A Cooperative Approach to Advancing Universal Health Coverage in Kenya

The government of Kenya (GOK) is dedicated to the provision of universal health coverage (UHC) for its citizens. In the last two decades, it has added the right to health care to its constitution and included UHC in strategic plans for the development of the country. To reach UHC, the government hopes to leverage its long-standing National Health Insurance Fund (NHIF). Currently, ninety nine percent (99%) of formal sector employees and their families are enrolled in NHIF. But a substantial challenge remains – how to reach, enroll, and retain the informal sector, which accounts for some 80% of Kenya’s total population.  For that, NHIF has partnered with HealthPartners.

HealthPartners is a US-based integrated health care organization, providing health care services and health plan financing and administration. Founded as a cooperative in 1957, today it is the largest consumer governed nonprofit health care organization in the nation. Internationally it works with stakeholders to launch and manage local health financing solutions and ministries to ensure the regulatory environment exists to expand access to quality, responsive health care. 

To reach the informal sector, NHIF and HealthPartners – together with the Ministry of Health and USAID – are taking advantage of the vast cooperative sector in Kenya. Sixty two percent (62%) of the informal sector derive at least a portion of their income from cooperatives and many use their cooperatives to gather information, build their skills, and develop trusted relationships. The challenges of reaching the informal sector – identifying accessible channels of communication, sharing information in a contextually appropriate manner, and building trust – are largely overcome by accessing members through their cooperatives. The cooperative infrastructure can also be used to provide feedback about the quality of services being offered and customer satisfaction, allowing NHIF to provide better and more responsive services to members. 

HealthPartners, GOK, NHIF, USAID, and cooperatives recognize the win-win opportunity – meet cooperative member needs and GOK will be able to enroll and retain millions of members in NHIF, quickly advancing progress toward UHC. For cooperatives, access to quality, responsive health care means not only improved health, but increased productivity. 

In July, NHIF and HealthPartners brought together 42 local and international cooperative and health organizations to strategize and collaborate to meet a collective goal – expanding access to quality health care through cooperatives. HealthPartners is keenly aware that important work is being done in the cooperative and health sectors by existing stakeholders. Rather than duplicate efforts, HealthPartners is serving in a facilitative role, bringing those stakeholders together to network, plan, and collaborate. Through a series of meetings and mapping exercises, NHIF, HealthPartners, health and cooperative development organizations created actionable plans they will carry out over the next three months to move the group toward its goal. In October, it will convene the group again to review progress, re-assess, and continue to build momentum.  

GOK will be celebrating the launch of UHC on October 20th, Heroes Day.  On that day, NHIF and HealthPartners will be proud to stand next to the myriad cooperative stakeholders that are doing the work of connecting their members to quality, responsive health care.If you or any of your partner organizations would like to be involved in this effort or would like more information, please reach out to Britt Cruz, Deputy Director, International Development, HealthPartners at

Cooperative Champion trainers learn how to listen and explain insurance benefits and how to enroll. The picture above shows the most recent group of cooperators trained. NHIF Champion Training of Trainers is being rolled out country wide in partnership with Ministry of Health Community Health Promoter investments and through MOUs NHIF is signing with cooperatives directly. This presents an opportunity for cooperative development partners to help cooperatives offer and manage health products for members. 

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Participants from NHIF, USAID, KUSSCO, ICA, USAID Kenya, Global Communities, and HealthPartners at Cooperative Development Organization Round Table 

Trainers role play at NHIF Champion Training of Trainers. 

NHIF Champions Training of Trainers