Five things we learnt at the Kenya Health Summit about what comes next

The most revealing moment at the Kenya Health Summit came when President William Ruto moved away from laws, institutions and national figures and spoke about the person seeking care.

“Because the ultimate measure of reform is not the laws we pass or the numbers we register, but the experience of every patient in terms of dependable, affordable and dignified care,” he said.

That statement changed the question.

Kenya has passed new health laws, introduced a new financing system, expanded community health services and invested in digital tools. The Government reported that 32.3 million people had registered with the Social Health Authority. It also reported more than 20 million outpatient visits supported through the Primary Healthcare Fund and the deployment of 107,800 Community Health Promoters.

These figures show the size of the effort. They do not tell us what happened when a person needed care.

Did the patient know what services were covered? Was a health worker available? Was the prescribed medicine on the shelf? Did a referral lead to treatment? Could the family receive care without having to borrow money or sell an asset?

Five lessons from the Summit point to where Kenya could make its next gains.

The ultimate measure of reform is not the laws we pass or the numbers we register, but the experience of every patient in terms of dependable, affordable and dignified care.

1. The numbers only tell us where the journey starts

Registering millions of people with the Social Health Authority matters. It gives people the chance to receive care through a shared national system.

But registration is the beginning of the journey, not proof that the journey was completed.

A registered person must understand what the health scheme covers. They must find a facility that can provide the service. The facility must recognise their membership. A health worker must be available and the claim must be processed. The person must then receive safe care without being asked to pay an unlawful or unaffordable charge.

The Government reported that eight million people had received treatment through the new system. This shows that the system is being used on a large scale. However, the information provided at the Summit does not show how many people tried to obtain care but could not, how long they waited or how much they still paid from their own pockets.

The President acknowledged that this part of the system needs more attention.

“We know that there are areas to improve, including making registration easier, benefits to be made clearer, claims faster, digital systems more seamless, and the quality of care more consistent,” he said.

The next useful figures will therefore go beyond registration. Kenya needs to know whether people understand their benefits, whether they receive the service they need and whether care protects their families from financial hardship.

A registration card matters most when it works at the facility door.

2. The nearest health worker may be the one who never waits inside a hospital

One of Kenya’s greatest opportunities to improve access may already be working inside communities.

“These days with the Community Health Promoters, the hospital is going to the people,” Nairobi Governor Johnson Sakaja told the Summit.

The Government reported that 107,800 Community Health Promoters had reached more than nine million households and made over 750,000 referrals.

Behind those figures are thousands of people visiting homes, identifying health risks and helping families decide when and where to seek care.

A Community Health Promoter can encourage a pregnant woman to attend antenatal care. They can identify a child who has missed an immunisation, recognise signs of illness and support a patient who needs follow-up. They can also help families understand a health system that may feel unfamiliar or difficult to navigate.

This work could help Kenya prevent illness and identify problems before they become emergencies.

Yet one important question remains unanswered. What happens after a Community Health Promoter makes a referral?

The referral only succeeds if the patient reaches the facility, finds an appropriate health worker and receives the required care. If the facility is too far away, understaffed or without medicine, the referral has been recorded but the patient has not been helped.

UN Resident Coordinator Garry Conille described what completed delivery should look like: “A reform is delivered when a mother in any county reaches safe and respectful care in time, when a community health promoter can complete a referral, when a clinician finds the medicine that was prescribed and when a family seeks treatment without fear that illness will push them into poverty.”

Community Health Promoters need regular payment, useful equipment and proper supervision. They also need a clear way to find out whether the people they refer actually received care.

The country should not measure community health only by home visits and referrals made. It should also measure referrals completed and people successfully treated.

3. Money must arrive before the medicine runs out

“A health system is only as credible as the medicine on its shelves,” Health Cabinet Secretary Aden Duale told the Summit.

His point was simple and important. A patient cannot be treated with an allocation, a payment report or a procurement plan. They need the right medicine at the right time.

The Government reported that Kenya shillings 23.3 billion had been disbursed through the Primary Healthcare Fund. It also said Kenya shillings 178 billion had been paid to contracted health facilities since October 2024.

These are significant amounts. The next question is whether facilities receive the money predictably enough to keep providing care.

A delayed payment may eventually become an unpaid supplier, an unavailable test or an empty medicine shelf. The patient may then be sent to buy medicine elsewhere, turning a problem inside the financing system into a cost for the family.

Government speakers also reported a large improvement in the Kenya Medical Supplies Authority’s order fill rate. However, they gave different figures. Some cited 91 per cent while others cited 95 per cent. They also gave different starting points.

Those figures should be checked and explained before publication. Even after that, a national percentage cannot tell a patient whether the medicine they need is available at their local facility.

The same is true of medical equipment. Delivering a machine to a facility is only the first step. The equipment must be installed, maintained and supplied with the materials needed to use it. A trained health worker must also be available.

The most useful question is not simply how much money was paid or how much equipment was delivered. It is what care became available as a result.

4. Patients should not have to understand which level of government is responsible

Kenya’s national government passes health laws and runs national financing systems. County governments manage much of the care delivered in local facilities.

For the person who is sick, these responsibilities are not separate. They are one experience.

Prime Cabinet Secretary Musalia Mudavadi put it plainly: “The two levels of government must work together all the time.”

There are examples of that cooperation. The national and county governments share the cost of paying Community Health Promoters. Counties reported receiving Kenya shillings 46 billion through the new health financing arrangements. The Government also reported that 98 per cent of public facilities had joined the Social Health Authority system.

But joining a system does not mean every facility is equally ready to provide care.

Counties need enough health workers. Facilities need reliable funding and medicines. Referral services must connect smaller health centres to hospitals that offer more specialised treatment. National digital systems must work in facilities with different levels of staffing, equipment and internet access.

Council of Governors Chair Ahmed Abdullahi acknowledged that workforce shortages and labour relations remain difficult. He then offered a useful way forward: “Let’s build on what has worked, confront what has not.”

This requires honest information from every county. Where are patients waiting longest? Which facilities regularly run out of essential medicine? Where are health workers most stretched? Which referrals are not being completed?

National progress will depend on answering these local questions. A person’s access to dependable care should not be decided by their county, distance from a major town or ability to travel elsewhere.

5. Trust will be earned one ordinary visit at a time

“Systems do not deliver simply because they are well designed,” Conille told the Summit. “They deliver because people, leaders, health workers, communities, keep faith in one another.”

Trust can sound like a vague idea. In health care, it is practical.

A patient goes to a facility believing that the service will be available. A facility treats a patient believing that the claim will be paid. A health worker reports for duty expecting to have the tools needed to provide care. A household contributes to the health scheme believing that support will be available when illness comes.

When these expectations are repeatedly disappointed, people may delay care, stop contributing or look for help elsewhere.

Kenya’s digital health reforms are intended to make the system more open and easier to check.

“Digitisation is not simply about replacing paper with screens,” the President said. “It is about making every patient visible, every treatment traceable and every payment accountable.”

A digital record can show what happened. It cannot ensure that anyone acts on that information.

Mistakes still need to be corrected. Suspicious claims need to be investigated. Complaints need to be answered. Patients need to know what they should pay and where they can seek help if they believe they have been charged unfairly.

Trust can be measured through everyday experiences. How long does a claim take? How many complaints are resolved? How often are patients asked to pay for covered services? Do people remain in the scheme after registering? Are problems found through digital records corrected?

Public confidence will not be built by registration campaigns alone. It will be earned when the system works as promised during an ordinary visit to an ordinary health facility.

Systems do not deliver simply because they are well designed. They deliver because people, leaders, health workers, communities, keep faith in one another.

What happens next

The Summit showed that Kenya has put many important parts of a new health system in place.

The next phase is less visible but more demanding. It is about making sure that registration leads to care, a community referral leads to treatment, facility funding leads to available services and digital records lead to action.

“A right written is a promise. A right delivered is a country keeping its word,” Conille said.

For a patient, keeping that word is practical. It means finding a health worker, receiving the right medicine, completing a referral and leaving the facility without a bill that places the family in hardship.

That is where the next chapter of Kenya’s health reforms will be judged. Not only in laws passed or people registered, but in whether care works when and where a person needs it.