Access Afya: Bringing care closer to communities in Kenya
For people in Kenya’s low-income communities, seeking care can mean choosing between treatment and a day’s income. Access Afya is bringing affordable care closer to home; while connecting patients to the wider health system.
27 October 2026 Anna Thabuis
For many people living in informal settlements and other low-income communities, reaching health care facilities means finding time, covering travel costs, and paying for treatment without losing a day’s income. These practical barriers can leave people disconnected from the care they need, even when services exist.
In Kenya, Access Afya, a social enterprise, has built its model around closing this gap in access. Through a network of franchise-based micro-clinics operating under the Curafa brand, the social enterprise brings low-cost primary healthcare into neighbourhoods where access remains limited. Its contribution is not a replacement for public services, but an additional route into care, linked to the wider health system through referrals, public health insurance, and reporting.
The clinics offer consultations, screening, treatment, and follow-up care close to where people live, with an emphasis on keeping services affordable and of high quality. This helps reduce the trade-off between seeking care and protecting a day’s income.
For people relying on daily wages, the trade-off between travel costs, treatment, and lost income can delay care. For chronic conditions such as diabetes and hypertension, those delays can have serious consequences: early diagnosis and sustained management are essential to prevent complications.
Affordability, accessibility, quality and consistency of care are the pillars of Access Afya’s model. Refined between 2012 and 2019, its ‘clinic-in-a-box’ model keeps set-up, rent, and staffing costs low, with at least two staff on duty. Supplier discounts bring further savings for patients as the franchise network grows.
Access Afya trains and equips Community Health Promoters (CHPs), trusted local members who lead awareness activities, health talks, and diabetes and hypertension screenings. They mobilise residents for screening camps at markets, churches, and community gatherings within two to three kilometres of Access Afya or Curafa facilities. Each camp connects people at risk to a nearby clinic for assessment and ongoing care, rather than a one-off screening.
For chronic conditions such as diabetes and hypertension, diagnosis is only the first step; Access Afya sends reminders five days and one day before appointments, and calls after missed visits to understand barriers and reschedule, to help maintain continuity of care.
When Cansu Ünalan, WDF Project Manager, first heard of Access Afya, what stood out to her was its commitment to people who fall through the gaps in care. That focus places the communities it is set out to serve at the centre of the model.
By 2025, Access Afya’s 21 Curafa franchise clinics had recorded 780,000 cumulative health visits across Kenya. Its NCD programme reaches thousands of people for whom distance, gaps in care, quality, or difficulty accessing medication had made regular care difficult to sustain. Community outreach has also made it possible to screen tens of thousands of people, connecting them to ongoing care for diabetes and hypertension.
Access Afya is woven into the public health system. Indeed, most of the social enterprise's facilities accept SHIF, Kenya’s public health insurance fund. Additionally, patients needing services beyond the clinics’ scope are referred primarily to public facilities. Only the medical information needed for continuity of care is shared with the public health system. Access Afya follows up on patients’ experience of care, but does not receive data on clinical outcomes after referral, limiting what it can report about. Separately, monthly reporting to the Ministry of Health at sub-county level uses aggregated, non-identifiable data, not individual patient records.
For Cansu, there is value in helping patients navigate the barriers between them and care: “By bringing clinics closer to communities and accepting SHIF at most facilities, it is helping patients overcome both the practical and financial barriers to healthcare.”
Bringing care closer to communities addresses one barrier to universal health coverage, but sustaining affordable services remains a challenge.
At the country level, limited fiscal capacity, large informal workforces, and high out-of-pocket spending constrain progress towards universal health coverage in many low-income settings. In Kenya, an estimated 86.49% of the workforce is in the informal sector, meaning they are often not covered by formal employment-based health financing mechanisms and must rely on irregular incomes to pay for healthcare. While some informal workers have the capacity to contribute to healthcare financing, unstable earnings frequently make regular insurance contributions difficult, leading many to depend on out-of-pocket payments and increasing the risk of delayed care. For people living with chronic conditions such as diabetes, missing work for treatment can result in immediate income loss, while untreated complications can undermine long-term earning potential.
Models such as Access Afya can expand access to affordable primary care and support countries on the long journey towards universal health coverage. Supporting social entrepreneurs and social enterprises with a mission to address the health care gap, requires new forms of financial support as global health financing shifts. Only 2% of global development aid is allocated to NCDs, even as the burden grows and international aid budgets shrink, widening the financing gap.
“As global health financing changes, we need to think beyond grant giving and explore innovative financing models and innovative service deliver models,” reflects Cansu. “For the Diabetes Investment Accelerator, impact investment means committing patient capital to promising social enterprises and helping build a financially resilient business while keeping affordable, quality care at the centre of its purpose. Public financing, philanthropy, and impact investment each have a role to play. The challenge is to bring them together in ways that strengthen local capacity and sustain access to care over time.”
The Diabetes Investment Accelerator is fully in line with the World Diabetes Foundation’s philanthropic purpose, complementing grants with impact investments that help locally rooted health social enterprises sustain affordable care by becoming more financially resilient and gaining greater capacity to shape their future.
For organisations such as Access Afya, access to impact linked and patient capital can support expansion while maintaining a focus on measurable improvements in access, quality, and continuity of care. While these results cannot be attributed solely to the Diabetes Investment Accelerator funding, the inflow of capital has helped Access Afya bring more than 500 additional NCD patients into its clinics, screen over 7,000 people for diabetes and hypertension, and train more than 400 healthcare workers nationwide through its Continuous Medical Education programme. And this only within the past year.
WDF’s investment in Access Afya has been made possible through the ImpactBridge partnership, which brings together the World Diabetes Foundation, Philips Foundation, and We Share Forward Foundation.
As Kirza Buch Kristensen, WDF Associate Director, Business Development and Strategy, explains, “By co-investing and sharing expertise and resources in the Impact Bridge partnership, we make our collective support stronger and more effective. For social enterprises like Access Afya, this means access to both capital and partners committed to helping them grow.”
Closing the healthcare gap in Kenya means making treatment affordable, keeping patients connected between visits, and enabling referrals when further care is needed. Access Afya brings these connections closer to low-resource communities, contributing to more equitable access while supporting the wider health system. Sustaining and extending that reach also requires investment in the locally rooted organisations delivering it.