Re-shaping Health Service Delivery in Tharaka Nithi County through CMaT

By Rachael Gathoni – CHAK

In the heart of Kenya’s eastern region, Tharaka Nithi County is emerging as a national blueprint for sustainable healthcare.

The successful implementation of the CMaT model in the county has marked a historic shift in how devolved units manage critical health interventions, particularly in the fight against HIV.

CMaT, a model co-created by CHAK Jamii Tekelezi and the county governments of Embu, Meru, Tharaka Nithi and Nyandarua, was designed to address a looming crisis: the “funding cliff.”

For years, Kenya has relied heavily on external donor support (such as PEPFAR) for technical expertise and personnel. CMaT is designed to transition health program ownership from donor-driven systems to county-managed structures.

This approach aligns with Kenya’s broader goal of achieving sustainable health systems by empowering county governments to take full responsibility for planning, financing, and delivering services.

Tharaka Nithi County Department of Health team had the privilege of presenting on the CMaT model during the 2026 Health Integration Summit in Mombasa. As one of the four counties supported by Jamii Tekelezi, Tharaka Nithi has demonstrated strong progress in effectively implementing the model.

Through CMaT, health services in the county have become more integrated and patient centered. HIV services are increasingly embedded within primary healthcare, ensuring that clients receive comprehensive care, including HIV testing, treatment, and cervical cancer screening, under one system.

One of the most notable successes of CMaT in Tharaka Nithi is the growing sense of ownership among county stakeholders.

Through structured collaboration and formal agreements, the County Government Department of Health and CHAK-Jamii Tekelezi have created an enabling environment for sustainable service delivery.

CMaT supports gradual transition of responsibilities, ensuring that counties are not only recipients of support but active leaders in health programming. This approach has strengthened accountability and laid the foundation for long-term resilience in the health sector.

The model provides a practical framework for achieving sustainability in health programs through structured capacity development, embedded mentorship, and joint accountability.

Due to its practicability and effectiveness, the model has been adopted by the U.S Department of State as the principal framework to guide County engagement and drive the sustainability journey across all Implementing Partners (IPs).

The CMaT model supports the PEPFAR sustainability agenda, strengthens county ownership and enhances health system resilience by embedding technical expertise within county structures for long-term sustainability beyond donor funding.