Dr.Edris N.Omondi (Advocate)
The journey that began in 2017 has finally found its culmination in 2025, with the elevation of JOORTH (Jaramogi Oginga Odinga Teaching and Referral Hospital) to a Level 6 National Referral Hospital. This milestone is a testament to the vision and determination of the County Government of Kisumu and Governor Anyang Nyong’o, whose leadership has paved the way for a transformation that promises to reshape the healthcare landscape not just in Kisumu, but in the entire western region of Kenya.
The Genesis of JOORTH’s Transformation
The journey toward this achievement began with the gazettement of JOORTH as a National Government Referral Hospital through Gazette Notice No. 11041 of 10th November 2017. This was done under the framework of the Health Act No. 21 of 2017, specifically Section 25(1) of its First Schedule, which mandated the establishment of Level 6 National Referral Hospitals. At the time, JOORTH was classified as a Level 5 referral facility, and the move to elevate it was part of a broader strategic effort to enhance healthcare delivery in the region.
The gazettement was driven by three key factors:
1. The Health Act 2017: This law established a clear framework for the creation of six National Referral Hospitals, and JOORTH was identified as one of the key candidates for elevation due to its existing role and capacity in providing specialized care.
2. JOORTH’s Historical Significance: Historically, JOORTH had been providing referral services at Level 5, making it a natural candidate for further specialization.
3. The Need for National Government Support: Health services in Kenya are constitutionally devolved, and there was a growing recognition that for facilities like JOORTH to thrive, they required more significant support and resources from the National Government.
Governor Anyang Nyong’o, understanding the importance of modernizing the facility, embarked on a comprehensive restructuring of JOORTH. This restructuring aimed to attract semi-specialized and specialized professionals, focusing on building the infrastructure and resources necessary to support such a transformation. From 2022, the Governor’s leadership, alongside myself as his County Attorney and the health team, laid down the groundwork for the elevation, which culminated in this week’s announcement by the Kenyan Cabinet that JOORTH is now officially a Level 6 Referral Hospital.
What Does it Mean for JOORTH to be a Level 6 Facility?
The elevation of JOORTH to a Level 6 National Referral Hospital means it will provide the highest level of specialized medical services, similar to that of Kenya’s other flagship referral hospitals, such as Kenyatta National Hospital (KNH) and Moi Teaching and Referral Hospital. These hospitals are renowned for their specialized care, state-of-the-art equipment, research capabilities, and training opportunities for medical professionals.
JOORTH will now join the ranks of these prestigious institutions, providing complex, specialized care to patients who previously had to travel far from Kisumu County. The elevation means JOORTH will:
1. Handle More Complex Cases: It will become the go-to facility for specialized treatment across multiple disciplines, including neurology, cardiology, oncology, and orthopedics.
2. Attract International Attention: With specialized services, JOORTH will draw patients not just from Kisumu County, but from neighboring counties and even neighboring countries.
3. Contribute to Research and Training: JOORTH will now serve as a key center for medical research and training, in collaboration with local universities like Uzima, Bondo, and Maseno University, further contributing to the development of medical professionals in the region.
Challenges Leading to Autonomy:
While the elevation of JOORTH is a major milestone, the road has not been without its challenges. Overcrowding has been a significant issue, as JOORTH has been providing services to patients who should typically be treated at lower-level facilities. This strain on the facility is due to the lack of affordable, high-quality primary and secondary health services in Kisumu County and its neighboring counties.
In addition to overcrowding, there has been a shortage of essential inputs, such as medical equipment, drugs, and adequately trained staff. These issues have been exacerbated by funding constraints, which are a hallmark of the devolution process in Kenya. Continuous industrial unrest, often linked to delayed salary payments, has further hindered the hospital’s ability to provide consistent care.
A critical issue has been the management structure, within its elevation this should be effectively rationalized.
The Autonomy Expected Gains
The shift toward autonomy for JOORTH is expected to bring about several positive changes, both for the hospital and the wider community:
1. Regional and International Referral Centre: JOORTH will become the referral center of choice in the region and even attract patients from across Africa seeking specialized care.
2. Increased Funding and Expansion: With autonomy, JOORTH will have greater flexibility to attract funding from both local and international sources to support its expansion and modernization.
3. Research and Medical Training: The hospital will contribute significantly to research and medical education, becoming a hub for future generations of healthcare professionals.
4. Improved Regional Healthcare: By enhancing its services, JOORTH will play a critical role in improving healthcare outcomes in Kisumu County and surrounding areas, creating a multiplier effect on the local economy.
5. Increased Specialization: The hospital will produce specialized and sub-specialized professionals, meeting the region’s demand for specialized medical expertise.
Legal Framework and the Road Ahead
While the elevation of JOORTH is a triumph, the legal framework for its autonomy is still under development. For instance, Kenyatta National Hospital (KNH) and Moi Teaching and Referral Hospital (MTRH) were both established under the State Corporation Act (Cap 456). A similar framework needs to be developed for JOORTH, taking into account Kenya’s devolved system of government.
The legal model must focus on establishing clear governance structures, with local representation on the board and accountability to both the National and County Governments. It should also incorporate provisions from the County Government Act, ensuring efficiency in service delivery.
Additionally, the autonomy should establish fully functional human resource, finance, clinical governance, and health economics frameworks, as well as solidify corporate and documentation structures to ensure sustainable growth.
Conclusion
JOORTH’s elevation to a Level 6 National Referral Hospital marks a significant achievement for Kisumu County and Kenya’s health sector as a whole. While challenges remain, the move towards autonomy will empower the hospital to offer world-class healthcare services, attract funding, contribute to medical research, and support the training of healthcare professionals. As Governor Nyong’o’s vision for a specialized facility takes shape, JOORTH will be poised to play a pivotal role in the future of healthcare in Kenya and the broader East African region.
