Nairobi Hospital

The Nairobi Hospital’s decline began in the mid-2010s when steady-handed trustees like industrialist and philanthropist Dr Manu Chandaria, who for years anchored the Nairobi Hospital Board of Management with mission-first oversight, strategic discipline, and tireless fundraising, gave way to a younger, deal-hungry board.

This was a textbook case of what Peter Drucker warned against when he wrote that the purpose of an organisation is to create a customer and that all else must be subordinate to that mission. In communications terms, it marked the first erosion of brand equity, a trust-based asset built over decades that was now being cashed in for short-term optics and asset growth.

By 2018 and 2019, boardroom politics had intensified. Procurement controversies multiplied, and the high-profile exit of CEO Gordon Odundo in 2019 signaled a rupture in leadership culture. What had begun as mission drift, the gradual shift of priorities away from patient-centered care toward capital projects, collided with internal factionalism.

Edgar Schein’s leadership theory teaches that culture is shaped by the worst behaviour leaders are willing to tolerate. The new tolerance was for political maneuvering, opaque deals and competing personal agendas.

2020: The Year the Locks Changed

In early 2020, KHA members approved a governance overhaul, creating a Board of Trustees with sweeping control over assets and strategic direction. The first trustees were formally installed in 2021.

Organisational theorists describe this as resource capture, when decision-making is wrested from mission aligned stewards and concentrated in the hands of actors who reallocate resources to serve their own competitive blocs. The hospital now exhibited what institutional sociology calls land sacco style factionalism with contested elections, opaque procurement and patronage replacing consensus.

The hospital’s clinical strength, direct consultant led care, began to fade. Senior doctors pulled back from ward work to focus on private clinics within the complex or to manage construction and procurement deals.

Patient care increasingly fell to interns and junior doctors. From a service design perspective, this marked a decisive shift away from customer centredness. As Levitt’s marketing principle puts it, people do not buy products, they buy solutions to problems. Nairobi Hospital’s solution had always been trusted access to the country’s top medical minds. That trust eroded when the day to day running of care leaned on trainees, however promising, in a facility marketed and priced as premier.

Turning Care into a Checkout List

Historically Nairobi Hospital was not cheap, but its pricing reflected the costs of a world class, unsubsidised facility. Today’s price hikes are driven not by improved care but by systemic inefficiencies.

Overprescription and a flood of unnecessary tests now resemble what health economists term the commodification of care, transforming treatment into a series of billable items rather than a healing journey. From a public health standpoint, this overuse of pharmaceuticals accelerates antimicrobial resistance, undermining future treatment effectiveness.

The most chilling episode was the killing of the head of procurement under suspicious circumstances. Widely seen as politically connected and rising in influence, he was allegedly caught in fierce contract disputes. Official statements were carefully sanitised, but inside the hospital, the whispers framed it as a signal in a broader power struggle.

Around the same time, rumours swirled of a potential takeover by a high profile tycoon known for aggressive acquisitions. Whether or not such a move was real, the plausibility itself revealed deep institutional vulnerability, what James March and Johan Olsen would call institutional drift, the slow displacement of original goals by new self reinforcing ones.

Burning Through Brand Equity

In brand management theory, Nairobi Hospital is engaging in brand equity misappropriation. Keller’s framework warns that once brand associations shift from positive performance to negative experiences, recovery becomes exponentially harder. Patients still choose the hospital for its name, but each disappointing encounter depletes that reputational capital.

If this trajectory continues, parts of the hospital’s prime facility could be repurposed for non-medical ventures, perhaps even affordable housing, to plug revenue gaps. This would be the ultimate break from its founding ethos and a visual marker of its retreat from healthcare leadership.

Reversing this decline demands more than PR campaigns or ribbon cuttings. Governance must be insulated from political interference. Quality control and staffing must take precedence over construction. Senior consultants must be restored to the heart of patient care. Procurement must be transparent and competitive.

Reclaiming the Patient as the Core Product

The Kenya Hospital Association must urgently reevaluate the brand and not through glossy PR designed to mask its boardroom squabbles. Communications theory is clear, reputation is the memory of promises kept, not the result of polished press releases.

Mission and patient centredness must return to the core. The hospital’s product is not the building but the total patient experience. That product must be refined. Investment must go into staffing, not marble floors. Expansion should pause until the hospital’s core business is stable, respected, and patient satisfaction is restored.

Most critically, KHA’s governance model needs reengineering so that hospital operations are inoculated against internal beefs, political interference, and procurement intrigue. Nairobi Hospital still holds the infrastructure, human capital, and brand heritage to recover, but those reserves are finite, and reputations, unlike buildings, cannot be rebuilt with concrete.

Gem Musings is a seasoned International Relations and Public Affairs Strategist with extensive experience in global diplomacy, communication and policy analysis.