{"id":115857,"date":"2026-06-05T14:36:09","date_gmt":"2026-06-05T11:36:09","guid":{"rendered":"https:\/\/www.capitalfm.co.ke\/business\/?p=115857"},"modified":"2026-06-05T14:36:09","modified_gmt":"2026-06-05T11:36:09","slug":"rising-illness-burden-among-elderly-and-children-deepens-kenyas-health-financing-gap","status":"publish","type":"post","link":"https:\/\/www.capitalfm.co.ke\/business\/2026\/06\/rising-illness-burden-among-elderly-and-children-deepens-kenyas-health-financing-gap\/","title":{"rendered":"Rising Illness Burden Among Elderly and Children Deepens Kenya\u2019s Health Financing Gap"},"content":{"rendered":"<p><strong>NAIROBI,Kenya,June 5-<\/strong>Kenya\u2019s healthcare financing challenge is increasingly being shaped by the needs of school-going children and older adults, with new expert views suggesting that healthcare products and coverage models have not kept pace with the distinct risks facing the country\u2019s youngest and oldest populations.<\/p>\n<p>The findings point to mounting pressure on households already grappling with rising living costs, with out-of-pocket spending still accounting for about 27 percent of total health expenditure.<\/p>\n<p>This means many families continue to pay directly for treatment, often forcing them to draw on savings, seek support from relatives or delay care when faced with major health events.<\/p>\n<p>More than 8.5 million Kenyans are school-going children, while over 1.4 million are aged 60 and above, making them among the largest demographic groups with healthcare needs that differ significantly from those of the working-age population.<\/p>\n<p><strong>Rising costs of ageing add to family financial burden<\/strong><\/p>\n<p>Data from Heritage Insurance&#8217;s analysis of 7,459 claims cases involving members aged above 60 highlights the growing financial impact of healthcare in later life.<\/p>\n<p>The review found that inpatient admissions averaged Sh318,117 per case, while major disease events averaged Sh255,885.<\/p>\n<p>&#8220;The research suggests that the burden remains significant and, in many cases, destabilizing. Out-of-pocket spending is still roughly 27% of total health expenditure, which means a substantial share of care is still being paid for directly by families,\u201d said Antony Mwangi, General Manager, Health at Heritage Insurance.<\/p>\n<p>&#8220;In practical terms, that often means dipping into savings, delaying treatment, relying on family contributions, or turning to informal support systems when a serious health event occurs.&#8221;<\/p>\n<p>The insurer&#8217;s analysis further showed that circulatory diseases were the largest cost driver among older members, accounting for Sh33.1 million across 1,452 cases, underscoring the growing burden of chronic illnesses and specialist care needs as Kenya&#8217;s population ages.<\/p>\n<p><strong>&#8216;Sandwich generation&#8217; feeling the pressure<\/strong><\/p>\n<p>The findings also shine a spotlight on Kenya&#8217;s growing &#8220;sandwich generation\u201d; working adults simultaneously supporting children and ageing parents.<\/p>\n<p>Health shocks affecting either group can quickly strain household finances, particularly where insurance coverage is limited or poorly aligned with actual healthcare needs.<\/p>\n<p>Industry observers argue that traditional one-size-fits-all insurance models are becoming less effective as healthcare needs become increasingly age-specific.<\/p>\n<p>Children often require school-linked healthcare access, emergency response mechanisms and mental health support, while older adults need continuity of care, chronic disease management and protection against severe inpatient events.<\/p>\n<p>&#8220;The market now needs to think beyond broad benefit design and ask a more strategic question: how do people actually navigate care at different points in life?&#8221;<\/p>\n<p>&#8220;The next phase of market growth is likely to come from that level of relevance, not from repeating the same generic cover message to every audience.&#8221;<\/p>\n<p><strong>Stakeholders urged to rethink healthcare access<\/strong><\/p>\n<p>Mwangi argues that employers, schools, insurers, brokers and policymakers all have a role to play in addressing healthcare affordability and access gaps.<\/p>\n<p>For employers, family healthcare costs increasingly affect employee wellbeing and productivity, while schools are under growing pressure to strengthen health and wellbeing support systems.<\/p>\n<p>For policymakers, the findings come as Kenya continues implementing health sector reforms aimed at expanding access and reducing the financial burden of care.<\/p>\n<p>Mwangi note that closing healthcare gaps will require stronger coordination between public initiatives and private-sector solutions.<\/p>\n<p>While Heritage Insurance and Liberty have positioned HeriAfya as one response to these emerging needs, the broader market signal is that healthcare products designed around specific life stages may become a key growth area as insurers seek to address evolving demographic and financial realities facing Kenyan households.<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>NAIROBI,Kenya,June 5-Kenya\u2019s healthcare financing challenge is increasingly being shaped by the needs of school-going children and older adults, with new expert views suggesting that healthcare products and coverage models have not kept pace with the distinct risks facing the country\u2019s youngest and oldest populations. The findings point to mounting pressure on households already grappling with [&hellip;]<\/p>\n","protected":false},"author":14438,"featured_media":115858,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1874],"tags":[28282,28281],"coauthors":[9476],"class_list":["post-115857","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health","tag-financing-challenge","tag-health-expenditure"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v25.7.1 (Yoast SEO v27.5) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Rising Illness Burden Among Elderly and Children Deepens Kenya\u2019s Health Financing Gap - Capital Business<\/title>\n<meta name=\"description\" content=\"NAIROBI,Kenya,June 5-Kenya\u2019s healthcare financing challenge is increasingly being shaped by the needs of school-going children and older adults, 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