By Milliam Murigi
In 2023, Kenya took a major step toward formalizing its digital health ecosystem with the passage of the Digital Health Act, a law that governs the generation, sharing, and use of health data across the country.
Framed as part of the country’s broader digital transformation agenda, the Act positions digital health systems as public infrastructure—meant to be interoperable, secure, and accessible across public and private healthcare providers. But nearly two years on, the gap between policy ambition and on-the-ground implementation remains significant.
To better understand what this shift toward digital health as public infrastructure means in practice and why progress has been uneven, Science Africa sat down with Dr. Wanjiru Kigathi, a health economist and digital health policy specialist who has played a key role in shaping Kenya’s digital health governance.
Q: How did your journey for advocating for digital health begin?
A: My advocacy for digital health didn’t start from technology; it started from systems that weren’t working for people. I’ve seen patients move between facilities carrying paper files, health workers duplicating work because systems don’t talk to each other and governments investing in tools that don’t scale or last. Digital health, when done right, is a way to fix those structural gaps. For me, it’s about using digital systems to make healthcare fairer, more efficient, and more responsive to real human needs, not just more modern.
Q: What were the core ambitions behind Kenya’s Digital Health Act, and what problem was it meant to solve within the health system?
A: The Digital Health Act was designed to move Kenya away from fragmented, project-based digital health solutions toward a coordinated, nationally governed digital health ecosystem. Its core ambition is to treat digital health as a public infrastructure, not as isolated technologies, by ensuring that health data systems are interoperable, secure, and usable across public and private healthcare providers.
At its heart, the Act seeks to solve a long-standing systems problem: the lack of continuity of care caused by disconnected health information systems. By establishing clear governance, standards, and institutional oversight through the Digital Health Agency, the Act aims to ensure that patient data can safely follow individuals across facilities, reduce duplication of services, improve clinical decision-making, and enable better planning and accountability within the health system.
Q: For readers unfamiliar with policy language, explain digital public infrastructure for health, and why it matters for everyday healthcare delivery?
A: I often explain digital public infrastructure (DPI) for health as the shared digital backbone that allows health services to function smoothly, much like roads or electricity. It includes things like shared patient records, national health IDs, data exchange standards, and secure platforms that allow different health systems to talk to each other. When DPI works, a nurse in a rural clinic can access a patient’s history, lab results don’t need to be repeated, and referrals actually follow the patient.
For everyday healthcare delivery, this means less waiting time for patients, fewer errors, lower costs, and better continuity of care. Without DPI, digital health tools remain isolated apps. With DPI, they become part of a functioning health system.
Q: Why is digital health increasingly being framed as a public good rather than just a technology solution?
A: Because health itself is a public good and digital health shapes who gets access to it. When digital health is treated purely as a commercial or standalone tech solution, it often benefits those who are already connected in urban areas and insured citizens. Framing digital health as a public good shifts the focus to equity, sustainability, and national ownership.
It asks different questions: Who controls the data? Who benefits from the system? Can it be reused, adapted, and governed in the public interest? This framing is especially important in African contexts, where governments must ensure digital investments strengthen public systems rather than fragment them further.
Q: Are Kenya’s digital health systems interoperable?
A: Interoperability simply means different digital health systems being able to talk to each other and share information safely and accurately. It is what allows digital health to actually work for patients. Without it, digital tools simply reproduce the same fragmentation we had with paper records, only this time on screens.
In Kenya, we’ve made much progress, but we’re not fully there yet. Many systems still operate in silos. A patient’s records in one facility often can’t be accessed in another. A lab system may not connect to a clinical system. County and national platforms don’t always align.
The challenge isn’t just technical. It’s also about governance, incentives, and coordination. Different actors build systems for different purposes, often without shared standards or long-term integration plans. The Digital Health Bill was a key step in addressing this by creating clearer rules, accountability, and alignment across the ecosystem.
However, translating these policy commitments into fully interoperable systems will require sustained investment, strong enforcement of standards, and collaboration across government, the private sector, and development partners.
Q: What’s being done to ensure digital health systems in Kenya are interoperable?
A: Kenya is taking several concrete steps to make its digital health systems interoperable. At the national level, the Digital Health Act 2023 established the Digital Health Agency, which coordinates digital health initiatives, sets standards, and ensures accountability across the ecosystem.
A key tool is the Kenya Health Information Systems Interoperability Framework (KHISIF), which provides national guidance on how different health information systems should exchange data securely and consistently. The framework promotes the adoption of open standards, including HL7 and FHIR, to allow systems built by different vendors to “talk” to each other.
In addition, the government is working to integrate county and national platforms, streamline electronic medical records, and connect public and private health facilities. Training programs, technical support, and stakeholder coordination are also being strengthened to build capacity at all levels of the health system.
Q: Who risks being left behind in the digital health transition, and how can DPI help close those gaps rather than widen them?
A: Those most at risk are rural communities, persons living with disabilities, women, adolescents and youths, and people who rely most heavily on public health systems. If digital health is designed without these groups in mind, it can easily widen inequalities. DPI helps close these gaps by ensuring systems are inclusive by design by building them on open standards, accessible technologies, and public oversight.
When digital infrastructure is shared, interoperable, and governed in the public interest, it lowers costs to both the patient and facility, enables local innovation, and ensures that solutions work for the last mile, not just the pilot phase. Inclusion has to be intentional; it doesn’t just happen automatically.
