Kenya Health Ministry Confirms SAGA Governance Framework

Kenya’s Ministry of Health has reinforced its governance framework for Semi-Autonomous Government Agencies (SAGAs) as performance contracts for 2025/2026 are finalized. This action aims to improve accountability within the healthcare system as it implements Universal Health Coverage (UHC).

The move comes at a time when the healthcare system is balancing the UHC rollout with existing challenges related to bureaucratic processes.

Accountability Framework

The Ministry of Health has emphasized that unsatisfactory performance will not be accepted. The reaffirmed governance framework includes strict Key Performance Indicators (KPIs) for all SAGAs.

These contracts are intended to ensure that state resources, totaling hundreds of billions of Kenyan shillings, directly contribute to improved health outcomes for citizens. All 19 SAGAs under the Ministry have signed the 2025/2026 agreements. Quarterly audits will now be conducted, replacing the previous annual review system, to ensure ongoing compliance. Budgets exceeding KES 50 billion are now directly linked to verifiable service delivery metrics.

Universal Health Coverage Implications

The effectiveness of the UHC agenda is closely tied to the operational efficiency of these agencies. Accountability is considered essential for areas such as the KEMSA supply chain and the transition of the National Hospital Insurance Fund (NHIF).

Health stakeholders have expressed support for the strengthened governance structure, noting its potential to reduce issues previously encountered in medical supply and financing.

Future Outlook

The impact of these contracts will be assessed through their effects on healthcare services provided in dispensaries and referral hospitals across Kenya’s 47 counties. The Health Cabinet Secretary stated that accountability is fundamental to healthcare and essential for fulfilling promises of universal coverage.