This story has significance for readers across Kenya and beyond.
I attended this week’s two‑day town hall meeting on the health sector at the Kenyatta International Convention Centre (KICC), presided over by President William Ruto and here is my take.
My initial inclination was to dismiss the two‑day town hall as yet another PR exercise, staged to let Cabinet secretaries, mandarins and governors dazzle the public with propaganda and pipe dreams about the much‑maligned Universal Health Coverage programme and its centrepiece, Social Health Authority (SHA).
Yet as I followed the deliberations closely, what struck me most was the robust discussion, the informed exchanges, and the sheer volume of factual information disseminated about the state of play in the health sector—what is happening in front of our noses and in the real world in our health spaces, but which we refuse to acknowledge.
My biggest takeaway, however, did not come from the speeches and presentations by the large gathering of mandarins and politicians in attendance.
Clearly, personal testimony is a powerful communications tool. Of course, it is not beyond cynical mandarins to ferry ordinary citizens to such events to mouth fairy tales about the successes of SHA.
But any discerning and dispassionate observer following the happenings at the town hall—and keenly observing the demeanour and stories of those ordinary folks—would not conclude that the citizens telling stories about how SHA coverage had settled their medical bills were simply a bunch of fakes.
Among the most moving testimonies was that of John Gikonyo, President of the Renal Patients Society of Kenya and a kidney transplant patient, who described how SHA coverage has helped him and many other renal patients meet the cost of dialysis and related care.
The testimony from the manager of Pumwani Maternity Hospital, and from small health facilities in far‑flung corners of Lamu County, describing how SHA coverage had improved their operational efficiency, was also compelling.
Together, these testimonies did more to convey the basic facts about the positive impact of the Universal Health Coverage programme than any official presentation could.
If you want to know whether SHA works or not, don’t ask a politician. Ask your next‑door neighbour or relative who has just been discharged from hospital.
Universal health care schemes, wherever they are rolled out, tend to generate friction—and Kenya is unlikely to prove the exception. We should never imagine that SHA will ever be free of controversy.
Part of the reason is structural. Universal coverage requires enormous, sustained fiscal commitment, financed through taxes, payroll deductions or premiums that citizens feel directly in their pockets.
It forces governments into trade‑offs between the breadth of coverage, the quality of care and the speed with which patients are attended to—trade‑offs that inevitably disappoint someone.
And because health touches people at their most vulnerable, disputes over these schemes tend to be far more emotive and personal than, say, arguments over road contracts or telecoms regulation.
One need only look to the United States and Britain to see how durable this friction can be, even in much older, wealthier democracies. Sixteen years after Obamacare—the Affordable Care Act—was signed into law, most of the American public now views it favourably, yet opinion remains as sharply partisan as ever.
Roughly nine in 10 Democrats hold a favourable view, against a large majority of Republicans who remain opposed—a chasm that has barely narrowed in over a decade, with fresh disputes over premium subsidies and rising costs still dominating the debate.
Britain’s National Health Service (NHS) tells a related but distinct story. The NHS is one of the most cherished institutions in British public life, and a large majority of Britons still insist it should be free at the point of use, funded through general taxation and available to everyone.
Yet satisfaction with how the service actually runs has been dismal, falling to a record low of just one in five Britons in 2024 and recovering only modestly to about a quarter in 2025, with services such as accident and emergency care and dentistry remaining stubbornly unpopular.
Britons, in short, love the idea of the NHS; they are far less enamoured with its performance.
The lesson from both cases is the same: broad public support for the principle of universal healthcare can coexist quite comfortably with sharp, persistent dissatisfaction—or outright political division—over the way it is implemented.
We should therefore not be startled that SHA has attracted its share of criticism, nor treat every complaint as proof that the whole programme is failing.
The real test, as with Obamacare and the NHS, will be whether Kenya’s policymakers keep listening to both the testimonies and the grievances, and keep adjusting the scheme accordingly, rather than either dismissing the critics or resting on the applause.
The writer is a former Managing Editor for The EastAfrican.
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Reporting originally appeared via Business Daily. Read the full source for additional context.