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Paper short abstract:

This paper explores how struggles and future uncertainties surrounding access to health care foster the creation and maintaining of different relationships and networks of care and support through digital and mobile technologies within the realm of Kenya´s national health insurance and outside it.

Paper long abstract:

Over the last decade, the Kenya government has continued to expand the country’s national health insurance (National Hospital Insurance Fund, NHIF) to include those in the informal sector, the elderly people, and vulnerable populations. Recently, the government has even resulted to coercive measures in persuading its citizens to become members or pay premiums to the NHIF. The Kenyan state portrays the national health insurance as a national collective and frames it within the language of inclusion, common good, equity, financial protection and state responsibility to care. Meanwhile, the national health insurance does not offer reliable access to healthcare. In many cases, patients and health workers navigate both mundane and persistent complexities, disappointments, frustrations and failure of the national health insurance through different kinds of solidarities, even beyond ethnic, kinship-based, and patronage networks. The increasing digitization of Kenya’s economy through mobile money technology over the last decade has transformed these forms of solidarities/networks of care in different ways. Based on ethnographic fieldwork in Kenya, this paper explores how struggles and future uncertainties surrounding access to health care have fostered the creation and maintaining of different relationships and networks of care and support through digital and mobile technologies within the realm of the health insurance and outside it. Membership to these solidarities is not a straightforward one, which complicates their future and that of the insurance, but also triggers questions about the kinds of care produced and maintained in the process.