Why healthcare remains unaffordable for many Kenyans despite SHA reforms
Healthcare affordability is emerging as a major concern for Kenyans, with the rising cost of treatment, medicines and insurance placing pressure on households already struggling with the cost of living. Behind the concern is a difficult question facing Kenya’s health system: how can the country guarantee access to quality medical care when many families still […]
Affordability of healthcare in Kenya remains a pressing issue, despite recent reforms. The rising cost of medical treatment, medicines, and insurance is a significant burden on households already facing higher living expenses. Kenya's Constitution recognizes the right to the highest attainable standard of health, but this does not guarantee that every household can afford necessary medical care.
Out-of-pocket payments account for nearly 25% of Kenya's healthcare spending in 2023, indicating the financial strain on patients. These payments cover direct expenses for healthcare services and products, which can force families to choose between treatment and other essential needs. The Ministry of Health's 2025 Service Availability and Readiness Assessment found that user fees have increased from 28% in 2018 to 51% in 2024, discouraging healthcare utilization and exposing households to financial hardship.
The Social Health Authority (SHA) reform, launched in August 2026, has registered over 32.3 million people, about 55% of Kenya's population. The reforms have supported over 20 million outpatient visits, 1.2 million safe deliveries, and 500,000 surgical procedures. However, registration numbers alone do not ensure that every enrolled person can access treatment without additional payments.
Affordability is also tied to the capacity of health facilities to provide services. The Parliamentary Budget Office noted that out-of-pocket expenditure has only modestly decreased over 15 years, from 30% to around 25% of total health expenditure. Uneven service delivery, health workforce constraints, and digital health system weaknesses also pose challenges to translating increased financing into better health outcomes.
Kenya's healthcare debate now focuses on whether the SHA system protects families from medical expenses and whether quality treatment is accessible not only in policy and registration figures, but also at the hospital gate and pharmacy counter.
Written by urgent.news from People Daily Kenya's reporting — not their text. Machine-written — may contain errors; check the original before relying on it.
