Imagine a mother in rural Turkana whose child develops a fever. The nearest health facility is kilometres away. She has a basic mobile phone, unreliable network coverage and barely enough money for transport.
Kenya has invested billions in digital health infrastructure, yet this mother cannot access the system because it requires a smartphone, internet connectivity or digital literacy that she does not possess.
The Digital Health Act, 2023, the establishment of the Digital Health Agency and ongoing efforts to integrate health information systems represent significant opportunities to address longstanding weaknesses in healthcare delivery. But digitisation is not inherently transformative. Its value depends on whether it reaches those historically excluded from healthcare.
The Covid-19 pandemic accelerated the adoption of digital technologies in healthcare, demonstrating their potential to connect patients with providers, support disease surveillance and improve continuity of care. Yet it also exposed the inequalities that determine who can benefit from technological advancement.
The World Health Organization has cautioned that digital interventions cannot substitute for functioning health systems. Technology can improve information exchange, but it cannot replace healthcare workers, medicines, financing or effective governance.
Our greatest opportunity is to use technology to reduce preventable illness, disability and death, particularly among communities that experience the greatest barriers to care. Consider a pregnant woman experiencing complications in an underserved community. A digital platform could identify danger signs early, alert a community health promoter, coordinate referral, establish whether an appropriate facility has capacity and support timely intervention. But if the platform merely records her pregnancy, we have digitised information without improving her chances of survival.
We cannot design healthcare systems around the assumption that every Kenyan owns a smartphone, can afford mobile data or enjoys reliable electricity and connectivity. Digital platforms must accommodate basic phones through SMS, USSD and voice-based services, while enabling offline data capture and synchronisation. Digital health must be designed around the realities of people’s lives, including language, disability, gendered power dynamics and unequal control over resources.
The second challenge concerns our healthcare workforce. Technology must strengthen rather than overwhelm frontline workers. A nurse should not have to enter the same patient’s information into several disconnected applications. A community health promoter should not spend more time completing digital forms than engaging with households. Interoperability, integration with existing national health information systems and sustained investment in workforce training are essential. Otherwise, Kenya risks accumulating expensive pilot projects that generate impressive dashboards but little lasting improvement in clinical care.
The third challenge is governance. Health data is sensitive. Its collection creates responsibilities concerning privacy, consent, cybersecurity and accountability. As artificial intelligence becomes increasingly integrated into healthcare, Kenya must also interrogate the evidence underlying clinical algorithms. Whose populations were represented in the datasets used to develop them? Have these tools been validated among Kenyan patients? Can they reliably identify disease across different ages, sexes and clinical settings? An algorithm trained on unrepresentative data can reproduce existing biases, potentially missing illness among populations already underserved by healthcare systems.
Finally, digital transformation requires sustainable public investment. Too many promising innovations depend on short-term donor funding, only to disappear when financing ends. Kenya needs digital infrastructure that is publicly accountable, financially sustainable and integrated into routine service delivery.
This requires measuring outcomes that matter: fewer missed immunisations, earlier cancer diagnoses, improved treatment adherence, faster referrals, better chronic disease control and reductions in avoidable maternal and child deaths.
Kenya has an opportunity to build a digital health system that advances equity rather than reinforcing privilege. But that requires policymakers, technology developers, healthcare professionals and communities to confront a fundamental question: Are we designing technology around the health system as it currently operates, or around the health system Kenyans deserve?
A truly transformative digital health system must work for the woman with a basic phone, the older person who cannot navigate an application, the adolescent seeking confidential care and the patient living hours away from the nearest specialist. The last mile is not simply a geographical distance; it is the distance between a person’s health needs and a system’s ability to respond.
The promise of digital healthcare must be measured in lives improved and lives saved. Kenya cannot celebrate technological progress while preventable illnesses continue to claim lives simply because people cannot access timely, quality care. Digitisation must be an instrument of health equity, not another layer of exclusion.
