Health Cabinet Secretary Aden Duale faces mounting criticism over alleged ethnic imbalance in the appointment of Social Health Authority (SHA) county operation managers across Kenya’s 47 counties.
Constitutional Concerns Raised
Kenya’s 2010 Constitution mandates that public appointments reflect the country’s ethnic diversity to promote inclusivity and national cohesion. However, recent SHA hirings have sparked debate about whether these constitutional principles were upheld.
According to reports, nearly half of the appointed county operation managers come from the Somali community—the same ethnic group as CS Duale, who previously served as Garissa Township Member of Parliament. The Kikuyu community reportedly occupies approximately a quarter of the positions, with the Kalenjin and Luhya communities filling significant portions of remaining slots.
Ethnic Representation Disparities
Critics point to notable gaps in representation. Despite the Luo community’s strong educational credentials and professional presence in Kenya’s healthcare sector, only one Luo individual was reportedly appointed as SHA county operation manager.
Kenya has over 44 distinct ethnic communities, raising questions about whether the appointment process adequately represented the nation’s diversity.
SHA Program Under Scrutiny
The Social Health Authority represents President William Ruto’s flagship initiative to provide universal healthcare coverage to all Kenyans. However, the program—which has consumed billions in taxpayer funds—now faces multiple challenges, including allegations of corruption, mismanagement, and service delivery failures that have left many Kenyans dissatisfied.
Public Expectations vs. Reality
When President Ruto appointed Duale to lead the Ministry of Health, many Kenyans hoped for transformative leadership in a sector historically plagued by governance issues. The current controversy has disappointed stakeholders who expected merit-based appointments and transparent processes.
Critics across the political spectrum argue that the hiring pattern prioritizes ethnic affiliation over qualifications and merit, potentially undermining the SHA program’s effectiveness and public trust.
What’s Next?
As public pressure mounts, questions remain about accountability mechanisms and whether the appointment process followed established guidelines. The controversy highlights ongoing tensions between constitutional ideals of ethnic balance and practical implementation in Kenya’s public service.
Here is the list of Duale’s appointments

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