Blog

By Dr. Wairimu Mwaniki

Healthcare today demands more than clinical expertise. Doctors must also be leaders who are capable of managing teams, navigating systems, and advocating for better care. Yet in Kenya, medical students graduate with little to no formal leadership training. This gap leaves many feeling unprepared for the realities of healthcare delivery, particularly in overstretched public facilities.

In high-income countries, leadership education is increasingly embedded in undergraduate medical programs. A global review found that effective models use interactive teaching like case discussions, mentorship, and real-world projects to build skills such as communication, systems thinking, and emotional intelligence. In contrast, Kenyan students often rely on informal experiences to learn how to lead, resulting in wide variability in exposure and skill development.

This gap is especially concerning given the context in which Kenyan doctors practice. Devolution, universal health coverage ambitions, frequent industrial actions, and resource constraints require clinicians who can negotiate, coordinate across levels of care, and make sound decisions under pressure. Without leadership preparation, young doctors are thrust into roles that demand authority and judgment before they are adequately equipped.

The consequences are real. Poor teamwork, communication breakdowns, and lack of initiative among junior doctors can contribute to medical errors, inefficiencies, and low morale. Without structured training, doctors may hesitate to speak up, take charge, or innovate, even when patient safety or service delivery is at stake.

Transformational leadership is particularly relevant for healthcare. It focuses on inspiring and empowering others, leading with integrity, and fostering a shared vision. Imagine what could happen if medical students were taught how to mobilize teams, mentor peers, and challenge the status quo to improve care. Kenya’s health sector would benefit from leaders who not only deliver care, but also drive reform at facility, county, and national levels.

We can start by integrating a leadership module into the core curriculum that is practical, participatory, and tailored to Kenya’s context. Topics could include conflict resolution, ethical decision-making, resource management, quality improvement, and community engagement. Faculty development is equally important, ensuring trainers can model leadership and assess these competencies meaningfully.

To succeed, collaboration is key. The Ministry of Health, medical schools, the Kenya Medical Practitioners and Dentists Council, and professional bodies such as the Kenya Medical Association must work together. Leadership training should be foundational, not an optional add-on or extracurricular activity. The payoff would be confident, collaborative young doctors ready to lead healthcare transformation at every level. Kenya’s future healthcare depends not just on doctors, but on doctors who lead.

Reference
Frich, J. C., Brewster, A. L., Cherlin, E. J., & Bradley, E. H. (2015). Leadership development programs for physicians: A systematic review. Journal of General Internal Medicine, 30(5), 656–674. [https://doi.org/10.1007/s11606-014-3141-1](https://doi.org/10.1007/s11606-014-3141-1)

About the author
Dr. Wairimu Mwaniki is a Consultant Physician and the Convener of the KMA Policy Advocacy and Communications Committee

Leading Healthcare Forward Through Transformative Leadership
By Dr. Wairimu Mwaniki

On May 15th, 2025, I had the privilege of moderating a thought-provoking webinar hosted by the Kenya Medical Association’s Policy Advocacy and Communications (PAC) Committee. The webinar titled Transformative Healthcare Leadership in a Changing World, brought together a powerful panel of experts to unpack the evolving demands of leadership in today’s complex healthcare environment.
Our panel included Dr. Frederick Ephraim Mukabi, a seasoned governance and leadership consultant and Deputy Director of Learning and Development at the Kenya School of Government; Dr. Rafael Chiuzi, an organizational psychologist and Associate Professor at the University of Toronto Mississauga whose work focuses on team dynamics and psychological safety; and Dr. Jacqueline Kitulu, a family physician and President-elect of the World Medical Association, widely recognized for her leadership in health policy across Kenya and beyond.
Each speaker offered practical, deeply insightful perspectives that resonated with our audience. What follows is a brief reflection on the key lessons shared.

Dr. Frederick Mukabi: Leadership is Learned, Practiced, and Shared

Opening the session, Dr. Mukabi challenged the age-old question—are leaders born or made? His answer was clear: “Though leadership qualities may be inherent, skills can always be developed.” Drawing from his decades of experience, he emphasized that leadership is a craft honed through training, contemplation, and practice.
He walked us through core leadership styles—authoritative, democratic, transformational, transactional—and stressed that the most effective leaders are those who know when to adapt their style to fit the needs of their teams. “There is no one-size-fits-all in leadership,” he said, adding that flexibility and emotional intelligence are indispensable tools in managing people.
Dr. Mukabi also spoke passionately about the need to embed leadership training early in medical education. “We push doctors into management before giving them the tools to lead,” he noted, calling for deliberate investment in leadership capacity from undergraduate level onwards. He reminded us that strong leadership is not about commanding teams, but about modeling the values we expect from others, and creating spaces where trust and collaboration can flourish.

Dr. Rafael Chiuzi: Leading Through Change and Psychological Safety

Dr. Chiuzi brought a refreshing psychological lens to the leadership conversation. He spoke about how fear and uncertainty—rather than stubbornness—often lie at the heart of resistance to change in healthcare teams. “People resist change for good reasons,” he said. “As leaders, it’s our job to understand what those reasons are.”
He emphasized that fairness and adherence to process, while important, are not enough to make teams feel safe. “Psychological safety doesn’t happen by default. You have to create it—through consistent behavior, clear communication, and the courage to welcome dissent,” he said. Inviting input, listening deeply, and avoiding defensiveness were just some of the tools he recommended for leaders managing through uncertainty.
One standout quote from his session: “You must be comfortable with being uncomfortable.” In other words, true leadership isn’t about having all the answers—it’s about staying present when tensions arise, and seeing resistance as an opportunity for growth rather than a threat to authority.

Dr. Jacqueline Kitulu: Blending Clinical Practice with Policy Influence

Closing the session, Dr. Jacqueline Kitulu offered a compelling case for why healthcare professionals must move beyond the clinic to lead at systems level. With over 20 years of leadership experience in national and international health institutions, she reflected on how doctors are uniquely positioned to influence policy—if they are equipped with the right mindset and training.
“Clinical practice gives us insight into what’s not working in the system,” she said. “But without leadership skills, we can’t move from identifying the problem to fixing it.” Dr. Kitulu emphasized the importance of aligning clinical duties with broader governance responsibilities, especially for those seeking to shape sustainable health reforms.

She also advocated for early leadership development and mentoring, noting that leadership should not be reserved for the most senior. “Leadership is not a position. It’s a way of thinking and engaging—with systems, with people, and with purpose,” she shared. Her lived experience, from leading KMA to securing major health grants and championing universal health coverage, gave weight to her message: impact is possible when leadership is intentional, ethical, and inclusive.

Final Thoughts

Moderating this session was a powerful reminder that leadership in healthcare today requires more than technical excellence. It demands courage, adaptability, and an ability to inspire trust in the midst of uncertainty.
Whether through Dr. Mukabi’s call for flexible, value-based leadership, Dr. Chiuzi’s challenge to foster psychological safety, or Dr. Kitulu’s vision of clinically engaged policy leaders—it was made clear that transformative leadership is not a destination, but a continuous journey of learning and growth.
As we equip the next generation of healthcare leaders, may we carry forward these lessons with clarity and purpose.

About the author
Dr. Wairimu Mwaniki is a Consultant Physician and the Convener of the KMA Policy Advocacy and Communications Committee

Missed the webinar CLICK TO REWATCH

Introduction

The modern workforce is evolving and becoming more gender diverse. Women now more than ever are entering, re-entering and staying in the workplace for longer. However, occupational health has always had a traditional approach of a ‘one size fits all’ where policies and practices are designed the same way to address health and safety of employees without examining the role gender and age play. The workplace experience while similar, differs significantly based on gender, underscoring the importance of creating gender-inclusive workplaces.

A brief History of Occupational Health and Safety (OSH)

The Industrial Revolution (1760-1840) marked a major shift in the nature and scale of work with many people entering employment and flocking cities due to technologies, such as steam engines, textile machines, railways, and factories. The increased productivity introduced new hazardous factory conditions, long work hours, poor pay, and increase in child labour, and by the 19th century, Britain attempted to regulate workplace health and safety through the Factory’s Act 1802.

OSH in Kenya, dates back to the 1950s with the incorporation of the Factories Act of 1951, also known as the Factories and Other Places of Work Act, governed by (Chapter 514 of the Laws of Kenya). In 2007, it was replaced by the Occupational Safety and Health Act (2007), commonly known as OSHA 2007, with Work Injury Benefits Act (WIBA) being implemented in the same year. The Act promotes workplace safety by preventing work-related injuries and illnesses. It also safeguards third parties from injuries and diseases associated with the workplace. Additionally, WIBA was established to make sure that workers who sustain work-related injuries and diseases receive appropriate compensation.

Understanding Gender-Specific Health Needs in the Workplace

Gender-specific occupational health risks and challenges often stem from differences in biology, societal roles, and expectations. Women face challenges related to reproductive hazards, discrimination, harassment, marginalization, and the double burden of work, which can contribute to stress, anxiety, and other mental health concerns. A gender-responsive approach to occupational health ensures that all workers, regardless of gender, have equal opportunities to health, safety, and well-being, and have access to the necessary resources, support, and environments to thrive.

Common gender-related issues in occupational health include:

1. Workplace Harassment and Discrimination: Gender-based discrimination, such as sexual harassment or discrimination, impacts the individual's mental and physical health.
2. Reproductive hazards: Inadequate workplace policies to support menstruation, pregnancy, breastfeeding, and menopause.
3. Mental Health: Women tend to report higher levels of occupational stress than men.
4. Double burden of work: Women manage majority of unpaid domestic responsibilities while still engaging in paid employment.
5. Workplace Safety: Exposure to hazardous chemicals and physically demanding tasks affects men and women differently due to physiological differences.
6. Health and sanitation: Lack of access to clean, safe, and separate toilets and welfare amenities for women.

Strategies for Building a Gender-Responsive Workplace

To create a gender-responsive workplace, organizations must take proactive steps in designing occupational health policies and practices that consider the specific needs of all genders. Moreover, the International Labour Organization created 10 key guidelines to Gender Sensitive OSH practices that were aimed at governments, employers and workers highlight.

Example of gender- sensitive strategies

Conduct Gender Analysis: Assessment of health and safety needs of the workforce with a focus on gender differences.
Equal Access to Health Resources: Provide support services for female employees at various stages of life, such as pre-conception, pregnancy, and breastfeeding, and the menopause transition.
Safe and Inclusive Workspaces: Implementing zero tolerance policies for gender-based harassment or discrimination.
Flexible Work Policies: Provide flexible work arrangements, such as flexible hours or remote work options, to accommodate female employees' needs.
Support Mental Health: Promote mental health by offering counseling, stress programs, gender-specific support, and open dialogue to reduce stigma and support well-being.
Gender-Specific Health Benefits: Provide health benefits that cater to the various needs of female employees, such as coverage for reproductive health, family planning, hormone therapy for perimenopause employees.

Conclusion

Promoting gender-responsive workplaces is not just a box-checking exercise; it is an important step toward creating an inclusive and supportive environment for all employees. Central to this effort is the role of male allyship in supporting equitable policies, challenging harmful stereotypes, and addressing unconscious biases that affect women's safety and well-being.

Inclusive Occupational Health: Building a Gender-Responsive Workplace Webinar
Date: 27th February 2025
Moderator: Dr Sheila Njuguna -Co-Convenor- KMA Policy, Advocacy and Communications Committee (KMA-PAC).
Panelists: Dr. Ann Njuguna, Occupational Health Practitioner, MP Shah Hospital; Dr Nzyoki Mulovi, Workplace Wellness Consultant; and Dr. Michelle Muhanda, CEO and Founder of One Health Medical Center and Occupational Health Practitioner.

Author: Dr. Sheila Njuguna

The rapid emergence of artificial intelligence (AI) and its incorporation into various sectors and industries has been transformative with notable advances in healthcare making a significant impact. The Kenyan healthcare system faces several challenges due to limited resources and therefore integration of AI goes a long way into enhancing efficiency of healthcare delivery to achieve the Quadruple Aim of Care. Currently, use of AI is already transforming healthcare delivery locally and while its clinical applications are promising, it raises significant concerns related to data protection and potential for bias, understanding the advantages and challenges will be integral in shaping a sustainable future for AI driven solutions.

Clinical Applications of AI in Kenya’s Healthcare system. 

In the realm of medical imaging, the use of AI algorithms in diagnostics and imaging analysis is allowing faster and more accurate diagnostics, by AI powered diagnostic tools. For example, the Ministry of Health in partnership with USAID, Centre for Health solutions and Tamatisha TB program launched a Computer Aided Detection (CAD) chest X ray screening and triage tool for pulmonary TB that has significantly improved detection by circumventing the inefficiency of inter and intra reader variability and automating and standardizing interpretation.

This is not only applicable to X-rays, but to CT, MRI and even cardiac imaging ensuring patients, even in rural and under resourced areas, can receive accurate diagnoses in a timely fashion.

AI is also being used to enhance clinical decision making by way of predictive analytics for patient risks. Machine learning models process vast data sets from electronic health records to identify trends, predict patient outcomes, suggest treatment plans and identify high risk patients in settings such as the critical care unit. This data driven approach then allows clinicians to forecast complications, intervene proactively, personalize treatment plans and have more efficient resource allocation.

Additionally, use of AI driven triage systems has brought about the automation of triage and workflow optimization in emergency care and outpatient settings. This serves to streamline patient flow, reduce waiting times and improve the efficiency of care delivery, especially in the emergency setting.

Furthermore, AI is playing a crucial role in telemedicine with AI powered telemedicine platforms enabling virtual consultations. Remote patient monitoring is another viable option where patient access is limited. It is enabled by AI monitoring devices or wearables that can be used to alert clinicians and allow timely interventions, reducing hospital admissions as clinicians can intervene remotely.

Data protection and Bias challenges

However, with access to this frontier emerges the challenge of the ethical and responsible handling of data. AI systems require access to vast amounts of sensitive health information which raises the concern of data security and privacy. Aligning and complying with the tenets of the General Data Protection Regulation (GPDR) and Health Insurance Portability and Accountability Act (HIPAA) globally, and the Data Protection Act of 2019 locally, is a step in the right direction.

Some of the practices outlined in these policies that should be enforced include:

• Transparent collection of all data with informed consent which fosters patient trust and accountability.
• Data anonymization and de-identification before being entered into AI models to protect patient identity by removing any Personally Identifying Information (PII) and application of pseudonyms where necessary. Data is therefore anonymized even when handled by third parties.
• Data minimization, where only necessary data is collected.
• Use of secure data storage and access controls where encrypted storage systems that comply with standards such as ISO 27701 for information security management are employed. This will restrict access to sensitive data highly, requiring multi factor identification and role-based access permissions, which minimizes risk of unauthorized access.
• Having a data governance framework and regular auditing to track data handling, access and security protocols.

The challenge of bias can also not be ignored. AI systems developed in different cultural demographics and healthcare ecosystems may not perform optimally locally where factors like genetics, disease prevalence and even healthcare infrastructure differ. Bias monitoring and inclusive data practices that recognize that AI models can be biased should be carried out, and data sets should be assessed for demographic diversity to ensure that they are representative of patient populations.

What does the future hold?

Looking ahead, Kenya must invest in developing robust regulatory policies with clear guidelines on how AI algorithms should be developed and tested to minimize bias. Challenges such as lack of secure data sharing protocols between health institutions impede the potential of AI in healthcare delivery and must be addressed in our data protection law. Patient privacy should be safe guarded while allowing AI systems to function effectively.
The expansion of telemedicine and mobile health applications also promises to make health care more accessible by overcoming barriers posed by geography and limitations in healthcare infrastructure.

In conclusion, the future of AI in healthcare delivery in Kenya has the potential to be revolutionary. Provided the challenges are addressed conclusively, Kenya can build a healthcare system that utilizes AI to improve health outcomes for her people.

Dr. Cynthia. N. Kamau
Member, KMA Policy, Advocacy and Communications Committee.