Kenya - Italy alliance unveils 15 new hospitals in US$419 million healthcare deal

President William Ruto witnessed the signing at State House Nairobi on Tuesday, September 8, with Health Cabinet Secretary Aden Duale and GKSD Group chairman Kamel Ghribi signing the agreement.

The programme, being developed under Italy's Mattei Plan for Africa, covers 15 hospitals in 15 counties.

The package comprises 13 Level 5 county referral hospitals and two Level 6 national teaching and referral facilities.

The investment has been valued at about US$419 million, roughly Sh54 billion.

It is a healthcare partnership and Letter of Intent, setting the framework for development and financing of the projects.

It does not mean Kenya has already received or spent the entire US$419 million.

Italy's wider Mattei Plan uses a mix of public and private financing, and the Kenya projects will still move through their financing and implementation stages.

Location of the new proposed hospitals

The two Level 6 hospitals are planned for Mombasa and Uasin Gishu.

In Mombasa, the project is the proposed Mombasa National Teaching and Referral Hospital in Jomvu.

In Uasin Gishu, the President identified Moi Teaching and Referral Hospital in Eldoret as the other Level 6 facility.

The Eldoret project is already under construction, meaning it is not a completely new project emerging from Tuesday's signing.

The President named the counties targeted for the Level 5 hospitals as Kilifi, Mandera, Marsabit, Embu, Migori, Nyamira, Turkana, Kisii, Baringo, Bomet, Narok and Murang'a, alongside the remaining county in the 13-facility programme.

There has, however, been some inconsistency in the publicly released lists.

An August Ministry of Health announcement for the 13 planned Level 5 hospitals named Nakuru and Laikipia, while the President's latest announcement named Kisii and Murang'a.

The full 13-county list has therefore not been published consistently enough to treat every location as final.

What exactly is a level 5 hospital?

Level 5 is Kenya's secondary hospital tier.

Under the Health Act, these facilities provide specialised services, train health workers, serve as internship centres and conduct research of county importance.

They sit above Level 4 primary hospitals in the referral chain.

The Ministry's current programme envisages 300-bed Level 5 county referral hospitals.

The planned facilities are expected to include substantial critical-care and diagnostic capacity, with the government previously specifying at least 16 ICU beds and 10 high-dependency beds for each hospital.

In practical terms, a stronger Level 5 network should mean more specialist treatment is available within counties rather than patients being routinely sent to Nairobi or other major referral centers.

What does a level 6 hospital offer?

Level 6 is Kenya's tertiary hospital tier.

The Health Act defines Level 6 facilities as providers of highly specialised services, while also serving as national research and training centres.

That makes the proposed Mombasa facility particularly significant.

A national teaching and referral hospital on the Coast could reduce the need for patients requiring highly specialised treatment to travel to Nairobi.

The second Level 6 facility, at Moi Teaching and Referral Hospital in Eldoret, would strengthen an existing national referral center rather than create a new referral hub from scratch.

Referral hospitals

The government's argument is that Kenya does not have enough hospital capacity at the higher levels of care and that access is uneven across the country.

Ruto has cited a figure of about 12 hospital beds per 10,000 people, compared with a planning target of 25.

The distinction is important:

WHO says there is no single global benchmark for hospital-bed density, although Kenya has used 25 beds per 10,000 as a national planning target.

The 2023 Kenya Health Facility Census recorded only 34 Level 5 and five Level 6 facilities, underlining how limited the country's higher-level referral network remains.

Italy's role beyond financing

The partnership is being implemented under Italy's Mattei Plan for Africa, a broader framework covering areas including health, water, agriculture, energy and infrastructure.

Italy says the Mattei Plan currently has 18 partner countries and 76 projects, backed by an initial €5.5 billion financial endowment and additional public and private financing mechanisms. Kenya is one of the plan's priority partners.

GKSD's role also brings healthcare infrastructure and specialist expertise from Italy's private health sector.

That potentially makes the partnership about more than constructing hospital buildings; it also opens the door to design, technology, medical systems and management expertise.