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What is really killing Kenyans: A look at the issues behind our health crisis
Kenyans are living longer, with life expectancy climbing to nearly 67 years, but the journey to old age is increasingly marked by preventable suffering, inadequate care, and widening inequalities that follow ethnic, geographic and economic lines.
What you need to know:
- The numbers reveal three big problems happening simultaneously: Kenyans are dying from both old diseases and new ones; the health system does not have enough doctors, nurses or medicines to treat everyone; and the population is growing faster than the system can keep up.
Walk into any hospital in Kenya today. Look around the wards. Chances are you will see patients suffering from two completely different types of diseases at the same time.
In one bed might be a child with malaria or pneumonia, diseases that have been killing Kenyans for generations. In the next bed might be someone recovering from a stroke or managing diabetes or cancer, conditions that used to be rare but are now increasingly common.
Kenya's health system is being asked to do more with less, and it is starting to crack.
Non-communicable diseases (NCDs) such as heart disease, diabetes, cancer and mental health conditions now account for nearly 40 per cent of all deaths in Kenya. That means four out of every 10 deaths in the country are caused by these conditions. Meanwhile, infectious diseases like malaria, TB and HIV have not gone away.
With a young, growing population and an emerging middle class, the country has enormous potential. But realising that potential requires a functioning health system, one that protects mothers, saves children, prevents disease, treats the sick, and leaves no one behind. Right now, Kenya is falling short.
Kenya's 2025 Population Situation Analysis Report, a comprehensive assessment of the nation's health and demographic landscape, paints a troubling picture. Kenyans are living longer, with life expectancy climbing to nearly 67 years, but the journey to old age is increasingly marked by preventable suffering, inadequate care, and widening inequalities that follow ethnic, geographic and economic lines.
The numbers reveal three big problems happening simultaneously: Kenyans are dying from both old diseases and new ones; the health system does not have enough doctors, nurses or medicines to treat everyone; and the population is growing faster than the system can keep up.
"This report is a wake-up call," says Dr Mohamed A Sheikh, director general of the National Council for Population and Development. "The data shows us that we are making progress in some areas, but losing ground in others. Most importantly, it shows us that the deaths we are seeing today are not inevitable. They are preventable."
Maternity ward deaths
Perhaps nowhere is Kenya's health crisis is more painful than in maternity wards.
At 355 deaths per 100,000 live births, the maternal mortality rate remains stubbornly high, far above the Sustainable Development Goal target of 70. The country is five times worse than the global target. And depending on where you live, your odds can be even grimmer.
A woman in Mandera or Wajir is three times more likely to die during childbirth than a woman in Nairobi, because northern counties have fewer trained nurses, health centres are far away, and medicines frequently run out for months at a time.
The causes of these deaths have not changed in years: excessive bleeding after delivery, seizures from high blood pressure during pregnancy, infections, and obstructed labour. These are not mysterious conditions. Doctors know exactly how to prevent and treat them. The question is whether leaders have the political will to fund interventions and direct resources to the women who need them most.
Beatrice Kimani, 29, nearly became one of these statistics.
Eight months pregnant with her second child, Beatrice began experiencing severe headaches and swelling in her feet, signs of preeclampsia, a dangerous condition that can lead to seizures and death if untreated. But the health clinic in her home county of Mandera had no blood pressure monitors, no medication, and no ambulance to transfer her to a better-equipped facility.
"They told me to rest and drink water. By the time my husband borrowed a motorbike to take me to the district hospital two hours away, I was convulsing," she says.
She survived. Her baby did not.
"The nurse at the district hospital told me that if we had gotten there three hours earlier, they could have saved my baby. We didn't have a car. We didn't have money for transport. And the clinic near us had nothing."
The report identifies this pattern clearly: counties in northern Kenya and arid regions record some of the highest maternal mortality rates in the country. These are also the counties with the fewest skilled health workers, the longest distances to health facilities, and the most frequent medicine shortages.
Children dying of treatable conditions
If Kenya's mothers face preventable deaths, its youngest children face even grimmer odds.
Most deaths among children under five are caused by birth complications, prematurity, pneumonia, diarrhoea and malnutrition. These are not exotic conditions requiring advanced treatment. Effective, affordable interventions have existed for decades. Yet, children keep dying from them.
The report notes that skilled birth attendance and antenatal care coverage have declined in recent years, particularly in underserved counties. Fewer mothers are delivering with trained health workers present. Fewer children are receiving essential vaccinations on time. When complications arise, families face a devastating choice: spend money they do not have on emergency transport to a hospital that may not have the required drugs, or stay home and hope for the best.
Too often, hope is not enough.
A building not the same as care
Kenya's health infrastructure has expanded significantly over the past decade. The number of health facilities has increased, and facility-to-population ratios now meet World Health Organization standards. On paper, access has improved.
But as any Kenyan who has visited a rural health clinic knows, a building is not the same as care.
"In the majority of counties, it is like they are competing to put up structures. This is a way for them to get money from county projects. We don't have the staff, the medicines, or the equipment," says a nurse working in one of these rural facilities. "I am the only nurse here for a catchment area of over 10,000 people. I am supposed to deliver babies, vaccinate children, treat malaria, manage HIV patients, and counsel on family planning. How is that possible? I am overwhelmed, and at times I break down."
The numbers tell the same story. Kenya has 0.89 medical doctors per 10,000 people, against the 7.79 required to achieve Universal Health Coverage. For nurses, the gap is even wider: 10.14 per 10,000 against a requirement of 58.64. Even where health workers exist, they are not evenly distributed. Nairobi and other urban centres have relatively well-staffed facilities. Rural counties, particularly in the north and along the coast, face chronic shortages. Health workers posted to remote areas often leave within months, citing poor pay, lack of housing and professional isolation.
And when health workers are present, they often have nothing to give. Patients are regularly sent to buy drugs from pharmacies out of their own pockets.
Frequent stock-outs of essential medicines plague health facilities across the country. Antibiotics run out. Anti-malarials are delayed. Contraceptives disappear for months.
"Procurement inefficiencies and administrative bottlenecks are to blame," the report states. "Even when funds are allocated for essential commodities, delays in procurement and low absorption rates create room for funding cuts during supplementary budgeting." The result is empty pharmacy shelves and preventable suffering.
Population outpacing its health system
Underlying all of these failures is a demographic reality. Kenya's population has grown from 5.4 million in 1948 to 47.6 million in 2019 and is projected to exceed 50 million by 2030. More than 60 per cent of the population is below the age of 25, creating enormous demand for healthcare and social services that the system is not equipped to meet.
A youthful population means high demand for maternal and child health services, school health programmes, adolescent-friendly clinics and youth employment support. Yet the health system remains understaffed, underfunded and ill-equipped.
Fifteen per cent of girls aged 15 to 19 have ever been pregnant, though rates in some Asal (Arid and Semi-Arid Lands) counties are significantly higher.
Grace Lekaita was 16 when she became pregnant. She lived in a remote village in Samburu County, where schools are few, health clinics are far, and information about contraception is virtually non-existent.
"I didn't know I could prevent pregnancy," she says. "No one talked about these things. When I told my mother, she just cried."
She dropped out of school. Her boyfriend disappeared. She delivered her baby at home with the help of a traditional birth attendant because the nearest health facility was 30 kilometres away. Both survived, which is not always the case.
Now 19, Grace has two children and has never used contraception. "I asked at the clinic once," she says. "They told me I was too young. That I should wait until I am married."
The report is clear: adolescent fertility undermines national development goals. Teenage pregnancies derail education, limit economic opportunities, and perpetuate cycles of poverty and ill health. Yet youth-friendly sexual and reproductive health services remain limited, particularly in rural areas. Cultural and religious barriers prevent many young people, especially girls, from accessing contraception even when it is available.
Where contraception is scarce
Kenya has made real progress in reducing fertility rates overall. The total fertility rate has declined from over eight children per woman in the 1980s to about 3.4 today.
Modern contraceptive use has increased steadily since the mid-1990s. But the gains are slowing, and in some places being reversed.
The contrast between counties tells the story clearly. In Nyeri, where modern contraceptive use exceeds 70 per cent, women are having fewer children, spacing births better, and investing more in each child's health and education. Maternal and child mortality rates are among the lowest in the country.
In Garissa, where contraceptive use barely reaches two per cent, fertility remains at 5.2 children per woman. Over 45 per cent of births in some northern counties occur within two years of a previous birth. Maternal mortality is high. Child malnutrition is rampant.
"The irony is painful," the report observes. "The counties that need family planning the most are the ones where it is least available and least accepted."
What must change
Dr Sheikh says that to address the dual disease burden, Kenya needs integrated service delivery that tackles infectious diseases and NCDs together.
"This means training health workers to screen for both while expanding access to affordable medications for chronic conditions," he says.
The report also recommends that to reduce maternal and child mortality, the government must direct funding and resources to counties with the highest mortality rates, expand skilled birth attendance, ensure that health facilities have emergency obstetric care capabilities, and address the harmful cultural practices and misconceptions that delay care-seeking.
On the workforce crisis, the report states: "To fix the broken health workforce, Kenya needs to work on a comprehensive strategy: better pay and working conditions to attract and retain health workers in rural areas, expanded training programmes to increase the supply of doctors and nurses, and task-shifting policies that allow clinical officers and community health workers to take on more responsibilities."
Dr Sheikh also advises that to end stock-outs and ensure health facilities consistently have essential medicines, there is need to strengthen planning and distribution
systems.
On family planning, he adds: "We must also expand access to modern contraception, particularly in underserved counties and among adolescents. This means youth-friendly services, addressing harmful norms through targeted campaigns, and ensuring that funding for family planning is sustained, not slashed, when donor support declines."
