Paper short abstract:

2018 ushered in a state declaration and hope for Universal Health Coverage in Kenya. This paper highlights the possibilities but also the limits of health insurance, and the importance of kinship and social networks in navigating care.

Paper long abstract:

2018 ushered in a state declaration and hope for Universal Health Coverage in Kenya. Years of structural adjustments, mounting costs of health care, the institution of ‘user fees’ and rising rates of chronic illnesses mean that ordinary Kenyans have little control over their health and healthcare costs. However, the universal health coverage agenda reignited hope, desire and claims of public health control for the ordinary citizens as it promised their inclusion into the insurance fold offering better access and affordability of necessary care. At the national level, the World Bank financed social health insurance experimentations in four select counties during 2018 and 2019, which are still ongoing. Elsewhere, county leaders experimented with specific premium based insurance schemes. Various health sector actors, whether for-profit and not-for-profit, made claims and spearheaded efforts to bring the uninsured into the insurance fold, positioning themselves as compassionate caregivers, dependable networks and welfare champions to the poor and vulnerable or to the off grid populations. This context of renewed hope for the expansion of health insurance arise alongside efforts to ‘restructure’ sub-Saharan’s oldest health insurer as the ideal public health purchaser. Drawing from 12 months ethnographic fieldwork in Kenya. This paper highlights the possibilities but also the limits of health insurance, and the importance of kinship and social networks in navigating care. It also attends to the politics of value and strategic inclusion emerging among uninsured publics and actors, through following some Kenyan families seeking redress of emerging and prolonged health crises for loved ones.