NAIROBI,Kenya – The right to health in Kenya is under threat due to the rising cost of healthcare, making this right inaccessible for a majority of the population. According to the latest Kenya National Bureau of Statistics Consumer Price Indices and Inflation Rates 2025 Report, the cost of healthcare went up by 3.3 per cent over the past year.
Many people pay for healthcare out of pocket, meaning they make direct payments to health facilities at the time of accessing healthcare services. The rise in healthcare costs will make it more difficult for people to afford healthcare services, and also expose them to the risk of becoming poor due to high out-of-pocket healthcare payments. According to the Parliamentary Budget Office, Budget Watch 2023, Kenyans spend about 150 billion shillings in out-of-pocket healthcare payments each year.
Very few people have health insurance coverage, with one in four persons in Kenya having some form of health insurance. This is according to the 2022 Kenya Demographic and Health Survey. Without financial protection, access to health care is reduced, worsening health inequalities.
Further, the lack of a comprehensive social health insurance scheme, combined with the privatization of health services has excluded millions of Kenyans from accessing quality healthcare services and remains a major threat to the attainment of the goal of universal health coverage.
To strengthen the legal framework for universal health coverage, the government enacted enabling laws, namely, the Social Health Insurance Act, Primary Healthcare Act, Facility Improvement Financing Act and the Digital Health Act in 2023.
The Social Health Insurance Act defines universal health coverage as, “all individuals and communities receive the health they need including the full spectrum of essential, quality health services from health promotion to prevention, treatment, rehabilitation, and palliative care without suffering financial hardship.”
Among the objectives of the Social Health Insurance Act is to provide a framework for improved health outcomes and financial protection in line with the right to health and universal health coverage. The Social Health Insurance Act establishes three funds, that is, the Primary Healthcare Fund, the Social Health Insurance Fund, and the Emergency, Chronic and Critical Illness Fund.
The Social Health Insurance Act requires every Kenyan to register as a member of the Social Health Insurance Fund. A person shall only access healthcare services under the Social Health Insurance Act where their contributions to the Social Health Insurance Fund are up to date and active.
However, the implementation of these laws is facing numerous challenges. In July 2024, the High Court declared the Social Health Insurance Act, Primary Healthcare Act, and Digital Health Act unconstitutional for inadequate public participation in the law-making process and for violating the right not to be denied emergency medical treatment. However, the Court of Appeal suspended the High Court judgement, allowing the government to proceed with the implementation of the three laws.
The rollout of the social health insurance fund began on 1st October 2024. According to the draft 2025 Budget Policy Statement, about 15 million people have enrolled out of a population of over 57 million. This means that a majority of the population still does not have health insurance coverage.
The government must act urgently to ensure that every person in Kenya, particularly the most vulnerable, is protected against financial risks linked to healthcare and from the rising cost of healthcare.
The writer, Christine Akinyi is an Advocate of the High Court and a Programme Officer at the International Commission of Jurists- Kenyan Section. This article was first published on the Daily Nation.
