The hospital organization structures, chain of command and leadership is divided into four major categories which are the Board of Trustees (BOT), Hospital Governing Committee (HGC), the Hospital Management Team (HMT) and the in charges of departments.
The Board of Trustees (BOT) is the owner of the hospital and its members are appointed by the abbot of Ndanda Abbey. It is responsible for management and governance of the hospital at high level. The Board of trustees appoints both Medical Officer In charge and Hospital Administrator. Those two are responsible for appointment of other members of the Hospital Management Team. The latter is responsible for daily decisions, organization, staff and finances of the institute. Thus, they also appoint in charges of the departments.