberculosis and malaria. The aim is to ensure partner resources support both national and county priorities without duplication or waste.

JOINING PUBLIC SERVICE

Muthoni did not start her path to public service in government. She was born and raised in Kiambu village, in Kirinyaga county, alongside her 10 siblings. She joined Ngiriambu Primary School and, later, Kabare Girls High School, before going to the Catholic University of Eastern Africa for higher education.

She graduated with a Bachelor of Education, and later earned her Master of Business Administration in Strategic Management and Marketing from the University of Eastern Africa Baraton. Muthoni taught English and Literature at Moi Girls School Nairobi and later spent years in business advocacy.

She founded Women in Business Kenya and also worked with the Kenya National Chamber of Commerce and Industry. Her shift from the private to public service was compelled by a desire to effect change at a national scale.

According to Muthoni, the public sector offers a platform where policy decisions can affect millions of lives. Health is one of the areas where that impact is most direct. When asked why she thinks Kenyans nominated her for Star Person of the Year, Muthoni said the recognition was a team effort, with progress made under the government’s health transformation agenda.

She believes the nomination reflects public appreciation for leadership that confronts challenges directly. As she puts it, Kenyans want to see results in terms of UHC, accountability in health financing and stronger primary healthcare.

She points to the implementation of SHIF, the expansion of community-based health services and the tough stance against fraud as key areas where it may have resonated with the citizenry.

“The award nomination highlights that Kenyans value public servants who address challenges head-on and remain focused on delivering accessible, quality healthcare for all,” she noted.

While the nomination does not suggest that the health sector problems have been solved, many of the reforms remain works in progress that will soon bear fruit.

But in a year marked by disruption and scrutiny, Muthoni's leadership has been defined by steady management of crises and the repair of systems under stress. It is that ability to keep the public health sector functioning amid uncertainty that now places her among the nominees for the Star's top honour.