Nairobi, Kenya- A fresh dispute has erupted between Kenya’s county governments and a key national health regulator over who should control ambulance and emergency services.
The row pits the Council of Governors (CoG) against the Kenya Medical Practitioners and Dentists Council (KMPDC), which has issued a directive requiring all ambulances, paramedics, and pre-hospital care providers to be formally registered by September 15 or risk sanctions.
KMPDC Pushes for Mandatory Registration
In its notice, KMPDC ordered every ambulance, emergency medical technician (EMT), paramedic, and operator in the country to register with the council. According to the regulator, the move is meant to streamline standards in pre-hospital care and ensure only certified providers are allowed to operate.
Failure to comply, KMPDC warned, could result in prohibition from service delivery. The council argued that regulation was necessary to safeguard patient safety, especially in emergencies where professional oversight could mean the difference between life and death.
Counties Push Back, Cite Devolution
But the Council of Governors has strongly opposed the directive, dismissing it as unconstitutional and an infringement on devolved functions. CoG Chairperson Ahmed Abdullahi accused the Ministry of Health and its agencies of ignoring prior agreements on how ambulance and emergency services should be managed.
In a letter to all governors dated September 9, Abdullahi advised counties to disregard the KMPDC directive, arguing that ambulance services fall squarely under devolved government functions as outlined in Article 186 and Part 2 of the Fourth Schedule of the Constitution.
“Counties have invested heavily in ambulance services over the past 12 years and built functional referral systems. The threatened consequences of non-compliance are of no effect,” Abdullahi wrote, adding that KMPDC’s directive amounted to duplication of roles already handled by county administrations.
County executives echoed these concerns, warning that parallel systems created by national agencies could spark operational inefficiencies, drain county resources, and confuse service delivery lines.
Broken Consultations, Growing Tensions
The dispute comes just days after health executives from across the counties rejected KMPDC’s draft standards on emergency medical care during a meeting in Mombasa on September 5. The officials insisted that any new framework must align with county-managed dispatch systems instead of imposing fresh layers of bureaucracy.
“The Ministry of Health and its semi-autonomous institutions have reneged on resolutions made towards cooperation and consultation,” Abdullahi said. “We therefore advise county governments to disregard the public notice and treat it with the contempt it deserves.”
The standoff underscores the persistent tug-of-war between national institutions and devolved units in Kenya’s health sector. While the KMPDC insists regulation is vital for public safety, governors see the directive as another attempt to claw back powers assigned to counties under the 2010 Constitution.
Unless a compromise is reached, the row threatens to delay reforms in emergency medical services — leaving Kenyans caught in the middle of a jurisdictional battle that could affect life-saving interventions.
