Paper short abstract:

This paper explores recent attempts in Kenya to expand formal systems of health insurance and how these intersect with household economies and class identities, forms of solidarity and networks of care, and understandings of citizenship.

Paper long abstract:

The Kenya government has recently sought to widen financial and social protection and access to healthcare for citizens by expanding health insurance under the ‘universal health coverage’ agenda. While the national health insurance fund caters mostly for the formally employed, there are attempts to persuade those outside formal employment, the majority of the population, to voluntarily enroll into health insurance. Many citizens, however, experience their social networks and/or membership of various mutual aid or savings groups as more reliable than the national health insurer. Drawing upon fieldwork conducted with actors involved in the design and implementation of these schemes, as well as with ordinary Kenyans struggling to access healthcare, I explore how attempts to expand or access formal systems of health insurance interact with household economies and class, forms of solidarity and social networks offering support and care, and understandings of citizenship. In doing so I interrogate meanings, relations, frictions and fragmentations in diverse forms of support, protection and care.