Context
SDG Target 3.8 calls for universal access to quality healthcare. I wanted to know how close Nairobi County actually is to that — not at the county level, where averages hide a lot, but region by region, facility by facility.
I combined the county's health facility registry with 2019 census sub-county population data, mapped every facility to one of ten regions, and benchmarked each region against WHO and county target ratios for facility density, hospital beds, and four specific services: inpatient/home-based care, childhood illness management, HIV treatment, and sexual and reproductive health.
At a glance
Where the gaps are
Facility count alone doesn't tell you much — a region can look "covered" and still be underserved once you account for population. Once I normalised by population, three regions stood out as consistently behind:
- Mathare, Kasarani, and Embakasi all sit under 2 facilities per 10,000 people, the lowest density in the county.
- Dagoretti, Makadara, Embakasi, and Kasarani fall short of the recommended 18 hospital beds per 10,000 people.
- Mathare has no cots in the region — a specific, fixable gap in neonatal and paediatric care.
Facilities and beds needed to reach target ratios
| Region | Population | New facilities needed | New beds/cots needed |
|---|---|---|---|
| Mathare | 207,000 | 26 | 53 (cots) |
| Kasarani | 1,408,000 | 98 | 2,074 |
| Embakasi | 989,000 | 53 | 909 |
| Dagoretti | 435,000 | — | 44 |
| Makadara | 190,000 | — | 128 |
Service-specific gaps (regions below county average)
| Region | Service | Current | Target | Gap |
|---|---|---|---|---|
| Kasarani | Family planning | 51 | 88 | 37 |
| Kasarani | Inpatient/home-based care | 46 / 79 | — | 33 (HBC) |
| Kasarani | Childhood illness (C-IMCI) | 7 | 24 | 17 |
| Embakasi | HIV treatment (ART) | 12 | 25 | 13 |
| Embakasi | Childhood illness (C-IMCI) | 9 | 17 | 8 |
| Mathare | Family planning | 5 | 13 | 8 |
Recommendations
- Quick winReopen the 19 closed facilities before building anything new — especially the one already equipped with 50 beds and 20 cots that operates 24 hours. This is capacity the county already paid for.
- Primary careExpedite the 6 facilities pending opening to strengthen outpatient access immediately.
- KasaraniPriority region for new investment — it's short on facilities, beds, family planning, home-based care, and childhood illness services simultaneously.
- MathareSmallest population of the underserved regions but the only one with zero cots — a targeted, low-cost fix rather than a large capital project.
What I'd do next
If I extended this, I'd want to weight recommendations by estimated cost per facility/bed rather than treating every gap as equally urgent — reopening an existing facility and building a new one aren't the same lift. I'd also like to bring in travel-time data instead of straight population ratios, since a region can hit its facility-per-capita target and still leave people an hour from the nearest one.