The Hidden Cost of Ignoring Informal Settlements in Healthcare Policy.
Author : Daniel Mathew | Published On : 19 Jan 2026
Across Kenya’s urban landscape, informal settlements pulse with life—markets bustling with trade, children playing in alleys, families building futures with limited means. These communities, often called slums, are more than just clusters of unplanned housing. They are homes to nearly two-thirds of Nairobi’s population and millions more across Africa’s fast-growing cities.
And yet, when it comes to healthcare policy, they are often treated as if they do not exist.
They are invisible in planning maps. Uncounted in budget allocations. Overlooked in emergency preparedness. The result is not just administrative omission—it’s a systemic health injustice.
The Problem: When Policy Pretends Places Don’t Exist
Informal settlements like Kibera, Mathare, Mukuru kwa Reuben, and Deep Sea exist in a policy blind spot. Because they are often seen as “temporary” or “illegal,” formal healthcare systems exclude them from infrastructure rollouts, data collection, and investment planning.
This erasure creates real-world consequences:
- Few or no public health facilities in high-density neighborhoods.
- No ambulance access due to unplanned roads or lack of addresses.
- Minimal emergency preparedness, leaving residents vulnerable during pandemics, floods, or disease outbreaks.
- Poor sanitation and environmental health risks go unmonitored.
- Mistrust between authorities and residents, fueled by decades of marginalization.
When governments ignore these areas, it’s not only a failure of inclusion—it’s a failure of vision. Because what happens in informal settlements doesn’t stay there. It spills into the entire health system, driving up preventable illness, overwhelming public hospitals, and creating barriers to urban health equity.
The Solution: Tailored Outreach and Flexible Health Infrastructure
To correct this oversight, cities must rethink how they design, fund, and deliver care to informal populations. The traditional model of fixed, centralized hospitals does not work in areas where land is contested, roads are narrow, and populations are transient.
Instead, what’s needed is a flexible, adaptive, and community-rooted model of healthcare—one that understands informal settlements not as problems to be solved, but as partners in urban health.
Successful interventions include:
1. Mobile Clinics That Go Where Facilities Can’t
Equipped with diagnostics, essential drugs, and telemedicine tools, mobile units can deliver routine care, maternal health, and chronic disease management right into the heart of Nairobi’s informal settlements.
2. Pop-Up Clinics in Schools, Churches, and Community Halls
Temporary care centers activated during vaccination campaigns, outbreak responses, or health drives allow access without the burden of land ownership or permits.
3. Community Health Volunteers (CHVs) With Real Support
Empowering CHVs from within the settlements to serve as health educators, referral agents, and care companions has proven to increase health-seeking behavior and trust.
4. Health Data Collection That Includes Every Address
GIS mapping, community-led surveys, and health risk registries must treat informal settlements as central zones, not footnotes. If you don’t measure it, you can’t manage it.
5. Public–Private Partnerships Built on Respect
When done right, partnerships between local government and ethical private providers can extend services without duplicating or undermining existing efforts.
But models alone don’t drive change—leaders do.
The Vision: Jayesh Saini’s Model for Inclusive, Adaptable Urban Care
Few leaders have addressed the urban health crisis in informal settlements as deliberately and consistently as Jayesh Saini. His philosophy is clear:
“No healthcare system is complete until it reaches the people who’ve always been ignored by it.”
Through his institutions, including Bliss Healthcare and Lifecare Hospitals, Saini has launched a multi-tiered strategy for serving Kenya’s urban informal populations—combining infrastructure, empathy, and innovation.
Here’s how his model stands apart:
1. Urban Care Nodes in High-Density Areas
Instead of building in only commercial hubs, Saini’s network places compact, low-footprint clinics inside informal zones. These clinics offer outpatient services, lab diagnostics, maternal care, and chronic disease management at affordable, transparent prices.
2. Mobile Outreach Synchronized With Data
Using mapping tools and patient flow data, his mobile units are deployed based on peak illness times and localized health trends—not just fixed schedules.
3. Intra-Community Hiring and Training
Most staff at these urban outreach clinics are residents of the neighborhoods they serve. This not only ensures trust, but also stimulates local economies and encourages health leadership from within.
4. Digital Follow-Up and Records
Even in areas with limited infrastructure, patients receive SMS reminders, digital test results, and continuity of care across locations through centralized electronic health records.
5. Zip-Code-Neutral Quality Standards
Regardless of whether a facility is in Kileleshwa or Kibera, clinical protocols, diagnostics, and patient dignity remain the same. This consistency builds confidence—and loyalty—across the income spectrum.
Rewriting the Rules of Inclusion
Jayesh Saini is not waiting for policy to catch up to reality. His healthcare ecosystem treats informal settlements as integral parts of the city—not exceptions to its services. He is showing that adaptability, not uniformity, is the key to healthcare equity in Africa’s urban future.
His model isn’t just about building more—it’s about building smarter, fairer, and closer to the people who need it most.
Conclusion: Ignoring the Margins Endangers the Center
Healthcare policy that ignores informal settlements doesn’t just fail the poor—it undermines the entire urban health system. Because when one neighborhood lacks vaccines, diseases spread. When one community has no prenatal care, maternal mortality rises city-wide. When one family avoids clinics due to mistrust, infections go untreated.
Jayesh Saini’s inclusive model reminds us that healthcare cannot afford to be elitist, static, or blind. If we are to build just cities, we must start by healing the parts we’ve neglected the longest.
Because in the end, the true measure of a health system is not how it treats the privileged—but how far it will go to care for the forgotten.
