Nairobi, Kiambu, Murang'a, Nyeri and Kirinyaga counties top the list of regions with the highest insurance uptake as Kisumu, Siaya and Meru sit at the bottom of the access ladder, revealing the country’s socio-economic imbalance.
A Financial Sector Deepening (FSD) survey shows the ratio of Nairobi City residents reporting access to at least one insurance product in their own name, excluding social health cover, stood at 12 percent last year—tying it with Kiambu.
They were followed by Murang’a at 11.3 percent, Nyeri at 10 percent and Kirinyaga at 9.5 percent, while Kisumu (1.1 percent), Siaya (1.2 percent) and Meru (1.3 percent) sit at the bottom.
The report’s county-by-county ranking reveals a link between insurance uptake and the country’s socio-economic status.
Counties such as Nairobi, Kiambu, Murang'a, Nyeri, Kirinyaga, Kajiado and Nyandarua which boast of higher levels of formal employment, business density, literacy levels and relatively diversified household incomes are able to tap insurance more.
In contrast, counties such as Kisumu, Siaya, Meru, Kitui, Taita-Taveta, Marsabit, West Pokot, Lamu, Homabay and Kilifi where there is higher dependence on informal sector and weaker financial infrastructure lag.
The divide in insurance uptake among counties leaves millions of households exposed to risks such as health crises, crop and livestock losses, accidents and natural disasters — shocks that often push vulnerable families deeper into poverty.
Insurance uptake is often viewed globally as a proxy for economic development and financial maturity. High uptake reflects financial literacy, better disposable income and stable livelihoods—factors more prevalent in urban and peri-urban counties.
“By 2024, exclusion from insurance (excluding NHIF) remains highest among casual workers, dependents and agricultural livelihoods, suggesting that informal employment and financial vulnerability limit access,” notes the survey.
“Those employed and business owners show relatively lower rates of exclusion. Those who are not financially healthy and in lower wealth quintiles consistently report high levels of insurance exclusion, while improvements are seen among financially healthier and wealthier individuals. The data underscores a persistent socio-economic divide in usage of insurance services.”
Kenya National Bureau of Statistics (KNBS) data shows Nairobi contributes 27.4 percent to the value of Kenya’s economy, followed by Nakuru (5.7 percent), Kiambu (5.5 percent), Mombasa (4.8 percent), Meru (3.5 percent) and Machakos (3.2 percent).
The FSD survey was carried out when the country was about to transition from the National Health Insurance Fund (NHIF) to the Social Health Insurance Fund (SHIF). The survey showed Kenya’s access to insurance (excluding NHIF) fell from 6.9 percent in 2021 to 6.3 percent in 2024, while access including NHIF fell from 23.7 percent to 22 percent over the same period.
At the same time, usage—including secondary use through another person’s policy—rose from 11.4 percent in 2021 to 13.7 percent in 2024 for insurance excluding NHIF and from 28.2 percent to 29.5 percent for all insurance including NHIF.
This divergence suggests that while fewer Kenyans had policies in their own name, many continued benefitting from employer-based schemes, group policies and dependents’ coverage.
“Overall trends show sustained disparities in access by residence, gender, age, and education level. These trends highlight growing inequalities and underline the need for inclusive reforms in Kenya’s insurance landscape,” said the survey.
The report identifies affordability as the single largest barrier to insurance uptake. A striking 76.2 percent of uninsured Kenyans cited cost as the main reason they do not hold an insurance product. Women (77.3 percent) are more affected by cost barriers than men (74.7 percent), reflecting gendered income disparities.
The second biggest obstacle is lack of understanding, reported by 23.4 percent of respondents— a challenge more pronounced in rural areas (27.8 percent) than in urban centres (15.5 percent). Other barriers include lack of national identification card (8.4 percent), belief that insurance is unnecessary (7.4 percent) and lack of trust in providers (1.6 percent).
Among those who previously held insurance but discontinued, 61.4 percent said they could no longer afford premiums while 41.9 percent cited job or income loss as the trigger for dropping out. About 65.5 percent of business owners who abandoned insurance did so because they could not afford premiums.
The findings reinforce the vulnerability of insurance uptake to economic shocks, especially in a country where a large share of the workforce is informal and income volatility is high.
Education strongly predicts insurance uptake, with tertiary-educated Kenyans enjoying 18.9 percent access to insurance— excluding NHIF— compared to only one percent for those with no formal education.
“The survey revealed that access to insurance excluding NHIF, varied by education level, reinforcing the findings that a lack of understanding contributes to low uptake among those without insurance in their own name,” said the survey.
