Harsh reality of Kenya's healthcare, as patients struggle to access basic services

Health care workers on strike [Fiele-Standard]

Jane Wangari is devastated and grieving.

She has just lost her father, Patrick Kimani, whom the family says died at Nanyuki Referral Hospital after failing to receive timely care.

Kimani arrived at the public hospital on Saturday, August 8, with a history of chest pain and general body weakness.

But, according to his daughter, he was turned away and asked to return on Monday because there were no health workers available.

On Monday, good Samaritans rushed him to hospital after they broke into his house when they failed to see him and found him unconscious.

He was experiencing breathing difficulties and had a partial response, having been in a critical state.

A health volunteer placed him on oxygen, to stabilise him as the family waited for further tests and treatment.

But with health services paralysed by the ongoing strike, the family says there was little progress.

Confused and anxious, they began searching for a private hospital where Kimani could be referred.

Most private facilities contacted were, however, operating at full capacity.

“We panicked. Services were sluggish at the hospital. We sought a referral, but we could not secure one,” says Wangari.

On Wednesday, a volunteer nurse at the facility recommended to have Kimani undergo an MRI scan at a private laboratory.

Kimani was diagnosed with pneumonia.

He was moved to the hospital’s Intensive Care Unit (ICU), as his condition was deteriorating.

The family spent about Sh20,000 on drugs, as the facility shelves were empty.

The unit was allegedly manned by a single nurse.

A doctor on call attended to Kimani once after he was moved to the ICU, the family says.

But, according to Wangari, Kimani received little attention thereafter because there were few health providers available at the facility.

On Thursday morning, the family asked to see their loved one in the ICU. Instead, they were met with devastating news-Kimani had died.

Kimani’s body was moved to Murang’a for ongoing burial preparations.

“I wish I had a way of saving my father. He died because of lack of care. I watched his condition get worse, but I could do nothing,” says Wangare.

During her father’s admission, Wangari says she witnessed several other deaths.

“As my father’s body was wheeled to the morgue, I witnessed patients die after groaning in pain,” she says.

For Wangari, talk of Universal Health Coverage (UHC) means little when patients cannot access basic and timely care.

Her father, she believes, could have survived had he received prompt treatment.

“We are not serious about our healthcare. If we are, then tell me why my father had to die?” she poses.

As the family prepares to lay Kimani to rest, Wangari remains convinced that his death could have been prevented.

She says he would have walked out of the hospital had he received timely and adequate care.

Kimani’s death reflects a wider frustration among Kenyans who continue to question whether the country’s healthcare gains are translating into timely, quality and dignified care for patients.

As Kenya heads into the Health Summit, where achievements in the health sector will take centre stage, experiences such as Kimani’s raise concerns about the state of healthcare in the country.

The summit, set for August 18 and 19 at the Kenyatta International Convention Centre (KICC), will bring together health experts, partners, Ministry officials, the Council of Governors (CoG) and governors from across 47 counties.

Wangari, is among many Kenyans who have little to celebrate when patients are still struggling to access basic care.

“I bought drugs, but my father died. What does the milestone benefit me?” poses Wangari. “We need access to care. Yes, death is inevitable, but can we prevent some deaths?”

This is the current situation across the country, where hospitals lack drugs and medical commodities, with patients bearing the brunt of persistent strikes- lives lost, conditions worsening and surgeries postponed.

Striking cadres include nurses and midwives, clinical officers, laboratory technicians, public health officers and pharmaceutical officers, employees who are pushing for signing of Collective Bargaining Agreements (CBAs) and promotions.

Even as lives are lost, nobody seems to take responsibility. Instead of getting a quick solution, counties are taking disciplinary action against striking workers, following a directive by CoG chairperson Ahmed Abdullahi.

The CoG Chief Executive Officer (CEO) Mary Mwiti too seems to downplay the scale of the strike.

In a media town hall meeting held on Tuesday, the CEO said the strike had affected only a section of health workers and a few counties.

The few, media pointed out, still represented real numbers of patients groaning in pain, struggling to access care and, ultimately, lives lost.

“A section, and I say a section of health workers are on strike,” said Mwiti.

Mwiti added that only two health cadres are on strike, that is nurses under the umbrella of the Kenya National Union of Nurses and Midwives (KNUN) and clinical officers under the Kenya Union of Clinical Officers (KUCO).

“I want to confirm there are only two cadres that are on strike, that is the nurses and Kenya Union of Clinical Officers, it is not in all counties. It is a section and a few counties that have varied agreements here and there,” said the CEO.

But Prof Anyang’ Nyong’o, a former Minister for Health Services and a sitting governor overseeing healthcare under devolution, says the crisis cannot simply be viewed through the number of cadres on strike.

He identifies human resources, particularly the remuneration of health workers, as one of the biggest challenges facing healthcare.

“I think the problem has always been in human resources, the remuneration of health workers, because health workers are very important in our lives,” he says.

Nyong’o calls for closer cooperation between the national and county governments, arguing that inadequate resources have contributed to persistent challenges, including strikes, delayed payments and shortages of medicines and medical supplies.

The two levels of government, he says, should agree on the actual cost of delivering healthcare, including paying doctors, nurses and other health workers.

“When somebody goes to a health centre or a county hospital and does not find medicine, it is devastating,” says prof Nyong’o.

Nevertheless, people living with HIV are demanding constant supply of quality and standard Antiretroviral (ARVs).

This follows an outcry that there has been shortage of some types of ARVs, forcing individuals to take expired medicines, including newborns for lack of alternative, following shortages of infant prophylaxis drugs including Nevirapine and Zidovudine.

The infant prophylaxis prevent mother-to-child transmission of HIV.

There is also an outcry over shortage of Tenofovir Alafenamide Lamivudine (TAF LD), and HIV viral load testing kits. TAF LD is a type of ARV administered to individuals at 60 years and above to protect their kidneys and bones.

Supply of HIV viral load reagents was linked to funding transition and shipment blockage following the war in Iran.

Head of NASCOP Dr Andrew Mulwa said there was a delay in supply of the commodities, whose supply he promised in August.

“We have a pipeline delays occasioned by the United States Government (USG) transition, products that were to be delivered in June/start of August,” said Mulwa.

With delay in supply of TAF LD, NASCOP advised on temporary stop of switching new clients to the molecule until the new supplies are in the country.

NEPHAK Executive Director Nelson Otwoma has however, told The Standard viral load testing kits have not been supplied.

“Viral load test kits are yet to be supplied. We were told they were procured, but there has been delay. We cannot say there is stock, when we individuals cannot undertake testing,” says the official.

The stock-outs of HIV commodities are reported at a time the country is racing against time to stop and eliminate new HIV infections and deaths, including mother-to-child transmission.

Data by National Syndemic Disease Control Council (NSDCC) shows 13,936 new HIV infections were reported in 2026.

Rate of mother-to-child transmission stood at 8.04 per cent, against below five per cent global recommendation.

At the same time, the country is experiencing an acute shortage of contraceptives.

Shortage of contraceptives risks unintended pregnancies, which risks abortions.

In a legislative health brief, the central inventory at KEMSA has collapsed below safe operation parameters of six months.

In a detailed report dated May 7, 2026, which The Standard has a copy, among contraceptives lacking include combined oral contraceptives (COCs), progestogen-only pills (POP), intramuscular depot medroxyprogesterone acetate (DMPA IM) and subdermal implants.

On Tuesday, during a media town hall engagement, Director General for Health Dr Patrick Amoth acknowledged shortage of contraceptives.

He said at least Sh500 million has been allocated to KEMSA for procurement of contraceptives.

However, Amoth did not give details on timelines for supply.

Stock-out of family planning is linked to gaps in budgetary allocation. Kenya has heavily relied on donors for family planning.

Kenya’s budget allocation of Sh500 million meets less than nine per cent of the country’s verified annual requirement of Sh5.8 billion.

Under the global family planning (FP 2030) commitment framework, the Government of Kenya formally pledged to systematically scale up local allocations to achieve 100 per cent domestic financing of family planning commodities by 2026.

Even as the health system struggles to provide treatment, gaps are emerging in disease prevention.

As El Niño rains approach, there are concerns in rise of malaria deaths and cases, following stock-outs of mosquito nets and malaria testing kits.

Annually, at least five million cases of malaria are reported in the country, with 11,000 deaths.

An investigation by The Standard in Siaya revealed stock-outs of long-lasting insecticide-treated nets (LLIN), Fansidar and malaria testing kits. This is despite Siaya being a malaria-endemic county.

Pregnant women are told to wait for mosquito nets, whose supply is not guaranteed.

Unfortunately, the nets are not available in shops as they are donor-funded.

In the county, Community Health Promoters (CHPs) have limited tests following stock-out of malaria testing kits.

Joan Anyango Lale, a CHP at Adunyo Kokisa in Rarieda, regrets the delayed testing of a 17-year-old Form Three student at Kandaria Secondary School after he presented with symptoms of malaria.

Lale vividly recalls receiving a phone call to test Evans Odhiambo, who complained of persistent headache, nausea and fatigue.

She referred the student to Abidha Health Centre where he was diagnosed with severe malaria, only for him to die on March 2, 2026, two days after being put on treatment.

“This death saddens me so much as a CHP. Perhaps I could have saved the student’s life, had I tested and referred him on time,” Lale regrets.

The health crisis is witnessed as President William Ruto continues to champion UHC, a cornerstone of his administration's health reforms.

UHC is the key health agenda of the Kenya Kwanza administration, aimed at ensuring every Kenyan can access quality healthcare regardless of their financial circumstances.

Prof Nyong’o says UHC is not a new conversation and should now be fully actualised.

Nyong’o says the principle is simple.

“Every Kenyan should have the right and opportunity to access healthcare regardless of the disease they are suffering from,” he says.

Kisumu was among the counties that pioneered UHC, alongside Isiolo, Nyeri and Machakos.

According to the Governor, existing health laws clearly define the responsibilities of the national and county governments, providing a framework for delivering UHC.

“We just implement the law and we will be okay,” says Prof Nyong’o.

While acknowledging that Kenya has significantly expanded access to health facilities under devolution, Nyong’o says the country still faces major gaps in delivering quality care.

“What devolution has done is that health services have increased in the country exponentially. And I think this should be maintained because when somebody is sick, you do not want them to die, simply because they cannot access a hospital,” he observes.

Infrastructure alone, is not enough, with the governor pointing to human resources and financing as persistent weaknesses in the system.

Kenya Legal and Ethical Issues Network on HIV and AIDS executive director Allan Maleche says UHC must ultimately be judged by the experience of the patient.

“For me, UHC should be judged from the patient's experience,” says Maleche.

“Can an ordinary Kenyan walk into a health facility, get the care and medicines they need, and walk out without being pushed into financial hardship?”

“If we can achieve that consistently across the country, then we can say UHC is working,” he adds.

Maleche says the biggest challenge remains the gap between policy and implementation.

Financing, corruption, accountability and implementation, he says, remain interconnected barriers to achieving UHC.

“You can have a very good policy on paper, but if hospitals are not paid, medicines are unavailable or there are not enough health workers, the patient does not benefit,” he observes.

The Government sought to overhaul the health system through legislation and the establishment of the Social Health Authority (SHA), main financier of UHC.

To actualise this, Parliament enacted four major laws to support the reforms, namely Social Health Insurance Act, Digital Health Act, Primary Health Care Act and Facility Improvement Financing Act.

Former Health CS Susan Nakhumicha previously told The Standard that previous governments had struggled to achieve UHC partly because of the absence of an adequate legal framework.

But according to experts, laws alone do not guarantee care at the bedside.

Health economist and public policy expert Beatrice Kairu acknowledges that Kenya has made significant progress in expanding access to healthcare.

However, she says the fundamental challenge is increasingly about how healthcare is financed, how resources are allocated, how services are purchased and how providers are paid.

“The real test of UHC is not how many people are registered under SHA,” says Kairu.

“The question is whether a Kenyan can walk into a health facility, receive the care they need without financial hardship, and whether the facility is paid promptly and predictably.”

At least 32.2 million Kenyans have registered with SHA, among them 22.2 million principal members and 10 million dependants.

In a media town hall, SHA CEO Dr Mercy Mwangangi said at least five million of the registered members were remitting premiums.

But Kairu says SHA must go beyond simply paying claims and evolve into a strategic purchaser of healthcare.

It should use data to determine what services Kenya needs, where they are needed, what they should cost and whether providers are delivering quality care and value for money, she says.

For Nyong’o, the debate over UHC financing should also take into account the ability of Kenyans to pay.

He calls for a broader debate on financing social health insurance, arguing that contributions should be based on ability to pay.

Those with greater financial capacity, including companies and the private sector, should contribute more to the social health insurance pool, while the poorest should be protected from contributions, he says.