More than 80 per cent of illnesses treated at Kenya’s Primary Healthcare (PHC) facilities are driven by just a handful of common conditions, a new report shows highlighting both a growing strain and a major opportunity to transform the country’s health system.
According to the Primary Healthcare Impact Report 2026, a small cluster of diseases accounts for the bulk of healthcare demand, with respiratory conditions alone responsible for nearly two in every five patient visits.
“Respiratory conditions alone account for close to 40 per cent of all primary healthcare encounters, making them the single largest driver of demand in the system,” the PHC Impact report notes.
These include common but widespread illnesses such as colds, pneumonia, asthma and acute upper respiratory infections conditions that are largely manageable at the primary care level when detected early.
The report further shows that other health-related factors such as malnutrition, environmental and social conditions account for nearly 19 per cent of visits, followed by digestive diseases like diarrhea and gastritis at 12 per cent, and infectious diseases including malaria and tuberculosis at 11 per cent.
“Together, respiratory conditions, health factors, digestive diseases and infectious diseases account for over 80 per cent of all primary healthcare claims,” the report states, underscoring the concentrated nature of Kenya’s disease burden.
The findings come at a time when more Kenyans are increasingly seeking care at the primary level, with over 20 million outpatient visits recorded and more than 15 million patients already served under the new system.
This trend signals a shift in how Kenyans interact with the health system.
“The data reflects a growing transition from reactive care to proactive care, where patients are increasingly seeking treatment earlier, allowing for timely intervention and better health outcomes,” the report observes.
Health experts say this shift is critical in reducing complications, lowering treatment costs, and easing pressure on higher-level hospitals.
However, the report warns that despite this progress, counties are losing billions in potential healthcare funding due to low registration under the Social Health Authority (SHA).
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Currently, about 29.8 million Kenyans roughly half the population are registered, leaving a significant portion outside the system.
“With the current level of registration, the PHC budget stands at Sh21.6 billion, but an equivalent amount is being lost due to incomplete population coverage,” the report indicates.
Under the SHA model, funding follows people meaning counties with higher registration levels receive more resources to support service delivery.
“Failure to scale up registration directly translates into reduced healthcare funding, limited-service expansion, and slower progress towards Universal Health Coverage,” the report warns.
If registration was optimal (i.e., at 100% coverage of Kenya’s 2025 KNBS projected population of 53,330,978), the global PHC allocation would have stood at KShs. 42,673,394,700. This implies that the total opportunity lost for PHC budgetary allocation in FY 2025/2026 is Sh21,091,011,300, translating to 49.42 per cent of the supposed deficit funding under PHC.
The data further reveals a growing divide between counties. Urban counties are leading the PHC rollout, with Nairobi emerging as the top performer: with over 732,000 patients served, more than 1.7 million facility visits recorded with the city county also holding the highest claims payout at Sh1.34 billion.
Other strong performers include Mombasa, Bomet, Kisumu, Nyeri and Kirinyaga, while Western counties such as Kakamega and Bungoma are also showing strong utilization despite being less urban.
“Counties with higher registration and utilization levels are effectively converting coverage into actual care, resulting in stronger funding flows and improved service delivery,” the report notes.
In contrast, ASAL counties including Turkana, Mandera, Wajir, Marsabit and Isiolo continue to lag behind due to low registration and limited SHA-compliant facilities.
This has created what the report describes as a “cycle of underfunding and under-service.”
The concentration of disease burden presents a clear pathway for reform.
By focusing on prevention and early management of a few high-burden conditions, Kenya has an opportunity to significantly improve health outcomes while reducing costs.
“Targeting a small number of high-burden conditions while expanding preventive services could substantially enhance the efficiency and sustainability of the healthcare system,” the report states.
Under the SHA framework, primary healthcare is designed not only to treat illness but also to prevent it through early diagnosis, routine check-ups, and timely intervention.
“Strengthening prevention and early intervention at the primary healthcare level remains critical to reducing disease burden and easing pressure on higher-level facilities,” the report concludes.
As Kenya’s healthcare system continues to evolve, the message from the data is clear:
A few common illnesses are driving most of the demand and addressing them effectively could unlock a healthier, more efficient system.
At the same time, expanding SHA registration may be the single most important step counties can take to unlock billions in funding and bring quality healthcare closer to every Kenyan.
