More than eight out of ten county governments in Kenya have implemented measures to improve healthcare services for persons with disabilities, marking significant progress in the devolution of disability-inclusive healthcare.
The disability inclusion assessment report, conducted by the National Council for Persons with Disabilities (NCPWD) across 41 of Kenya's 47 counties, found that 82.9 percent (34 counties) have taken specific steps to improve healthcare access for persons with disabilities.
These measures include physical accessibility to health facilities, disability-specific medical support, and inclusive health communication strategies.
Currently, 85.4 percent of counties provide essential mobility and support equipment such as wheelchairs, white canes, hearing aids, and prosthetics.
Of these, 91.4 percent offer the devices completely free of charge, removing a critical financial barrier that has historically prevented many persons with disabilities from accessing the tools they need for independence and social participation.
"These findings suggest that most county governments recognise the need to address disability-related healthcare access. However, the seven county governments without any reported interventions represent a significant gap," the report said.
"This raises concerns about potential inequality in healthcare delivery and the need for national-level guidance to ensure universal health access for all persons with disabilities."
The report also shows that nearly three-quarters of counties (73.2 percent) provide some form of rehabilitation services, with physiotherapy universally available in counties offering such care.
Additionally, 68.3 percent of counties offer disability assessment services free of charge, facilitating access to various disability benefits and support programs.
These numbers come at a critical time in the country's journey toward deepening devolution and incorporating inclusion in governance structures, as per the Constitution of Kenya.
The Persons with Disabilities Act of 2025 guarantees persons with disabilities the right to access healthcare.
However, despite these achievements, the assessment reveals persistent gaps that threaten to undermine progress. While 23 counties have established county-level health insurance schemes, only 15 counties (37.5 percent) have implemented special measures such as free or subsidised coverage to ensure persons with disabilities can actually afford the care they need.
"The absence of such schemes in nearly half the county governments limits access to affordable and inclusive healthcare, particularly for persons with disabilities who often face higher medical needs and costs," the report said.
Moreover, while rehabilitation services exist in most counties, only 43.3 percent provide speech-language and audiology therapy, and just 13 counties offer the full spectrum of rehabilitation care, including physiotherapy, occupational therapy, mental health support, orthopedic technology, and speech therapy.
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Geographic inequality further compounds these challenges, with specialised healthcare largely confined to urban centers, effectively excluding rural populations who face both distance and cost barriers.
Community-based rehabilitation programs that could bring services closer to where people live exist in only a handful of counties.
Furthermore, among counties offering free disability assessment, only 53.6 percent have anchored this policy in law, leaving these services vulnerable to budget cuts or reversal with changes in county leadership.
The assessment also found that while 68.3 percent of counties have waiver mechanisms to exempt vulnerable populations from healthcare costs, implementation remains inconsistent.
Kenya has made notable policy commitments toward disability inclusion over the recent years. However, for millions of persons with disabilities, everyday life remains defined by exclusion rather than access.
According to national census data, about 2.2 percent of Kenyans—roughly 900,000 people aged five and above live with some form of disability. Notably, women are disproportionately affected, with disability prevalence higher among women than men, while mobility and visual impairments remain the most common.
At the same time, more recent household surveys suggest that up to 15 percent of Kenyans report at least one functional difficulty, including challenges in seeing, hearing, walking, remembering, or communicating.
This disparity points to long-standing undercounting and highlights persistent weaknesses in disability data systems. Beyond prevalence, economic exclusion remains one of the most entrenched challenges.
Persons with disabilities are more likely to live in poverty and less likely to access stable employment.
In practice, despite legal provisions requiring inclusion, recent workforce assessments show that persons with disabilities make up just about 1.3 percent of the public-sector workforce, far below expected thresholds.
Without income security, households face compounded vulnerability, driven by additional disability-related costs such as assistive devices, transport, and ongoing care.
Meanwhile, social stigma and misinformation persist, shaping attitudes in homes, schools, workplaces, and public institutions.
“This assessment gives us a clear baseline," says Dr Alfred Mutua, Cabinet Secretary for Labour and Social Protection, in the report's foreword.
"We can now see where counties are succeeding and where urgent action is needed. The next step is to move from assessment to action—to ensure every county is equipped and committed to serving all its citizens, including those with disabilities."
