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PhD Research: Health Care is Politics by Other Means: Examining the Politics of Universal Health Coverage in Kenya through insights from UHC Pilot Programs

Research Summary

This research examines healthcare reform as political contestation, focusing on the Universal Health Coverage (UHC) pilot programmes launched in four Kenyan counties in 2018. Drawing on constructivist institutionalism, the thesis investigates how political-economic factors, stakeholder influence, intergovernmental rivalries, and global health actors shaped what these pilots became, often diverging sharply from their original design.

Set against Kenya's devolved governance system, the study treats UHC not as a neutral technical project but as "politics by other means," where contested ideas about what universal coverage should mean intersect with shifting alliances, resource struggles, and competing narratives of progress across national, county, and international levels.

Methodological Approach

Methodologically, this is a qualitative, interpretivist study using a comparative case study design with process-tracing elements across the four pilot counties, situated within a multi-level framework spanning global, national, and county dynamics. Data are drawn from semi-structured interviews with key informants, including government officials, political actors, civil society representatives, and international donors, alongside documentary, archival, and media sources.

Analysis combines framework analysis to organise themes around ideas, discourse, and strategic interpretation, the policy triangle of actors, content, and context to structure cross-county comparison, and narrative analysis to interpret competing accounts of the pilots' origins and trajectories.

Team members and supervisors

  • Diana Pauline Akinyi Wendo - PhD Candidate, NTU