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Kenya’s Healthcare Crisis: Patients Caught Between Bureaucracy and Injustice
Gerald Kombo
February 10, 2025
Kenya’s healthcare system is facing a crisis that goes beyond policy papers and political rhetoric. Patients are struggling to access essential medical services, while bureaucratic failures and financial constraints push them to the brink of despair.
At a recent Stakeholder Forum on Health Governance in Kenya, panelists and community members painted a grim picture of a system that is failing its people.The Harrowing Journey of Grace Mulei: A Personal Story of Struggle
Healthcare should be a basic human right. But for Grace Mulei, it became a journey of pain, loss, and systemic neglect. Her story is not just personal—it is a reflection of a broken system.
My father had brain surgery, but there was no ICU. He died while nurses were taking tea. When my mother fell and needed surgery, she refused to be treated in Kenya. We took her to India, only to discover she had cancer. Three days later, my father-in-law died. Then my husband was diagnosed with Stage 4 cancer.
Grace was forced to navigate a healthcare system that prioritizes bureaucracy over patient care. Even in her worst moments, she witnessed others suffering under the same broken system:
I met mothers with children sleeping on cold hospital floors. Some had no food. The NHIF system was down. Patients who needed emergency care couldn’t access services.
In a desperate attempt to seek answers, Grace went to the Ministry of Health, only to be arrested and harassed.
I was bullied, dragged out of the hospital, and moved between three police stations without being told why. Today, I still feel unsafe.
Her story is a damning indictment of Kenya’s healthcare governance.
Kenya’s transition from NHIF to Social Health Insurance (SHI) was meant to solve these problems, but experts at the forum questioned its effectiveness.
According to Prof. Dan Owalla, National Coordinator, People’s Health Movement:
The government claims healthcare is free, but when you show up, the services are either unavailable or require out-of-pocket payments.
The SHA (Social Health Authority) system is built on contributions, but experts argue that it is not financially sustainable. Dr. Kahura Mundia, Deputy National Chairperson, KMPDU, explained the dilemma:
We were told that NHIF’s biggest problem was enforcing contributions from informal workers. The same challenge will cripple SHA.
Martin Onyango, Associate Director, Center for Reproductive Rights, highlighted the fundamental issue:
If healthcare is a fundamental right, why are we treating it as a commodity?
Many Kenyans cannot afford to contribute to SHA, yet public hospitals remain underfunded while private institutions profit.
A Broken Funding Model: Who Really Benefits?
Kenya’s health financing model is riddled with inefficiencies. The government insists on insurance-based funding, despite clear evidence that it fails in countries with large informal economies.
A study by the Institute of Public Finance (IPF) found that:
Public hospitals are underfunded while private hospitals receive government payments.
Health funds are mismanaged, leading to service delays.
Patients are still detained in hospitals due to unpaid bills, despite court rulings declaring this practice unconstitutional.
According to Gladys Wachira, Health Financing Researcher at IPF:
Kenya’s health financing system is not new. We have tried these models before, and they have failed.
The solution, as Dr. Mundia suggests, lies in earmarked taxes rather than voluntary contributions:
Other countries fund healthcare through taxes on fuel, sugar, and other consumables. Why not Kenya?
Legal institutions meant to oversee healthcare accountability—including Parliament, the Ethics and Anti-Corruption Commission, and the Office of the Auditor General—have done little to prevent these failures.
As Martin Onyango noted:
The healthcare crisis is not just about money. It is about accountability. Who benefits from our contributions? Why are private hospitals thriving while public hospitals collapse?
Despite court rulings against SHA’s implementation, the government has pushed ahead with appeals, showing that political interests override public health needs.
What Next? A Call to Action
Kenya’s healthcare system is at a crossroads. The government must:
✅ Invest in public hospitals rather than outsourcing care to private facilities.
✅ Ensure health funds are transparent and accountable.
✅ Shift from insurance-based financing to tax-based healthcare funding.
✅ End hospital detentions for unpaid medical bills.
Healthcare is not a privilege—it is a right. Kenyans must demand better from their leaders. If the government cannot provide healthcare, it has no business being in power.
If we do not fix our healthcare system now, we are condemning millions to needless suffering and death.