Strengthening the Nervous System of Kenya’s Healthcare
Dr Noelle Orata Reflects on Diagnostics, Leadership, and Why Pathology Must Be Treated as Health Infrastructure
Diagnostics shape almost every decision in healthcare. They influence prevention, treatment, rehabilitation, emergency preparedness, disease surveillance, and health policy. Yet, pathology is still often treated as a supporting service rather than a foundational one.
For Dr Noelle Orata, that framing is the core problem. From Dr Orata’s vantage point, when diagnostics function well, the entire health system becomes more coherent. When they don’t, inefficiencies multiply, from delayed treatment and misallocated resources to weak disease surveillance and fragmented care.
In this interview, Dr Noelle discusses her broader vision for pathology to be recognised as a strategic asset for universal health coverage, cancer control, and health security.
She hopes policymakers and diagnostic practitioners take away a simple message: every laboratory, regardless of size, can begin making deliberate steps towards the future. Embedding quality indicators, using data to drive change, optimising test menus, engaging clinicians more actively, and forming partnerships are not optional extras but foundations of equitable care.
Thank you for taking the time, Dr Orata. To start, could you tell me what drew you to clinical pathology initially, and what keeps you passionate about it today?
Pathology is not just about “lab results and postmortems,” it is the nervous system of the health sector. Diagnostics guides promotion, prevention, treatment, rehabilitation, emergency preparedness, disease surveillance, and policy decisions.
Much of my work has been about making that nervous system stronger and more visible: building systems, forging partnerships, mentoring the next generation, and ensuring that, as Kenya innovates in health, diagnostics are never an afterthought.
Clinical pathology appealed to me because I think in pictures rather than words. It was the perfect intersection between science and art in my mind. It is fascinating, and many times, nothing is as it seems.
Can you walk me through the key objectives of this year’s KACP conference?
This year’s KACP conference was intentionally designed to move the profession from “doing tests” to deliberately shaping the future of diagnostics in Kenya and the region. The discussions centred on practice‑oriented goals that stitched together the sub‑themes, aligning it to the national quality and health agenda. The sessions were framed around real cases and workflows, so participants left with practical steps they could implement rather than just awareness of global trends. The KACP meeting was not just a scientific event, but also an implementation forum for a future‑ready, high‑quality, and more equitable pathology and laboratory medicine in Kenya and the wider region.
There were key speakers in digital pathology, AI, precision medicine, One Health, and key subspecialties (transplant pathology, immunology, bone marrow interpretation, tumour markers), examining pathology practice from theory to day-to-day decision-making in Kenyan laboratories. A keynote address on ‘quality and patient safety into routine laboratory practice’ aligned to the Kenya Quality Model for Health and the draft Quality Healthcare and Patient Safety Bill 2025.
Conversations on strengthening the “lab–clinician” interface so that advanced diagnostics (e.g. bone marrow panels, tumour markers, transplant monitoring assays) change prescribing, treatment and follow‑up, rather than being isolated test results. Through “from the lab to the bedside” and precision‑medicine sessions, the conference pushes teams to co‑design pathways, multi-disciplinary teams, and reporting formats that support personalised, data‑driven care in oncology, transplantation, infectious diseases, and chronic illness.
Finally, the conference aims to function as a neutral platform where public, private, and training institutions can design concrete partnerships and collaborations that expand access to quality diagnostics.
Which presentations or sessions stood out to you as particularly impactful, and why?
The digital pathology and AI sub‑theme was particularly energising because it showed practical working systems in telepathology, image analysis, and digital reporting that can address workforce shortages and inequities in access to sub‑specialist expertise. The sessions on quality and patient safety, including discussions around the new Quality Healthcare and Patient Safety Bill 2025 and digital tools for implementing the Kenya Quality Model for Health, were also pivotal in reframing quality as non‑negotiable rather than aspirational.
How was the conference organised differently this year compared to previous years?
Compared to previous years, the conference was more deliberately structured around a few strategically relevant pillars rather than a long list of disconnected topics. There was also more intentional integration of non‑traditional partners: health‑tech innovators, insurers, implementers, and county decision‑makers, so that policy, financing, and technology were discussed alongside classical pathology science.
What kind of attendance and engagement did you see? Were there any unexpected outcomes or discussions?
Attendance was strong, with a healthy mix of consultants (pathologists, and non-pathologists), residents, technologists, early‑career scientists, industry partners, and policy actors. Engagement was lively with a lot of debate and interrogation on laboratory package reimbursement in the social health insurance fund, transplant pathology and laboratory equipment purchase in the counties. An unexpected but welcome outcome was the number of spontaneous cross-institutional learnings, quality collaboratives, and joint training initiatives.
Looking at the conference outcomes, what do you hope participants will take back to their practise?
Every laboratory, large or small, can start making deliberate, incremental steps towards the futur,e embedding quality indicators, using data to drive change, optimising test menus, engaging clinicians more actively, and being open to partnerships and digital tools that improve access and efficiency.
You’ve been deeply involved with KACP – how have you seen the association evolve over the years?
When I first became involved, KACP was a committed but relatively small professional association, largely focused on scientific meetings and CPD. Over the years it has evolved into a more visible voice in national health policy, a convener across public and private sectors, and a platform for mentorship, advocacy, and standards in pathology and laboratory medicine.
What would you say are KACP’s biggest achievements during your time as chair?
There were many, but I must say it was a collective effort in positioning pathology more centrally in national health discussions, including quality, UHC, and cancer control. Strengthening the annual scientific conference into a strategic convening that attracts policymakers, industry, and regional collaborators. Advancing a more structured strategic plan for KACP, with clear priorities around education, mentorship, advocacy, digital transformation, and partnership.
What challenges has the association faced, and how have you navigated them?
Key challenges have included limited resources, uneven member engagement, and the reality that pathology is often “invisible” compared to more patient-facing specialities. Navigating this has meant building alliances with other wider medical associations, with the Ministry of Health, counties, and the private sector and deliberately investing in communication, showcasing impact stories through our website and social media platforms, and creating value for members through opportunities, continuous professional development, networks, and advocacy.
Where do you see KACP heading in the next 5-10 years?
In the next 5–10 years, KACP should become the undisputed reference point for diagnostic policy and standards in Kenya and play a stronger regional role in education. I see deeper embedding of digital, and AI-enabled pathology, developing sub-specialty depth, scaling structured residency and fellowship collaborations, and anchoring quality and patient safety as everyday practice, not project-based work.
What has serving as KACP chair taught you about leadership in the medical field?
Leading KACP has reinforced that medical leadership is less about titles and more about empathy, servanthood, convening, listening, and creating shared ownership of a vision. It has also taught me that clinicians respond best when they can see a direct line from “meeting talk” to improved patient care, training opportunities, or better working environments, so closing the loop between strategy and tangible practical action is critical.
What aspects of the role were more challenging than you anticipated?
Three things were more challenging than anticipated. First, balancing competing demands work, family, academic progression, and multiple governance roles while avoiding burnout. Second, managing preconceived notions, expectations, and change within a voluntary association, where people are passionate but also very busy. Third, pushing for innovation (for example in digital pathology and PPPs) in a system that is still structurally conservative and sometimes risk‑averse.
What are you most proud of accomplishing in this position?
I am most proud of the moments where people and institutions started to think differently about pathologists and laboratories not as back-room services, but as strategic assets for UHC, cancer control, and health security. I am also proud of helping younger colleagues and trainees find platforms to present themselves, including social media, publications, leading sessions, and seeing themselves as future leaders of the profession.
From your vantage point, what are the most critical gaps in pathology services in Kenya (and broader East Africa) today?
Geographic inequities in access to basic and advanced pathology services, especially outside major cities. Workforce shortages and maldistribution of specialists, technologists, and subspecialist skills. Fragmented quality systems and data, with underinvestment in Laboratory Information Systems, External Quality Assurance, and robust supply chains. Weak integration of pathology into policy, financing, and benefit design. These gaps are even more pronounced in parts of the broader East African region, where pathology services may depend heavily on referrals abroad or a few urban centres.
In some of your interviews, you’ve mentioned that waste is the biggest challenge facing Kenya’s health sector. You’ve also advocated extensively on public-private partnerships (PPPs). How can these help address some of these gaps?
When I refer to “waste” in Kenya’s health sector, I mean duplicated investments, idle equipment, poorly used data, fragmented procurement, environmental waste from redundant equipment and human-resource inefficiencies that do not translate into better outcomes.
Well-designed PPPs in diagnostics can help consolidate demand and leverage economies of scale for equipment, reagents, and maintenance. Create hub‑and‑spoke models and managed service contracts that guarantee uptime, quality monitoring, and training. Use data from PPP labs to inform policy, benefit packages, and targeted investments rather than fragmented, ad‑hoc decisions. The key is that PPPs must be transparent, accountable, outcomes-focused, and aligned with public goals, not simply outsourcing to inform comprehensive decision-making.
Outside of your professional roles, what brings you joy?
Outside work, joy comes from family, close friendships, reading, travel, and quiet reflective time. There is also a lot of fulfilment in mentoring younger professionals and being involved in the community.
How do you maintain work-life balance with so many commitments?
I was answering this question on a panel with an affirmation that life is not, at least in my case, always balanced and chances are it never will be. It’s Seasonal fire, water, earth and wind.
My family is my glass ball; the rest are rubber balls in my life. I can run off to look for a rubber ball wherever it’s bounced off, too, and I know I’ll be able to catch it and pick it up. Some things will work out; I’ll excel in other things, and many times my plans just backfire. Such is life. When I accepted my life would never be a balanced pendulum, I settled into doing what I can, as I run and do the many things I do. I ask for help, I’m raising my children with my community, doing work with teams, thinking with others, and just listening to music quietly, humming gently in my mind. I like the words ‘work life integration’, so I work with that. I dropped the word balance.
Who have been your mentors or inspirations along your career journey?
I have had many mentors: Prof. Rogena and Prof. Wafula, who modelled excellence and integrity; health‑system leaders who demonstrated how to navigate complexity; and women leaders who showed that it is possible to lead, parent, study, and still have a sense of self. Inspiration also comes from patients and families encountered along the way—they are a constant reminder of why laboratory systems and policy work matter beyond the technical details.
Is there anything we haven’t discussed that you think is important for people to understand about pathology or your work?
Pathology intersects patient care, systems thinking, and scientific curiosity. It offers a way to impact thousands of patients daily by improving how laboratories are organised, how tests are selected, and how results are interpreted and used in clinical decisions. Over time, what keeps the passion alive is seeing that when laboratories work well, the population gets well, and we are stronger to enable us build the nation. Kenya is our business, and forever it will be.
