Picture this: you live in a rural part of Murang’a County, you have a chronic illness, and the one system that connected you to a doctor without a three-hour matatu ride has just been switched off — not because it failed, but because someone in Nairobi decided it was time for a transition. That is not a hypothetical. That is what is happening right now, and Murang’a County is not taking it lying down.
The Murang’a County government has gone to court to challenge the abrupt shutdown of Afya.ke, a digital health platform that was quietly killed off by the national government’s Ministry of Health as part of a migration to the Health Management Information System (HMIS). The move, according to court documents filed by the county, has left more than 170 health facilities unable to operate normally. One hundred and seventy. Let that number sit with you for a moment, because behind each of those facilities are nurses, clinical officers, and patients who showed up expecting a functioning system and found nothing.
The county’s legal argument cuts straight to the heart of the matter: HMIS, the system that Nairobi has pushed counties to adopt, simply does not have the capacity to support telemedicine. This is not a minor technical glitch or a software update gone sideways. Telemedicine is not a luxury feature in Murang’a’s health infrastructure — it is, by the county’s own account, central to how healthcare is delivered across its facilities. Stripping that out without a functional replacement is not a transition. It is a disruption dressed up in bureaucratic language.
What makes this particularly alarming is who gets hurt the most. Murang’a has specifically flagged patients living with non-communicable diseases — conditions like diabetes, hypertension, and cancer — as the most vulnerable to this blackout. These are patients who require consistent, ongoing monitoring and consultation. They cannot just wait for the government to sort out its systems. Every missed check-in, every delayed prescription, every consultation that doesn’t happen carries a real cost, and that cost is measured in human health, not budget lines.
The county is now seeking court orders to halt the shutdown entirely and restore continuity of healthcare services. This legal battle is bigger than a spat between a county and a ministry. It is a live stress test of Kenya’s devolution framework — a question of whether counties have real authority over how healthcare is delivered within their borders, or whether Nairobi can unilaterally pull the plug on systems that communities depend on, with no adequate replacement in sight and no meaningful consultation. Young Kenyans who believed in devolution as a promise of responsive, locally-accountable governance should be watching this case very closely, because the outcome will say a great deal about how much that promise is actually worth.
