While undertaking clinical rotations as a nursing student at Gatundu Level 5 Hospital in 2017, Naom Monari noticed that some patients remained admitted long after they no longer required acute care because they lacked a safe and supported option for continued recovery outside the hospital.
The observation stayed with her and eventually became the basis for Bena Care. “I felt there was a missing layer between hospital and home. So I built Bena Care to give people living with chronic illness an alternative to prolonged hospitalisation, while ensuring that home did not mean losing access to care,” she says.
Naom also recognised a fundamental mismatch in the healthcare labour market, a pool of newly qualified healthcare workers facing prolonged underemployment despite the rising demand for community-based care. She responded by building a decentralised network of health professionals to provide clinical services in patients’ homes, creating job opportunities for young practitioners while expanding home care access for families.
“To support this service structure, we expanded into medical logistics, establishing an equipment division that procures, warehouses, and leases specialised devices—including hospital beds, oxygen concentrators, and mechanical ventilators—to home-bound patients,” she says.
Grounding its operational strategy in field data, the firm commissioned a study in 2023, examining the prevalence of kidney disease in Murang’a County, using the findings to better understand the healthcare needs of the communities it serves. Spurred by a growing number of patients requiring renal dialysis, the company secured research funding from the International Development Research Centre (IDRC) and Villgro Africa to investigate the underlying causes and identify ways to better support affected patients.
The enterprise then partnered with Jomo Kenyatta University of Agriculture and Technology (JKUAT) to assess treatment modalities for chronic kidney disease across Murang’a County. “The study exposed critical structural friction across the region, where patients were travelling up to 200 kilometres round trip, twice a week for life, to receive life-saving care,” she says, adding that in response to this data, they introduced a mobile haemodialysis unit designed to bring specialised renal care closer to patients.
With funding from Boehringer Ingelheim, the company brought together researchers, clinicians, engineers and nephrology specialists to design and build the region’s first mobile dialysis facility. The project moved dialysis beyond the confines of fixed hospital infrastructure, allowing the service to reach communities that would otherwise face lengthy journeys for treatment.
“We constructed our mobile dialysis unit from repurposed shipping containers and engineered it for full off-grid functionality.”
Naom Monari is the founder of Bena Care, a Kenyan healthcare enterprise.
Photo credit: Pool
Naom adds that to make the service sustainable, they integrated the mobile unit into the Murang’a public health system. The facility operates on a scheduled rotational route, bringing dialysis services closer to patients in remote areas. It later secured additional research funding from the IDRC to assess whether the approach was improving access to treatment. The post-implementation study, conducted by JKUAT, evaluated the service’s effectiveness, including its impact on patient travel distances and treatment adherence.
It found that the mobile dialysis service reduced the distance travelled by an average of 76.6 per cent and recorded 100 per cent adherence among those using the unit. Adherence was measured by attendance at prescribed dialysis sessions, completion of the required treatment hours and compliance with prescribed treatment plans.
“For us, this was extremely important. We had built the innovation because we believed distance was contributing to poor access to dialysis. The research allowed us to go back after implementation and ask whether it worked,” she says, adding that the evidence showed that decentralising dialysis was making a measurable difference.
Despite its expansion into dialysis, Bena Care continues to provide home-based care, the service on which it was founded. It now offers home-based nursing and medical equipment leasing, largely paid for directly by patients and their families, alongside mobile dialysis services financed through the Social Health Authority for eligible patients. The two areas serve different points along the care pathway and rely on different sources of financing.
Bena Care plans to intervene earlier in the progression of chronic diseases. They intend to expand their work in diabetes, hypertension and early-stage kidney disease, with a focus on delaying complications that can lead to kidney failure and dialysis.
“Kidney disease is still not talked about enough. It is silent, yet incredibly brutal. We see young people affected. We see young mothers affected. And when someone develops kidney failure, the consequences are clinical, economic and social, affecting entire families,” Naom says. “That is a bill Africa cannot afford.”
The burden extends beyond healthcare costs; as high out-of-pocket spending can push households into financial hardship. For her, their next phase has two priorities, earlier intervention to slow the progression of kidney disease and continued efforts to decentralise lifesaving treatment for patients who have reached kidney failure.
“We want to do more in the secondary prevention of kidney disease. We want to identify and manage people earlier, particularly those living with diabetes and hypertension. But for patients who already need dialysis, we also want to continue bringing that treatment closer to them.”
Bena Care has attracted more than $2 million (Sh259 million) in investment and grant funding from organisations and international partners, including Villgro Africa, Boehringer Ingelheim, the International Development Research Centre, the World Diabetes Foundation, Echoing Green and Madiro. The capital injection has accelerated expansion from home-based nursing to medical equipment leasing, mobile dialysis deployment, and clinical research, significantly diversifying its portfolio for chronic disease management. In doing so, the enterprise has transitioned from an initial home care proof-of-concept into a scalable, vertically integrated healthcare provider.
Naom ultimately aims to scale the company’s decentralised care system beyond Kenya. “We want Africa to adopt this model of care. Specialised healthcare such as dialysis does not always have to remain confined to major hospitals; it can move closer to patients.”
The long-term strategy is to combine earlier intervention with community-based care. “If we combine prevention, continuous chronic disease management and decentralised treatment, we have an opportunity to change the trajectory of kidney disease across the continent,” she says.
