The Hidden Challenge in Healthcare Expansion

Primary care remains the foundation of any strong health system. Yet in rural and peri-urban areas across the continent, it is often the most fragile link, plagued by inconsistent staffing, medication stock-outs, and long travel distances to facilities. Community clinics, when thoughtfully executed, reverse that narrative.

1. Invisible Patients: Who’s Still Being Missed and Why It
Matters
In Kenya’s evolving healthcare system, access continues to be celebrated as a policy success.
Facilities are expanding, mobile clinics are increasing, and private networks are entering
counties once considered medically underserved.
But even as the map fills in, a critical question remains unanswered:
Who is still missing from the system, and why?
From elderly patients who cannot navigate long queues, to people living with disabilities who
face architectural and communication barriers, to migrant workers and refugees who remain
undocumented and excluded—entire populations are still effectively invisible to the very
health systems built to serve them.
As the conversation around healthcare equity deepens, Kenya must now confront not only
where access is available, but who it is truly designed for.
Understanding the “Invisible” in Kenya’s Health System
Invisible patients are not necessarily distant from clinics. Many live within walking distance of
health facilities. Their invisibility is not geographic—it is systemic.
These patients may never register at a front desk because signage is unreadable or in the
wrong language. They may leave waiting rooms because no one assists them. They may avoid
facilities altogether due to stigma, fear, or lack of culturally sensitive care.
Among those most affected are:
●People living with disabilities, particularly those with visual, mobility, and cognitive
impairments
●Elderly citizens, especially in rural regions where assistance and follow-up systems are
limited
●Migrant laborers, domestic workers, and displaced individuals who face legal, financial,
or social exclusion
●Youth with chronic mental health needs, often misunderstood or unsupported in
outpatient models
Despite being statistically present in national datasets, these individuals rarely complete patient
journeys—making them effectively invisible to planning, budgeting, and evaluation mechanisms.

2. Inclusive Infrastructure Begins at the Design Table
Some healthcare providers are beginning to shift this narrative—not just by acknowledging
these gaps, but by designing for them from the ground up.
Healthcare networks such as Lifecare Hospitals and Bliss Healthcare have introduced more
inclusive planning principles into their facility development and operations. Their emerging
model treats inclusion as a structural input, not a downstream service.
At Lifecare, hospital branches in counties like Bungoma and Meru were launched with features
often seen as optional elsewhere: ramps and wide corridors for mobility-impaired patients,
auditory navigation aids, and family waiting areas that accommodate elderly caregivers.
Bliss Healthcare, with its high-volume outpatient centers, has integrated appointment booking
support through community health workers for elderly patients and those with difficulty using
mobile platforms. Clinics also maintain multi-language staff support in areas with diverse
populations, such as Kisumu and Nairobi’s Eastlands.
Data, Outreach, and Visibility
Inclusion begins with acknowledgment—and that means gathering data that most systems still
don’t track.
Bliss Healthcare has piloted inclusive patient profiling, which allows staff to record
accessibility needs during the first visit. This information feeds into triage systems, ensuring that
patients with additional support needs are fast-tracked or provided with tailored care pathways.
Lifecare Hospitals has begun integrating disability-inclusive health audits into quarterly
reviews, evaluating not only physical infrastructure, but patient flow, signage design, and
communication practices.
These initiatives are complemented by outreach models that go beyond facility walls. Mobile
screening camps by both institutions are increasingly targeted toward underserved populations
—offering free services in locations where travel or stigma might otherwise prevent
engagement.
Such outreach isn’t an act of charity—it’s a necessary correction to a system that, by default,
overlooks the hardest to reach.
Leadership That Frames Inclusion as Strategy
The operational philosophy behind these shifts reflects a deeper commitment to inclusive care.
At the core of these systems is a belief that access cannot be universal if it’s not equitable—
a belief that has shaped the leadership priorities of institutions associated with Jayesh Saini.

3. Over the past decade, Saini’s healthcare ventures have steadily pushed for models that
proactively identify and respond to care gaps, especially among populations often ignored
by mainstream delivery structures.
Rather than treating disability access or elder care as separate pillars, Saini-led networks
integrate them into broader facility planning, service design, and community partnerships.
Inclusion is not an initiative—it is built into how success is measured, how workflows are
designed, and how expansion is prioritized.
This approach ensures that invisible patients are no longer an afterthought—they are
considered from the start.
Inclusive Care Is Smarter Care
Designing for the underserved isn’t just ethical—it’s efficient. Patients with disabilities are more
likely to suffer complications if basic care is delayed. Elderly patients are more likely to be
readmitted if discharged without proper support. Migrants are more likely to rely on emergency
care if preventive services are not accessible or trusted.
These are avoidable costs—financially and socially.
By incorporating inclusive design early, healthcare systems reduce long-term strain, improve
patient satisfaction, and build trust in communities that have historically disengaged.
Kenya’s private health sector is showing that it’s possible to build systems that serve everyone
—not just the visible, not just the easy to reach.
The Challenge Ahead: Scaling Visibility
To bring these models to scale, healthcare providers and policymakers must commit to:
●Inclusive data collection at registration and follow-up
●Patient feedback systems that capture the voices of marginalized groups
●Staff training on unconscious bias and inclusive communication
●Outreach partnerships with disability rights groups, elderly care associations, and
migrant support organizations
Without these investments, well-meaning expansions risk replicating the same patterns of
exclusion.

4. Conclusion: No System Is Truly Inclusive Until Everyone Is Counted
Invisibility in healthcare is not about distance—it’s about who the system chooses to see.
Kenya’s health networks are taking the first steps in correcting this imbalance. But the real
measure of success won’t be the number of clinics launched—it will be the diversity of patients
welcomed inside.
Healthcare equity will only be real when those most likely to be missed are placed at the
center of system design.