The National Hospital Insurance Fund is the most important health insurance program in Kenya. Membership is compulsory for all civil servants. As of 1990, contribution levels proved insufficient to meet hospital costs and the government was planning to broker private health insurance policies. The government is continually improving and upgrading existing health facilities and opening new ones. Kenya produces cotton wadding domestically, but all other medical equipment and supplies are imported. High-quality private practitioners require sophisticated medical equipment, but the public sector acquires less expensive equipment. Private health institutions account for 60% of total medical equipment and supplies (import value). Kenya also has a well-developed pharmaceutical industry that can produce most medications recommended by the World Health Organization.
The government is attempting to reduce malnutrition and combat deficiency diseases. Among Kenya's major health problems are tuberculosis and protein deficiency, the latter especially among young children. In 1999, there were approximately 417 reported cases of tuberculosis per 100,000 people. Although the incidence of malaria has been reduced, it still is endemic in some parts of Kenya and is responsible for anemia in children. Water supply, sanitation, bilharzia, and sleeping sickness also pose major problems. Schistosomiasis is endemic to some areas. In 2000, 49% of the population had access to safe drinking water and 86% had adequate sanitation. In 1991 and 1992, there were about 1,000 war-related deaths due to ethnic violence.
As of 2002, the crude birth rate and overall mortality rate were estimated at 27.6 and 14.7 per 1,000 people respectively. As of 2000, 39% of married women (ages 15 to 49) were using contraception. Average life expectancy was 47 years in 2000 and infant mortality was 78 per 1,000 live births. The fertility rate was 4.4 children per childbearing years of a Kenyan woman as of 2000. Immunization rates for 1997 for children up to one year old were fairly low: tuberculosis, 42%; diphtheria, pertussis, and tetanus, 36%; polio, 36%; and measles, 32%. Malnutrition affected an estimated 33% of children under five as of 2000.
As of 1999, there were an estimated 0.1 physicians and 1.6 hospital beds per 1,000 people. Each government hospital has an independent budget. As of 1999 total health care expenditure was estimated at 7.8% of GDP. The government is also encouraging the development of the private health care sector through tax incentives as well as other plans.
There has been a rapid spread of AIDS since the 1980s. At the end of 2001, the number of people living with HIV/AIDS was estimated at 2.3 million (including 15% of the adult population) and deaths from AIDS that year were estimated at 190,000. HIV prevalence in 1999 was 13.95 per 100 adults.