Struggling To Thrive: How Kenya’s Low-income Families (Try To) Pay for Healthcare

Drawing primarily on Kenya Financial Diaries, this report explores the nature of the healthcare financing challenge for poor Kenyan households, looking at how often the poor seek healthcare, how much they pay for it, how they raise money to finance healthcare spending, how they perceive their health risks and whether the costs of health services deter them from seeking access. Key insights from the Diaries are combined with the latest evidence on healthcare utilization and expenditure from other quantitative and qualitative studies to provide a comprehensive account of how the poor access and pay for healthcare in Kenya.

Key findings include:

• The direct and indirect costs of healthcare remain an important barrier to access and, in turn, better health for Kenya’s low-income groups.
• The government’s efforts to eliminate user fees have not solved the cost problem, since a large number of visits continue to take place at private facilities, and stock outages often force the poor to purchase drugs from private pharmacies.
• For many families, high spending on healthcare is the direct consequence of hospitalizations, for which the financing question is not if the household will experience the event, but when.
• Families’ own financing and funds from social networks outrank insurance in terms of health financing at the household level.

Based on these findings, the report then provides recommendations for different industry stakeholders to help tackle the problem of healthcare finance for the poor in Kenya.