Flaws in Kenya’s AI-driven health reforms driving up costs for the poorest

An AI system used to predict how much Kenyans can afford to pay for access to healthcare, has systemically driven up costs for the poor, an investigation has found. The healthcare system being rolled out across the country, a key electoral promise of President William Ruto, was launched in October 2024 and intended to replace Kenya’s decades-old national insurance system. Billed as “ accelerating digital transformation ”, it aimed to expand access to care to Kenya’s large informal economy: the day labourers, hawkers, farmers and non-salaried workers that make up 83% of its workforce. ‘No Kenyan will be left behind,’ William Ruto, Kenya’s president, said during the 2023 election. Photograph: AFP/Getty “No Kenyan will be left behind,” Ruto told a crowded stadium in Kericho during his 2023 presidential campaign, announcing that every citizen would soon have access to affordable healthcare. But his solution has instead sparked protests and anger, as healthcare contributions for millions of people are now calculated via a formula described as “flawed” and which sources have said has almost no transparency. That solution, which Ruto has described as AI-powered, does not rely on the recent advances in artificial intelligence which underpin large language models such as ChatGPT – instead it uses a predictive machine learning algorithm. …