Kenya is actively engaged in transforming its healthcare sector, with a strong focus on improving primary healthcare services, enhancing accessibility, and elevating the overall quality of care. These efforts are central to the nation's ambitious goal of achieving Universal Health Coverage (UHC).

Universal Health Coverage (UHC) as a Driving Force

The core of Kenya's healthcare reform agenda is the Universal Health Coverage (UHC) Policy 2020–2030, which aims to ensure all citizens have access to essential, high-quality health services without suffering financial hardship.

• Transition to Social Health Insurance Fund (SHIF): A monumental shift in Kenya's healthcare financing system is the transition from the National Health Insurance Fund (NHIF) to the newly established Social Health Insurance Fund (SHIF) under the Social Health Authority (SHA), enacted by the Social Health Insurance Act of 2023. SHIF is designed to be a more comprehensive and equitable health insurance system, with contributions from individuals, employers, and the government, pooling resources to cover preventative, promotional, curative, and rehabilitative services. As of May 2025, over 22 million Kenyans had registered under the Social Health Authority.

• Challenges in SHIF Implementation: Despite its noble objectives, the implementation of SHIF has faced hurdles. Concerns include a digital divide impacting accessibility in rural areas, unclear referral pathways, financial sustainability, and initial reluctance from some hospitals due to reimbursement concerns. Public awareness campaigns and strengthening national-county coordination are crucial for its success.

Improving Engagement with Primary Healthcare Services

Primary Healthcare (PHC) is being prioritized as the foundation of Kenya's health system. The rationale is to bring services closer to communities, reducing the burden on referral hospitals and focusing on preventive and promotive health.

• Community Health Promoters (CHPs): A significant initiative involves the professionalization and deployment of Community Health Promoters (CHPs). As of June 2025, over 107,000 CHPs have been trained, digitized, equipped, and remunerated. They serve as the first line of defense in the health system, delivering care directly to households, monitoring pregnancies, supporting immunization, promoting hygiene and nutrition, and spotting danger signs early.

• Primary Care Networks (PCNs): Kenya is rolling out PCNs, which are designed to link CHPs to nearby health facilities, referral hospitals, and county health teams. This strengthens referral systems, improves supervision, and provides a broader support system for CHPs.

• Increased Funding for PHC: The 2025/26 budget saw a notable boost for primary healthcare, with allocations rising from KSh 7.1 billion to KSh 13.1 billion. This increase is intended to strengthen health services at the community level.

• Digitalization of Community Health Services: The Electronic Community Health Information System (eCHIS) enables CHPs and health managers to collect and access real-time data, enhancing accountability, improving patient follow-up, and enabling timely, targeted interventions.

Enhancing Accessibility

Efforts are underway to address geographical inequities and other barriers to healthcare access.

• "Built from the Ground Up" Approach: By investing in community health and CHPs, Kenya is literally "bringing healthcare to the doorstep" of many Kenyans, especially in remote or underserved areas.

• Targeted Support for Vulnerable Populations: The World Bank's $215 million Building Resilient and Responsive Health Systems Project, secured in March 2024, specifically targets improvements in primary healthcare for women and children from low-income backgrounds, as well as refugees and host communities in Garissa and Turkana counties, where access barriers are particularly acute.

• Digital Health Act and Digitalization: The Digital Health Act, along with the rollout of digital enrollment and biometric identification for SHIF, aims to increase efficiency and transparency in service delivery. However, the digital divide remains a challenge, particularly for those in rural areas with limited access to electricity, internet, or digital literacy. Efforts are needed to provide offline alternatives.

• Addressing Transgender-Inclusive Healthcare: In 2024, organizations like NRHS Kenya took significant steps to improve access to transgender-inclusive healthcare services through targeted training programs for healthcare workers, community engagement, and policy advocacy.

Improving Quality of Care

Ensuring high-quality care is a multi-faceted endeavor with several ongoing initiatives.

• Quality Healthcare and Patient Safety Bill 2025: Currently in the public participation stage, this proposed legislation aims to establish the Quality Health Care and Patient Safety Authority. This authority would be responsible for registering, licensing, accrediting, and monitoring health facilities (both public and private) to ensure strict compliance with set standards regarding infrastructure, staffing, and service provision. It also aims to hold facilities accountable for negligence.

• Strengthening KEMSA: The Building Resilient and Responsive Health Systems Project will strengthen the capacity of the Kenya Medical Supplies Authority (KEMSA) to ensure the timely availability of health products and technologies at the primary healthcare level and enhance transparency and accountability in procurement processes. KEMSA has been allocated KSh 5.2 billion in the 2025/26 budget.

• Managed Equipment Services (MES): The MES initiative, which provides modern medical equipment to hospitals across all 47 counties, aims to improve diagnostic and treatment capabilities, with over 95% uptime reported in beneficiary facilities.

• Infrastructure Development: The 2025/26 budget allocates KSh 1 billion for the construction of a cancer center at Kisii Level IV Hospital, and additional funds for enhancing cancer treatment at Kenyatta National Hospital and Kenyatta University Teaching, Referral and Research Hospital. There are also allocations for constructing pediatric and burns centers at KNH.

• Health Workforce Development: Recognizing a doctor-to-patient ratio of approximately 1:16,000 (far below WHO recommendations), the government has set aside KSh 4.3 billion for medical interns, KSh 3.2 billion for community health promoters, and KSh 8.9 billion for Kenya Medical Training Colleges to strengthen the health workforce.

• Research and Innovation: KEMRI (Kenya Medical Research Institute) has been allocated KSh 2.7 billion to support medical supply chain and research. The opening of new research facilities and collaborations with international partners like AMPATH (Academic Model Providing Access to Healthcare) aim to strengthen the evidence base for healthcare improvements.

While significant progress has been made and ambitious projects are underway, challenges such as financial sustainability of SHIF, addressing the digital divide, ensuring accountability for human rights abuses within the health system, and consistently improving infrastructure and human resources remain critical for Kenya to fully achieve its universal health coverage goals and provide equitable, high-quality care to all its citizens.