When the government unveiled its ambitious Universal Health Coverage plan in 2018, hopes were high.
The promise was bold: affordable, quality healthcare for all Kenyans.
The pilot programme launched in four counties—Isiolo, Machakos, Kisumu and Nyeri—was intended to lay the groundwork for nationwide rollout.
Now, several years later, and after the programme’s expansion, it’s time to ask: Are we making progress or simply chasing headlines?
While challenges remain, there’s evidence of advancement alongside areas demanding urgent attention.
Learning from other countries’ UHC experiences, both within Africa and globally, can provide valuable insights.
A strong focus on long-term financial sustainability is crucial.
Kenya’s healthcare landscape remains riddled with gaps.
According to the Kenya National Bureau of Statistics, 16 per cent of Kenyans fell into poverty in 2023 due to healthcare costs, highlighting the persistent burden of out-of-pocket expenses.
The majority of citizens still face barriers to accessing healthcare.
Furthermore, a 2024 Ministry of Health report revealed that over 30 per cent of public health facilities lack essential drugs, severely impacting services.
These statistics highlight fundamental gaps in access, affordability and resource allocation.
Despite these challenges, progress has been made in some areas such as increased access to healthcare services.
Data from the Ministry of Health shows a 20 per cent rise in outpatient visits between 2018 and 2023 in counties where UHC has been implemented.
For instance, Kisumu recorded a significant increase in maternal health visits during the pilot phase.
Another key success has been improved infrastructure where counties like Machakos and Nyeri have benefited from investments in healthcare infrastructure, with more facilities upgraded to level 4 and 5 statuses, enabling them to handle more complex cases.
The ongoing reforms, including the introduction of mandatory contributions for all Kenyans, aim to expand the fund’s coverage and sustainability.
However, the reforms have been met with criticism for their financial burden on low-income earners.
The government should subsidise contributions for low-income households to make UHC truly universal.
Improved accountability and digital integration can enhance services.
There are however some challenges that must be addressed.
A key challenge is funding shortfalls.
Treasury allocated Sh141 billion for healthcare in the 2024-2025 budget, a 10 per cent increase from the previous year.
However, experts argue that this is still insufficient to meet the growing demand for UHC services.
Kenya must commit at least 15 per cent of its annual budget to healthcare, as per the Abuja Declaration.
This will ensure adequate funding for infrastructure, drugs and personnel.
We also have an acute human resource deficit that needs to be addressed urgently.
Kenya has a doctor-to-patient ratio of 1:5,000, far below the World Health Organisation recommendation of 1:1,000.
This shortage is especially dire in rural and marginalised areas.
Investing in the training and retention of health workers is critical.
Incentives such as better pay and working conditions can encourage skilled professionals to serve in underserved regions.
We also need to deal with corruption and mismanagement.
A 2023 Auditor General report revealed that over Sh4 billion earmarked for UHC was misappropriated, raising questions about transparency and accountability.
Another way to ensure that UHC becomes a reality is to enhance public-private partnerships.
Collaborations with private healthcare providers can expand access, especially in remote areas.
The dream of affordable, quality healthcare for all Kenyans is achievable, but it requires unwavering political will and a collective commitment to put the health of citizens above all else.
Only then can we claim
that progress, not headlines, defines Kenya’s UHC
journey.
