Is primary healthcare finally reaching more Kenyans?
Kenya has expanded its network of primary healthcare facilities as counties seek to bring essential medical services closer to communities and reduce pressure on major hospitals.
The number of established Primary Care Networks (PCNs) across the country rose by 22 per cent to 277 in the 2025/26 financial year, up from 227 the previous year.
The networks bring together health facilities and community-level services within defined geographical areas, allowing patients to access routine treatment closer to where they live.
“About 70 percent of health needs in the country are met at the primary healthcare level. Many of the conditions we commonly suffer from, such as flu, colds, and diarrhoea are handled at the primary healthcare level,” Dr Mwangangi said yesterday during a Media Town Hall ahead of the Kenya Health Summit next week.
The expansion is part of efforts to make primary healthcare facilities the first point of contact for routine medical needs while improving referrals and coordination between different levels of care.
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Why primary healthcare is getting more attention
Dr Mercy Mwangangi, Chief Executive Officer of the Social Health Authority (SHA), said the bulk of the country’s everyday health needs can be addressed at the primary healthcare level.
She argued that strengthening this part of the health system could also deliver significant economic benefits by preventing conditions from becoming more serious and reducing the need for expensive hospital treatment.
“For every shilling invested in primary healthcare, you can recoup nine shillings. That is the return on investment of primary healthcare,” she added.
According to SHA data, the government has invested Sh27 billion in primary healthcare over the past 18 months, compared with Sh1.8 billion invested by the previous government.
The expansion of PCNs has also been accompanied by efforts by counties to develop new approaches to healthcare delivery. The Council of Governors’ Maarifa Centre documented 23 county innovations and best practices from 15 counties.
The initiatives cover areas such as integrated service delivery, community health systems, referral coordination, digital health and strengthening the health workforce.
PCNs are designed to connect facilities operating within a particular area so that patients can receive appropriate treatment without unnecessarily being referred to higher-level hospitals.
The approach is expected to be particularly important for communities that face challenges travelling long distances to access specialised medical facilities.
A stronger primary healthcare system can also allow hospitals to concentrate on patients who require more complex treatment, rather than being overwhelmed by routine conditions that could be managed at lower levels.
The increase from 227 to 277 established networks represents one of the latest indicators of the government’s push to expand healthcare access through the primary care system.
However, the expansion is taking place alongside continuing concerns over the cost of treatment and charges imposed on patients at some facilities.
Government warns against charging patients
Health Cabinet Secretary Aden Duale said the government was working to remove financial barriers at lower levels of the healthcare system.
He said primary healthcare at Level Two, Level Three and part of Level Four facilities is supposed to be free to Kenyans, although he acknowledged that some facilities continue to charge patients despite the policy.
“A Kenyan should be able to walk into a facility, receive treatment and walk out without being charged,” Mr Duale said, adding that the policy applies whether a facility is faith-based, county-run, private or church-based.
The CS acknowledged that implementation has not been without difficulties, particularly in facilities where patients continue to encounter charges.
“I agree that there are challenges, including cases where some facilities still attempt to charge patients.”
Duale said the government had allocated Sh19 billion in the current financial year to fund treatment for Kenyans accessing dispensaries, health facilities and some Level Four services.
The government has maintained that the funding is intended to ensure patients can access essential services without having to pay out of pocket at facilities covered by the policy.
“Therefore, charging a Kenyan for these services is a criminal offence, regardless of the type of facility,” he said.
The warning comes as the government continues to restructure the healthcare system and expand the role of primary facilities in delivering care.
The success of the PCN expansion will ultimately depend on whether the networks translate into better services, shorter referral journeys and fewer financial barriers when seeking treatment.
The growth in the number of networks suggests counties are increasingly embracing a model that places community-level healthcare at the centre of the health system.
Yet establishing a network is only one part of the process. Facilities must also have adequate health workers, medicines, equipment and functioning referral systems to ensure patients receive appropriate care.
The innovations documented across the counties could provide lessons on how different regions are addressing these challenges, particularly in areas such as digital health and community-based services.
The government’s increased investment in primary healthcare is therefore expected to remain a key part of efforts to shift Kenya’s health system towards prevention and early treatment.
To millions of Kenyans, the closest dispensary or health centre remains their first interaction with the healthcare system. Strengthening those facilities could determine how effectively the country delivers its broader promise of affordable and accessible healthcare.
