Kenya’s shift to digital health: challenges and opportunities

Kenya’s journey towards achieving universal health coverage has taken a significant step with the transition from the National Health Insurance Fund (NHIF) to the Social Health Insurance Fund (SHIF).

This move, while promising equitable access to healthcare, is encountering significant hurdles, especially with the digitalisation of the health sector.

A March 2025 policy brief by the Kenya National Commission on Human Rights (KNCHR) Kenya’s National Human Rights Institution (KNHRI), The Collaboration on International ICT Policy for East and Southern Africa (CIPESA) and the Danish Institute for Human Rights highlights these challenges and explores the human rights implications tied to this transformation, particularly for vulnerable and marginalised groups (VMGs).

The policy shift marks a substantial change in how healthcare services are managed and accessed. While the introduction of digital solutions is expected to improve the efficiency of healthcare delivery, it also introduces concerns related to data privacy, unequal access to services, and systemic gaps in infrastructure.

Despite the advancements in Information and Communications Technology (ICT), there are still significant barriers preventing Kenya from fully leveraging digital health solutions to improve health outcomes.

Human rights concerns and the digital divide

A key concern in Kenya’s health system digitalisation is the potential for marginalising already vulnerable populations. The assessment revealed that healthcare digitalisation, including the NHIF to SHIF transition, is not equally accessible across the country.

The digital divide remains wide, particularly in rural and underserved areas where access to electricity, internet, and digital literacy is limited. This disparity could hinder the ability of these populations to fully benefit from the digital health services that are being rolled out.

In addition to infrastructure challenges, gender-based barriers persist, particularly among women in rural areas. Cultural and financial obstacles continue to limit their access to digital health, especially in areas like reproductive health.

Similarly, elderly individuals and persons with disabilities are struggling to access digital health services due to a lack of digital literacy, accessible platforms, and assistive technologies.

These disparities highlight the urgent need for inclusive digital policies that cater to all groups in society. Legal and policy frameworks supporting digital health Kenya has developed a robust legal framework to support digital health.

The Constitution of Kenya (2010) guarantees the right to the highest attainable standard of health, and several key laws have been enacted to support the integration of digital solutions into healthcare.

These include the Health Act of 2017, the National eHealth Policy 2016-2030, and the Data Protection Act of 2019. These laws ensure that digital health solutions are privacy-conscious, encourage the use of electronic health records (EHRs), and promote secure data management practices.

Despite these legal provisions, challenges remain in enforcement. The fragmented implementation of digital health policies between the national and county governments has created inconsistencies in service delivery. While some counties have embraced advanced digital solutions, others continue to rely on outdated systems, exacerbating inequities in healthcare access.

The lack of a unified health information exchange framework further impedes efforts to streamline healthcare services across the country.

Data privacy and consent challenges

Data privacy is another major concern. Inadequate data protection infrastructure, especially in community health units, dispensaries, and rural facilities, leaves patients’ sensitive information vulnerable to misuse.

Although Kenya’s Data Protection Act provides safeguards, the lack of expertise and resources to enforce these regulations means that breaches continue to occur. Furthermore, vulnerable groups, such as the elderly and persons with disabilities, often do not fully understand the implications of data sharing.

This lack of awareness, coupled with poor enforcement, increases the risks of unauthorized access to personal health information.

Risks of privatisation and accountability issues

The privatisation of public healthcare infrastructure is also raising alarms. The ministry of Health has outsourced the development of the Social Health Insurance Scheme’s Integrated Healthcare Information Technology System (IHITS) to a private consortium, led by Safaricom.

This arrangement has sparked concerns over accountability and the commercialisation of public health resources. Critics argue that private control over critical healthcare infrastructure could undermine public interest protections, particularly regarding patient data management.

Moreover, the transition from NHIF to SHIF has not been smooth. Many individuals have faced disruptions in their healthcare access due to technical failures, including issues with biometric verification and claims processing.

The introduction of a means-testing system has also led to the exclusion of vulnerable populations, especially those without national IDs or reliable mobile connectivity.

Recommendations

To address these challenges, the policy brief makes several key recommendations. First, there is a need for enhanced digital infrastructure, particularly in underserved regions. Ensuring access to reliable electricity and internet services is essential for the widespread adoption of digital health services.

Additionally, the government must invest in capacity-building programs for healthcare workers, ensuring they are adequately trained to manage digital health systems and uphold data privacy standards.

The brief also calls for targeted measures to bridge the gender digital divide, particularly by promoting women’s access to digital health services and dismantling cultural barriers.

Policies should be developed to provide offline alternatives for those who cannot access digital health services due to infrastructural or literacy challenges. This approach would ensure that no one is excluded from the benefits of digital health.

Finally, the brief advocates for greater coordination between national and county governments to streamline healthcare delivery. Aligning roles, responsibilities, and resources will help address the disparities in digital health infrastructure and ensure that all Kenyans, particularly marginalised groups, can access quality care.

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