Paper Short Abstract:

The piece we write about is but a sub-data of an ethnographic study on young women’s reproductive future in the wake of the COVID-19 vaccination rollout in Khwisero, Kenya. The ethnographic thoughts and stories portray how untimely state healthcare financing changes can do to vaccination discourse.

Paper Abstract:

Following independence in 1963, the Kenyan post-colonial government made free health care a key policy goal. This was an attempt to abolish the health care user fees (out of pocket) implemented by the colonialists. However, around 1989, following pressure from the World Bank and IMF, user fee was reintroduced. The reintroduced fees were again suspended in 1990 and reintroduced in phases in 1991. From 1991 onwards, several abolishment and reintroductions of user fees on different healthcare levels have continued to disorganize and stagnate the access and utilization of state care in Kenya. The continuity of these colonial and post-colonial public health histories of shifty, divisive user fees within care contributed to the discord between the Khwisero women and state healthcare systems in the region. Drawing on 8-month ethnographic work, I invite the audience to explore through stories embedded in photo ethnography, a mini-dynamics series on how state care engulfed in "user fee" policies fractured and reproduced vaccine hesitancy among women in the Khwisero. The health facility in this paper was not only a hospital premise but housed the history of care - of the women's idea of justice, inclusion and fairness. prior to July 2022- before the COVID-19 pandemic, care was administered free in the hospital premises, but with the introduction of the healthcare user fee, the hospital became a hotbed of politics- injustice- doubtful hope- vaccination rumours and hesitancy, and multiple dysfunctionalities. I situate my COVID-19 vaccination work within this plurality and complexities of women's vaccination hesitancy and care fees.