Why Kenya’s Healthcare Future Depends on Efficiency
Why Kenya’s Healthcare Future Depends on Efficiency
The Hidden Side of Healthcare
When most people think about healthcare, they picture doctors, nurses, and hospital wards. Few imagine the systems that keep everything running, approvals, claims, and coordination that determine whether care feels smooth or stressful.
This unseen machinery decides how fast a patient gets treatment, whether a hospital stays financially stable, and how much trust insurers earn from the public.
The Cost of Inefficiency
Across Kenya, patients still face delays caused by misplaced paperwork, slow approvals, or systems that do not communicate. These inefficiencies cost more than time; they impact lives.
Kenya spends about 5.2 percent of its GDP on health, yet out-of-pocket payments still make up nearly a quarter of all medical expenses.
Even as infrastructure expands and insurance access grows, inefficiency quietly drains patients through extra costs, stress, and preventable risks.
Globally, the problem is not unique. A McKinsey study estimates that up to 30 percent of total healthcare spending goes to administrative processes rather than actual medical care.
Kenya’s Challenge
In Kenya, the effects are visible in manual claims, disconnected hospital systems, and outdated data tools. These slow down services and create friction between insurers, hospitals, and patients.
But the conversation has started to shift. Healthcare efficiency is no longer just about cutting costs. It is now about improving the patient experience by making care faster, clearer, and more coordinated.
At Jubilee Health Insurance, we are tackling this challenge through our initiative, Re-Engineering the Care Experience. In 2024, we processed over 1.2 million medical transactions.
Our artificial intelligence systems now handle parts of claims processing, reducing turnaround time by more than 40 percent. This innovation has eased long-standing tensions between hospitals and insurers, ensuring quicker payments and smoother workflows.
Faster settlements also mean providers can spend more time on patients and less on paperwork.
Why Kenya’s Healthcare Future Depends on Efficiency
Guiding Patients Through Care
Another key improvement is our structured care navigation program. Through it, care managers guide patients from diagnosis to drug delivery and even home recovery.
This model has reduced hospital readmissions by up to 18 percent, proving that efficiency directly supports better outcomes.
Operational excellence is not just about faster machines; it is about connected systems. Insurers play a crucial role because they sit at the intersection of data, funding, and patient care.
Partnerships are also essential. Linking hospitals, pharmacies, and digital health providers into a shared, interoperable network can reduce duplication, shorten fulfillment times, and cut post-discharge delays. These lessons are already proven in several pilot projects.
As Kenya moves closer to Universal Health Coverage, the key question will change. It will no longer be about who builds the most hospitals, but who builds the smartest systems.
The future of healthcare lies not in expansion alone, but in efficiency, where every process, partnership, and innovation works toward one goal: better care for every Kenyan.
The writer is the Chief Operating Officer, Jubilee Health Insurance.
By Dr Musa Misiani
