A Business Daily article of December 9, 2025, highlighted increasing waiting times for radiotherapy patients at a major public referral hospital, attributing delays to rising demand, machine overuse, and frequent breakdowns.
While accurate, this is just the tip of the iceberg; beneath it lies a dysfunctional radiotherapy market whose very design constrains access.
Kenya’s radiotherapy sector operates within a paradoxical market structure combining monopoly and oligopoly dynamics. On one side are government-run parastatals and on the other, a small number of private providers. Both supply a homogenous service, radiotherapy, but under different pricing and financing conditions.
The public monopoly is dominated by Kenyatta National Hospital, Kenyatta University Teaching, Referral and Research Hospital, and Moi Teaching and Referral Hospital. These facilities offer radiotherapy at heavily subsidised rates, now further supported by the Social Health Insurance Fund.
Predictably, low prices generate high demand, leading to chronic overutilisation. Capacity constraints mean many patients cannot be accommodated in a timely manner, and machine breakdowns translate into prolonged waiting lists. For most patients, exit options are limited, as private alternatives remain unaffordable.
The private oligopoly comprises a handful of institutions charging significantly higher fees. Insurance coverage offsets only a fraction of these costs, requiring substantial out-of-pocket payments.
Demand is therefore comparatively low, resulting in underutilised capacity. Access is effectively restricted to patients with sufficient financial means, although this segment benefits from shorter waiting times and the ability to transfer between facilities when disruptions occur.
The resulting paradox is stark. Public providers offer affordable care but cannot meet demand, while private facilities possess spare capacity that remains inaccessible to most patients. Fixing radiotherapy inaccessibility crisis therefore calls for market reforms.
Without addressing pricing, insurance design, and public-private integration, Kenya’s radiotherapy access crisis will persist-not from scarcity alone, but from structural misalignment.