Kenya launched a new AI-driven health system in late 2024, promising to improve access to healthcare for all. The system was part of President William Ruto’s pledge to make healthcare affordable, especially for those working in the informal economy. However, an investigation reveals that the system is actually making life harder for the poorest Kenyans by increasing their costs and limiting their access to care.

How the AI System Works and Its Flaws

The government’s new healthcare model uses a machine learning algorithm to determine how much each household should pay for health insurance. Unlike advanced AI tools like ChatGPT, this system is a predictive model that estimates incomes based on household data collected through questionnaires. Volunteers like Grace Amani visit homes, asking questions about toilets, roofs, radios, and other household details. The responses are fed into the algorithm, which then calculates a premium for each family.

Investigators found that from the start, the system was systematically overestimating the incomes of the poorest households, leading to higher charges than they could afford. Conversely, it underestimated the incomes of wealthier families, resulting in lower premiums for the better-off. This flawed approach means that many low-income families are paying a significant portion of their tiny earnings—sometimes 10% to 20%—just to access basic health services.

Impact on the Poorest and Healthcare Access

Many families, especially in Nairobi’s largest slum, Kibera, are suffering because of these miscalculations. Grace Amani, a community volunteer, has seen families struggling to pay premiums they cannot afford. She reports that some critically ill patients are unable to get treatment because they haven’t paid the amount the system calculated as their contribution. This has led to protests and growing anger among residents who believed the new system would benefit them.

The promise was that those with the lowest incomes would pay little or nothing. Instead, many are being charged premiums that are far beyond their means. This situation has made many people feel betrayed, and some believe the system is penalizing the very people it was meant to help. The lack of transparency and perceived unfairness are fueling public discontent and protests across different regions.

While the government claims that the AI system is “accelerating digital transformation,” critics argue that its flawed design is doing more harm than good. It highlights a major gap between the system’s promises and its actual outcomes, especially for vulnerable communities.

Overall, the Kenyan AI health reforms show how technology can sometimes backfire when not properly designed or tested. Instead of helping the poorest, the system appears to be widening inequalities and increasing financial barriers to essential healthcare. This situation underscores the need for better oversight, transparency, and adjustment of such digital initiatives to truly serve all citizens fairly.

Inspired by

• https://www.theguardian.com/global-development/2026/may/04/kenya-ai-healthcare-reforms-driving-up-costs-for-poor

Sources

• go.ke
• lighthousereports.com
• co.uk
• co.ke