Kenya has one doctor for more than 5,000 people, far below the World Health Organisation’s recommendation of one doctor for every 1,000 people. The shortage continues to widen as trained clinicians migrate abroad while the country’s population keeps growing.
Yet millions of Kenyans access healthcare not through hospitals or specialist clinics, but through neighbourhood pharmacies.
This reflects how healthcare already functions in practice. Across urban, peri-urban and rural communities, pharmacies are often the most accessible, affordable and immediate point of care. They operate without appointments, lengthy queues or referral letters, making them the first stop for many seeking treatment.
Not every illness requires a hospital visit. Many common, self-limiting conditions can be managed safely with the support of qualified pharmacists, allowing doctors to focus on patients with more complex needs.
Recognising this reality, Kenya’s Pharmacy and Poisons Board issued Good Pharmacy Practice guidelines in May 2024. The framework expanded pharmacists’ role beyond dispensing medicines to include patient counselling, disease management support and broader clinical care, laying the foundation for the Pharmacy First model.
The principle is simple. Community pharmacists are often a patient’s first contact with the healthcare system. Minor illnesses, medicine-related concerns and chronic disease support can frequently be handled at this level before referral to a doctor or hospital becomes necessary.
In effect, pharmacies become frontline triage centres. Pharmacists can identify patients who require specialist attention while offering treatment advice, reassurance or monitoring for less serious conditions. Early intervention helps prevent complications, shortens waiting times and improves access to timely care.
The economic benefits are equally important.
Kenya’s healthcare system faces rising demand, overstretched public facilities and increasing treatment costs. Medical insurers are also grappling with escalating claims. Enabling pharmacists to manage appropriate primary healthcare cases can reduce unnecessary hospital visits, ease congestion and lower costs for households, insurers and government.
A stronger Pharmacy First culture would improve access to affordable care while allowing hospitals to concentrate resources on more serious cases. It would also reduce avoidable insurance claims and improve efficiency across the health system.
This approach does not diminish the role of doctors. Instead, it creates a more integrated health system where every professional works at the top of their expertise.
Countries such as the UK have already demonstrated the value of Pharmacy First. Kenya now has an opportunity to adapt the model to strengthen primary healthcare and make better use of its limited medical workforce.