Political Efficacy and Political Participation among Nurses in Tertiary Hospitals, the Republic of Kenya

Private health care, cancer, and the vulnerable middle class in Kenya

“…They portray India as a medical destination offering the best global medicine at prices below those of Kenyan private hospitals, with Indian doctors having access to state‐of‐the‐art technologies (Mahugu, 2018). Medical travel facilitators—companies that act as brokers between hospitals, insurance companies, and patients—are crucial nodes in this health care terrain (Ahoya, 2018; Hartmann, 2018). In 2016, one of these companies, Agile Global Health (AGH), received a contract from Kenya's national health insurer to broker treatment in India for Kenyan customers (Agile Global Health, 2017).…”

“…The struggles of Roselida, Jacinta, and their families illuminate how realigned relations among capital, states, markets, patients, and medicine are shaping patterns of access to medical treatment (Ong & Collier, 2005; Rose, 2007; Sunder Rajan, 2012), as states disinvest from public services while promoting the marketization of health on a model of consumer choice (Wilson, 2011). Kenya, with its intensive “fintech” capitalism (Donovan & Park, 2019, 2022; Kusimba, 2021; Park, 2020; Schmidt, 2019), decades of public health care austerity (Kabia at al., 2019; Pfeiffer & Chapman, 2010; Prince & Marsland, 2013), expanding private health care markets (Ahoya, 2018), and growing middle class, is emerging as an important site for these forms of biocapital. As Kenya becomes a location for global investment in corporate medicine, the vulnerability of an exploitable middle class to biocapitalist ventures is recalibrating its value.…”

“…In 2016, one of these companies, Agile Global Health (AGH), received a contract from Kenya's national health insurer to broker treatment in India for Kenyan customers (Agile Global Health, 2017). The company gained customers through advertising in medical camps, cultivating relations with health workers, and encouraging patients to identify new customers (Ahoya, 2018). In these ways, it reached patients who had either insurance or financial resources.…”

“…As Kenya's cancer and chronic disease epidemics gain visibility, its middle classes are emerging as a “sweet spot” for global health care markets (Landon, 2016). Private equity firms are heavily investing in private hospitals in Nairobi while global health care companies connect Kenyan patients to Indian corporate hospitals (Ahoya, 2018). Faced with strikes from health workers, long waiting times, and scarce and dysfunctional services in public hospitals, families with access to some resources seek private medical treatment in Kenya (or elsewhere, before COVID‐19 struck), but at great costs.…”