Insurer turns to faith groups to expand health cover

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For many Kenyan households, falling sick still means reaching into savings, borrowing or relying on community fundraising to access care.

Despite ongoing reforms in the health sector, a large share of Kenyans remain outside formal medical insurance, with rising treatment costs continuing to push families into out-of-pocket spending.

It is this gap that insurers are now attempting to address by shifting away from individual cover models and instead embedding health insurance within organised community structures.

Jubilee Health Insurance has partnered with the Sikh Council of Kenya to roll out a community-based medical cover targeting members of the Sikh community, in one of the latest examples of insurers turning to faith-based and social networks to expand uptake.

The scheme allows members to access inpatient and outpatient services through pooled contributions, with benefits ranging from Sh250,000 to Sh10 million depending on the chosen plan. Children as young as 38 weeks and adults up to 65 years are eligible, with enrolment coordinated through appointed community agents.

The insurer says the approach is designed to make cover more affordable by spreading risk across groups that already have established trust and social organisation.

“Healthcare should not feel out of reach,” said Njeri Jomo, Jubilee Health Insurance CEO and Principal Officer. “We are seeing a powerful shift where communities and affinity groups are becoming gateways to access.”

She added that structuring insurance around how people already organise themselves could improve preventive care and streamline referrals within health systems. Questions remain over who stands to benefit most from this shift.

Community-based insurance schemes often rely on SACCOs, religious organisations, professional associations and other structured groups, which tend to be more formal and economically stable than the wider population.

That leaves a large segment of Kenyans working in informal jobs, who may not belong to such networks and therefore remain outside organised insurance channels.

Kenya has struggled for years with low insurance penetration, particularly in health, where universal coverage efforts have yet to fully bridge the gap between formal systems and informal livelihoods.

Zul Abdul, Chairman of Jubilee Holdings Limited, said the model reflects Kenya’s long-standing tradition of collective resource pooling.

“In our society, the culture of pooling resources is deeply rooted, whether through harambees, SACCOs or other community structures,” he said.

The Sikh Council of Kenya described the partnership as aligned with the community’s values of mutual support.

“Our community has always believed in standing together and supporting one another,” said Gurdeep Singh Flora, National Chairman of the Sikh Council of Kenya.

The insurer says the partnership is part of a wider strategy to move away from purely individual retail insurance models and instead integrate coverage into trusted ecosystems where members already share identity and organisation.

It also positions the model as complementary to the Social Health Authority framework rather than a competing system.

Still, as more insurers lean on organised groups to expand coverage, questions remain over whether this approach will narrow Kenya’s insurance gap or simply concentrate access within already structured communities, leaving the most vulnerable still outside the system.