HERU Policy Briefs
This brief examines lessons from Kenya’s UHC indigent program, which enrolled over 880,000 households, highlighting successes and challenges in identifying and enrolling the poor for health insurance subsidies. It provides practical recommendations to guide the Social Health Authority as it implements the new Social Health Insurance Act.
The brief is part of a series from a Gates Foundation–funded study on PHC financing and system reforms in Kenya, jointly developed by the Health Economics Research Unit (HERU) at KEMRI-Wellcome Trust and ThinkWell.
This brief presents lessons from Kenya’s experience with health facility autonomy reforms, which give public health facilities the authority to retain and spend funds at source. While autonomy has improved facility responsiveness, timeliness of supplier payments, and availability of medicines, it has also created unintended effects, including reduced budgetary allocations to facilities, greater reliance on user fees, and financial barriers for the poor.
The brief offers recommendations for national and county governments on how to strengthen these reforms while safeguarding equity. It is part of a series from a Gates Foundation–funded study on PHC financing and system reforms in Kenya, jointly developed by the Health Economics Research Unit (HERU) at KEMRI-Wellcome Trust and ThinkWell .
Kenya has rapidly scaled up Primary Healthcare Networks (PCNs) as part of its Universal Health Coverage reforms, with nearly 200 established across the country. This brief examines early implementation experiences, highlighting strong political support and a comprehensive policy framework, but also critical gaps in governance, financing, digitisation, and functional integration. It provides recommendations for strengthening PCN design and capacity to deliver more integrated and equitable primary healthcare. The brief is part of a series from a Gates Foundation–funded study on PHC financing and system reforms in Kenya, jointly developed by the Health Economics Research Unit (HERU) at KEMRI-Wellcome Trust and ThinkWell.