The ageing population in Africa is rapidly growing, yet health financing systems remain ill-equipped to meet their needs. Older people are more likely to experience catastrophic health expenses that significantly strain their finances.
According to the World Bank, around 3.2 million Kenyans are 60 years old and above, marking a significant demographic shift in the country’s population. Despite this, healthcare systems are not tailored to meet the needs of this growing group.
Speaking at the Regional Health Promotion Conference (RHPC) 2025, the CEO and Founder of Ageing Concern Foundation (ACF), Titus Abworo, raised alarm over discriminatory healthcare systems especially financing structures that exclude older and ageing populations and poses a major hindrance to Universal Health Coverage (UHC).
“When we examine the intersection of health, finance, and population ageing, and then consider individual and household income security, the reality is that the majority of older people live in poverty. This is a shared experience for many.” He said.
In Kenya, the government, through a social protection scheme called ‘inua Jamii’, provides a monthly stipend of Ksh 2,000 for those aged 70 and above. This however is not enough to meet their basic needs such as food, shelter and healthcare.
According to the World Health Organization (WHO) the prevalence of unmet health needs among older people exceeds 50 per cent in several countries. Low health insurance coverage means that millions of households are pushed into poverty every year to cover high out of pocket expenditure.
During a discussion moderated by HENNET, Dr. Abraham Rugo, Executive Director of Bajeti Hub and a public finance economist, highlighted the significant financial burden on Kenya’s healthcare system
He noted that Kenya funds around 50 percent of its healthcare through public taxes, while 24 percent comes from out-of-pocket payments terming it as an unsustainable model.
“In a population where 4 out of every 10 Kenyans is poor, only public financing of healthcare is sustainable. Contribution mechanisms will not work for you. The private sector will not work for you. Only a public tax-funded mechanism can work in this context.”
Abworo highlighted the financial vulnerability of older people, noting that rising medical expenses and high unemployment leave many dependent on pensions, family support, or informal work to meet healthcare costs.
“Medical expenses are rising globally. High unemployment among older people compromises their income status leaving them dependent on pensions, family support, or informal work to meet healthcare costs also. The Constitution of Kenya defines an old person as someone aged 60 and above, yet the social protection scheme only pays those 70 and above. What happens to the group between 60 and 70?”
On the issue of Universal Health Coverage (UHC) and its effectiveness for older people, Abworo emphasized the need for inclusivity in healthcare provision, stating that there is a strong push to ensure every older person is heard in discussions on UHC implementation.
“We are dealing with a healthcare workforce that is not adequately trained to address the needs of older people. This is an area that requires significant investment.”
He pointed out the disparity in specialized care, noting, “For those with children, it is common to seek out specialists when a child falls ill. But what happens to older people? Despite being a growing population, they often lack access to specialized care.”
He lauded the government’s efforts so far as Kenya is one of the few countries that ratified the African Union Protocol to the African Charter on the Rights of Older People.
“It includes provisions for increasing health and care services for older individuals. Implementing these policies would be a significant step forward.”
Age discrimination remains one of the biggest challenges in ensuring equitable healthcare for older individuals, Abworo stressed the urgency of reforms in health financing and service delivery to ensure that Africa’s aging population is not left behind.
