Ruto acknowledges gaps in healthcare as Kenya pursues UHC agenda

President William Ruto has acknowledged that Kenya still faces gaps in healthcare that must be addressed to fully realise Universal Health Coverage (UHC), even as he defended reforms undertaken by his administration to transform the health sector.

The Kenya Kwanza administration, according to the President, has made significant progress in expanding access to healthcare.

Despite the progress, the Ruto acknowledged that the country’s destination remained full access to quality and affordable care for all Kenyans, regardless of their financial power.

Speaking at the inaugural Health Summit 2026 held at KICC, President said with achieved health reforms no patient should be denied emergency treatment.

He said the Government has also strengthened the supply of medicines and medical commodities, with the Kenya Medical Supplies Authority (KEMSA) fill rate rising from below 40, to at least 91 percent.

“This is commendable progress to KEMSA, but our destination remains 100 percent,” said President Ruto.

To boost supply of medicine and medical commodities at KEMSA, the government has allocated Sh100 billion, and extended a Sh1 billion credit line to strengthen the medical supplies chain.

Ruto said more than 5,024 facilities have been contracted under the new health financing system- the Social Health Authority (SHA), with more than Sh209 billion collected and Sh178 billion paid to contracted facilities across the 47 counties.

The President said the reforms were designed to move the country away from a healthcare system where access to treatment was determined by a patient’s ability to pay.

“For years, Kenya lived with access to health depending on the size of a patient’s wallet,” he said, noting that families had been forced to sell livestock, exhaust their savings or organise fundraisers to pay medical bills.

“Sickness became a pathway to poverty. It was wrong and also unjust," he said.

According to the president, the Constitution had, through Article 43, established healthcare as a right and guaranteed that no person should be denied emergency medical treatment.

The constitutional promise, he said informed his decision to make UHC one of the pillars of his Bottom-Up Economic Transformation Agenda.

The President, however, noted that in 2022, only about one in four Kenyans had health insurance, under the defunct National Health Insurance Fund (NHIF).

Insurance coverage under the scheme was, however, low among poor households.

Millions of poor families, he said, "were forced to borrow money, sold assets, organised harambees or stayed away from hospitals because they could not afford treatment".

SHA has registered 32.2 million Kenyans, the highest since independence.

Under NHIF, 7.9 million households were covered under NHIF.

The cover was also formal sector driven, leaning out individuals in the informal sector.

At the same time, according to the president, Kenyans were spending about Sh100 billion out of pocket annually on healthcare, while public facilities struggled with inadequate resources and KEMSA’s fill rate was below 40 per cent.

"We resolved to build the system from the bottom up, not to patch the old one, not simply to rename it, but to fundamentally change it,” said Ruto.

Additionally, the President said the reforms witnessed at the Ministry of Health were anchored in four laws signed in 2023.

Among the laws are the Social Health Insurance Act, Primary Health Care Act, Digital Health Act and Facility Improvement Financing Act.

The Social Health Insurance Act replaced NHIF with the Social Health Authority (SHA) and established three funds, while the Digital Health Act created the framework for a digital health system.

The Facility Improvement Financing Act enables health facilities to retain revenue and use it to improve services.

Ruto described digitalisation as a critical pillar of the reforms, saying it would make patients, treatments and health spending more visible and accountable.

“Digitalisation is not simply about replacing paper with screens. It is about making every patient visible, every treatment visible and making every patient accountable,” he said.

He also criticised attempts to undermine digitalisation, saying the reforms had faced significant opposition.

The President said the digital system was critical in preventing fraud and wastage in the health sector, recalling cases where patients had allegedly undergone repeated procedures.

“If you had amputation of legs several times, this wasn't healthcare, but theft from sick people,” he said.

Ruto said the reforms were also creating a new financial architecture for UHC, supported by contributions from Kenyans.

At the same time, he credited county governments and Parliament for supporting the changes, saying the reforms could not succeed without cooperation between the national and county governments.

“I thank governors for helping make UHC a reality across the country. Without participation and partnership of county governments, this exercise would have been difficult,” he said.

The President also highlighted the role of community health promoters (CHPs) in shifting healthcare towards prevention and early detection.

He said 107,800 CHPs had been deployed to work from household to household, screening for diseases, monitoring mothers and children, and identifying illnesses before they become emergencies.

According to Ruto, the CHPs have reached nine million people and referred about 750,000 for treatment.

“This is for the first time building a network at the doorstep of a Kenyan home, finding high-risk pregnancies before an emergency and disease before disaster,” he said.

He said the national Government would continue working with counties to support CHPs.

At the same time, at the primary healthcare level, Ruto said Sh27.4 billion had been allocated to dispensaries and Level Four health centres, with Sh23 billion disbursed to support services benefiting more than 15 million Kenyans.

He said the Government had also sponsored healthcare for 560,000 households, representing 2.2 million Kenyans, while about eight million people had received treatment and 500,000 surgical procedures had been paid for.

The President further praised public, private and faith-based health facilities for partnering with the Government to deliver care.

He said the reforms were intended to ensure that patients receive treatment early, while those requiring specialised services are referred appropriately.

“When Kenyans require surgery or treatment, they move to SHIF, but no one should be denied care because they cannot access it,” he said.

Ruto said UHC was part of the broader social transformation agenda of his administration, alongside programmes such as affordable housing.

“Tsifa care ni mfumo wa Kenya wamejijengea kwa mawazo, na ushirikiano wa Wakenya wote,” he said, describing the reforms as a system Kenyans were building collectively.

He also thanked MPs for passing legislation underpinning the health reforms, saying Parliament and county governments had played an important role in the transformation of the sector.

Despite the progress highlighted by the President, his acknowledgement of remaining gaps comes as the Government seeks to translate the legal and financial reforms into reliable access to healthcare for millions of Kenyans.

"We know there are areas to improve, including making registration easier, benefits made clearer, claims made faster, and quality of care more consistent because the ultimate measure of reforms is not laws passed, or registration but dignified care," Ruto said.

He added: "This is the measure. We all know reforms are not an event, but a journey, but closing the journey on promises made and the experience of Kenyans seeking care"

At the Health Summit, he said the Government shall meet expects in health, health workers, partners, and Kenyans to share their challenges for solution.

The summit comes as the Government seek a conversation on Kenya, beyond vision 2030.

Respective programs in health had capped targets under Vision 2030.

Barely there years to 2030, the Government has come up with Vision 2060, which has health clusters expected to be shared during the Health Summit.

"Healthcare Kenya should guarantee to people beyond 2030. Governments will change, but Kenyans' right to change cannot change with them," said Ruto in reference to visions.

He added: "We can't tear progress without an answer to what comes next. UHC is of the people and the republic, reason national chatter is important so that our children are not left behind where we start."

The President remained optimistic that the reform will boost the healthcare system in the country.

The reforms were also defender by Deputy President Kithure Kindiki, Health CS Aden Duale, CoG Chairperson Ahmed Mohammed, Prime Cabinet Secretary Musalia Mudavadi and the National Assembly Speaker Moses Wetangula, and governors among other health experts.

Duale defended health reforms, citing gains in medicines, equipment and workforce.

Thd CS said the reforms had been given political ownership and sustained over the past four years, geared towards achievement of UHC branded Taifa Care.

Duale applauded refilling at KEMSA, noting that through its digital system, it is serving about 11,400 health facilities, with 54 per cent of commodities going to dispensaries and health centres where most Kenyans seek care.

“This means a mother who walks to a dispensary finds medicine,” said the CS.

On medical equipment, Duale said the Government had invested Sh9.68 billion under the National Equipment Service Programme (NESP), covering 251 health facilities, including county and national facilities.

The equipment includes MRI and CT scanners, digital X-ray and ultrasound machines.

Duale said the investment was aimed at reducing the need for patients to travel to Nairobi to access specialised diagnostic services.

“Previously, Kenyans would travel to Nairobi, but equipment is now available in the counties and paid for by Taifa Care,” noted the CS.

On the health workforce, the CS said the Government had posted more medical interns at a cost of Sh19 billion and sponsored 262 medical registrars.

Additionally, the Government had also released Sh3.4 billion to settle doctors’ arrears and recruited 100,000 nurses and midwives.

At the same time, Duale acknowledged the role of county governments in implementing health reforms, saying the progress recorded in the sector had been achieved through cooperation between the two levels of government.

“To governors, health is a devolved function. These reforms have been a partnership between the two levels of government,” said the CS.

He also recognised the contribution of private and faith-based health facilities, as well as healthcare workers, in delivering services to Kenyans.

He noted that Sh27 billion had been allocated to the primary healthcare architecture in the previous financial year and Sh19 billion in the current financial year.

On shortfalls, he said one of the issues the Government would address was the financing of primary healthcare.

The Government would explain why it was investing heavily in primary healthcare as part of its UHC strategy.

“We are presenting the record so that Kenyans can compare what we promised and what we have delivered up to now,” Duale said.

Wetang’ula on his part said health reforms have tackled corruption and changed how care is financed.

Wetangula said the reforms were responding to the experiences of desperate families who are often forced to raise money at night to meet hospital bills.

MPs he said have in the past negotiated the release of patients or stand at hospital gates seeking help to pay for treatment.

While establishing the laws governing the health docket, the Speaker emphasized that Parliament understood the need for reforms and had played a key role in creating the legal framework to transform healthcare financing and delivery.

According to the Speaker, the National Assembly Departmental Committee on Health had recommended on June 8, 2022, that the Facility Improvement Financing (FIF) mechanism be established.

Further, he said NHIF, which was established in 1966, had been overtaken by changes in the economy and the evolving social needs of Kenyans.

“When the reforms came, they found a ready legislative framework. Parliament had made attempts to achieve what had been stalled,” said the speaker.

Further, Wetanga said the four laws had been subjected to robust public debate before their passage, with some facing resistance from those seeking to maintain the status quo.

“The majority were ready, and saw them as Damascus moments for the health sector,” he said.

He said Parliament’s constitutional responsibility was to appropriate and oversee public resources to ensure Kenyans received value for money.

“Parliament shall ensure any person accounts for money,” he said.

Wetang’ula said the law also provides for healthcare services that should not require direct payment by patients, including primary healthcare and emergency care, which are financed through parliamentary appropriations.

He said Parliament would continue pushing for rationalisation of health services so that Kenyans in both urban and rural areas could access quality care, including specialist services.

The Speaker called for greater emphasis on preventive and promotive healthcare, including regular health check-ups, physical fitness and immunisation.

He said technology was also being deployed to detect fraudulent claims and other abuses within the health system.

“Cases of fraud must be checked and action taken on those found. Now we have an AI fraud engine dealing with this,” he said.

Wetang’ula said Kenyans should not be subjected to additional charges for services they had already contributed towards through the health insurance system.

“Where a citizen is contributing for care, no more charges should be put on citizens,” he said.

He said Parliament would continue appropriating funds for healthcare and ensuring that the money allocated was used for its intended purpose.

“Parliament will appropriate funds and ensure appropriated funds are put to proper use. We remain ready to support government reforms to give meaning to health and benefit our country,” he said.

The Council of Governors (CoG) also defended SHA, saying the new health financing system has helped channel billions of shillings to county hospitals and primary healthcare facilities.

Mohammed said counties had recorded significant gains in the health sector over the past four years, attributing the progress to closer collaboration between the national and county governments.

“Today, our emphasis is on what we can achieve for Kenyans in the health sector through coordinated intergovernmental implementation and improved patient outcomes,” Mohammed said.

However, Mohammed acknowledged persistent challenges, including workforce shortages and industrial action by health workers.

Health Summit was an opportunity to consolidate the gains made in the health sector, take stock of the reforms and identify areas requiring further action.

“Together, we shall work to solve those. County governments reaffirm working together to address the gaps,” said the CoG chair.

He also cautioned against calls to scrap SHA, saying the scheme was already providing funding to hospitals, including facilities in peripheral areas.

“I have heard politicians say the first thing they will do if they get into office is to scrap SHA. One politician said, ‘On day one, I’ll scrap SHA,’” he said.

Mohammed said the focus should instead be on fixing challenges within the system and ensuring that funds reaching health facilities are used to improve patient care.

“Let us build on what has worked, scale innovations and ensure reforms impact where it matters,” he said.

Musalia Mudavadi, on his part, applauded President Ruto for his zeal in revamping health reforms.

"The summit has brought us here, so that we acknowledge a very important thing- transformation. Delivery in our health system today is not a story of fiction, but it's now a matter of fact," said Mudavadi

He added, "You have (President Ruto) stayed the course; when people went to court, you've stayed the course when there were demonstrations on the streets, and when critics were in every corner and even when people were branding you all sorts of names.

"Today we celebrate a major transformation in Kenyans health sector. What we are witnessing is fact, and not fiction," added the Prime cabinet Secreatry.