For a mother living in a remote village, a family in an informal settlement or an elderly person struggling to manage a chronic illness, healthcare reform is not measured by the number of laws passed or digital systems introduced.
It is measured by a much simpler question: When I need medical care, can I get it without being pushed further into poverty?
That question is at the heart of Kenya’s Universal Health Coverage (UHC) reforms, which were a major focus of the Kenya Health Summit 2026 held at the Kenyatta International Convention Centre in Nairobi.
The two-day summit, held under the theme Reforms Delivered, Health as a Right, brought together government officials, health workers, development partners, counties and other stakeholders to assess the progress of Kenya’s health reforms.
The government says significant progress has been made.
More than 32.3 million Kenyans are now registered with the Social Health Authority (SHA), almost twice the 16.9 million people previously covered by the National Hospital Insurance Fund (NHIF). More than 10,700 health facilities have also been accredited under the new system.
But for underserved communities, registration is only the beginning.
The real test is whether people can use the system when they need it.
Bringing healthcare closer to households
One of the most visible changes has been the expansion of community-based healthcare through Community Health Promoters (CHPs).
More than 107,000 CHPs have been recruited, trained and equipped to provide basic health information, screening and referrals at household level.
For communities that live far from health facilities, CHPs can provide an important link to the formal health system.
They can identify people with conditions such as hypertension and diabetes, educate families about disease prevention and encourage people to seek treatment before illnesses become more serious.
For Mandela Oguche, a Program Officer in charge of Community Health at Lvcthealth in Homa Bay and Migori, the impact of digitisation and support for Community Health Promoters (CHPs) is already visible at the community level. Better-equipped and digitally connected CHPs are reaching households more effectively, collecting and reporting health data, following up with patients, and linking communities to health facilities
“I have worked with communities from the time they were digitised until now, and there has been a huge improvement in terms of uptake and usage.”
He added that the government has also provided digital devices to support Community Health Promoters (CHPs) and health facilities. According to the Ministry of Health, more than 42,000 digital devices have been distributed against a target of 74,000, helping to strengthen digital reporting, data collection and access to health information at the community level.
The intention is to make it easier to collect information, follow up patients and connect communities with health services.
But technology alone cannot solve every challenge.
Some CHPs still face difficulties with digital skills and internet connectivity, while health workers must sometimes find ways of working around these limitations.
Oguche says continued training and support remain important.
“There are still hiccups. Some CHPs may struggle with digital skills, but with consistent training and coaching, their capacity can improve.”
The question of affordability
For many low-income households, however, the biggest concern remains the cost of healthcare.
The transition from NHIF to SHA was intended to create a more inclusive system in which access to healthcare is based on need rather than a person’s ability to pay.
The government says 32.3 million Kenyans have now registered with SHA, while 10,713 facilities have been accredited.
SHA CEO Mercy Mwangangi also reported that the scheme has facilitated 501,839 surgeries, compared with 237,741 under NHIF over a comparable two-year period.
These figures suggest increased utilisation of healthcare services.
But coverage should not be confused with access.
A person may be registered with SHA but still face challenges reaching a health facility, obtaining medicines, paying for services not covered or navigating the system.
For people living in remote areas, transport costs alone can become a barrier.
For families living in poverty, even a small additional medical expense can mean choosing between healthcare and other basic needs.
Medicines and equipment
Access also depends on whether facilities have the medicines, equipment and health workers needed to treat patients.
The government says its KSh10 billion recapitalisation of KEMSA has improved the availability of essential medicines, with the order fill rate rising to 95 per cent, from 35 per cent.
The National Equipment Service Programme has also deployed 862 specialised medical equipment units to 251 facilities in 44 counties, at a cost of KSh9.6 billion.
The aim is to reduce the need for patients to travel long distances or be referred to major hospitals in Nairobi and other urban centres.
For underserved communities, this could make a significant difference.
A specialised service available in a county hospital means a patient may no longer have to find money for transport, accommodation and other expenses associated with travelling to a referral hospital.
But equipment must be accompanied by trained personnel, maintenance and reliable supplies if the investment is to translate into better outcomes.
Health workers remain critical
The reforms also come at a time when Kenya continues to grapple with shortages and uneven distribution of health workers.
The government says 24,573 healthcare interns have been deployed across all 47 counties over the past four years.
It also plans to recruit and deploy 5,000 additional nurses and midwives under the Maternal and Newborn Health Acceleration Programme.
In July 2026, 7,414 UHC staff transitioned from contractual to permanent and pensionable terms, supported by a KSh8.94 billion allocation.
For underserved communities, the availability of a health facility means little if there is no health worker to attend to patients.
This is particularly important in maternal and newborn care, where delays in accessing skilled care can have life-threatening consequences.
From reform to reality
Kenya’s health reforms have undoubtedly changed the architecture of the country’s health system.
SHA has replaced NHIF. Primary healthcare has received greater attention. Health facilities are becoming more digitised. Equipment is being deployed outside major urban centres. Community Health Promoters are bringing basic healthcare and health education closer to households.
But the next phase must focus on whether these reforms are working for the people who have historically been left furthest behind.
For an underserved community, success is not simply 32.3 million SHA registrations.
It is a patient who does not have to sell livestock to pay a hospital bill.
It is a pregnant woman who can reach a skilled health worker in time.
It is a child in a remote village who can access essential medicines without travelling for hours.
It is a person living with hypertension or diabetes who can receive continuous treatment rather than only seeking care when the condition becomes severe.
And it is a Community Health Promoter who has the training, tools, connectivity and support needed to serve the households depending on them.
As Kenya moves from “reforms delivered” to “health as a right,” the ultimate measure of success will therefore be found not only in government statistics, but in the experiences of the communities those reforms are intended to serve.
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