What does it take to build a health system that centers community needs? “When government, civil society, and funders come together behind a shared vision, real systems change is possible,” says Ash Rogers, Lwala Co-CEO. This is the essence of Community Health Units for Universal Health Coverage (CHU4UHC), a coalition of 26 partners committed to strengthening Kenya's health system and accelerating progress toward Universal Health Coverage—a vision where all individuals receive high-quality health services without suffering financial hardship.
The coalition draws its strength from a shared purpose to make equitable access to health care a reality for everyone, everywhere–while establishing a flexible model that can be replicated globally. “Health for all cannot be realized by any one organization or institution alone,” explains Ash. “When efforts are aligned, the result is not just progress, but lasting, systemic change.”
Building a foundation for health equity
2020 marked a turning point for the health system in Kenya. The COVID-19 pandemic exposed critical gaps in primary health care and placed immense pressure on already fragile community systems, compelling partners to unite around a shared vision for change. “Before CHU4UHC, there were many partners supporting community health, but no clear coordination,” says John Wanyungu, Deputy Head of the Division of Community Health Services at Kenya’s Ministry of Health. “We didn’t know who was doing what, or where. The coalition brought everyone together to connect the dots at both national and county levels—creating the structure and synergy we were missing.”
Building on this momentum, CHU4UHC was formally launched as a platform for collective action, led by the Ministry of Health through its Division of Community Health, which oversees the Kenya Community Health Strategy. The platform brings together founding members–Lwala, Amref, Living Goods, Financing Alliance for Health, UNICEF, Medic, and Enai Africa–united in their commitment to advancing community-led health systems. “As we harmonized our priorities and rallied for policy reform, we realized that by pooling our expertise, resources, and influence, we could drive real, lasting change,” adds Julius Mbeya, Lwala Co-CEO and Chair of the CHU4UHC Coalition.
Since its founding, CHU4UHC has worked closely with Kenya’s Ministry of Health—a core partner—in championing major legislation which now shapes the Kenya health system. Together, we have advanced national-level policies and changes. In 2022, CHU4UHC led a historic effort to elevate community health workers (CHWs) in political manifestos in the 2022 presidential elections. This effort secured the President's backing and drove landmark reforms in community health, including the passage of the Primary Health Care Act (2023) and the Facility Improvement Fund Act (2023)–foundational legislation that integrates community health into Kenya’s broader health care framework.
CHU4UHC was also instrumental for advancing digital health systems across Kenya, including the development and rollout of the electronic Community Health Information System—a system tracking data in real time, enabling CHWs and county teams to make swift, evidence-based decisions and deliver more effective care–a step toward delivering better, connected care across Kenya. Payment of CHW salaries has always been a critical gap in the health system. Today, through these collective advocacy efforts by CHU4UHC, CHWs in all 47 counties are now receiving standardized stipends from the government.
At the county level, CHU4UHC has worked with 13 counties to adapt national legislation, passing laws that meet the needs of their communities. One notable approach has been the adoption of financial policies like the Financial Improvement Fund, which empowers health facilities to manage their own budgets and allocate resources to respond directly to their community’s needs.
Coalition members have also worked to strengthen community leadership in health. We supported the national government to develop tools like the Community Health Committee Curriculum and the Kenya Community Scorecard Guidelines. These resources empower community members to hold providers accountable, monitor service delivery, and resolve local health issues. In Migori County, for instance, community groups have used the scorecard to expose gaps in maternal health care and successfully pushed for more facility outreach visits, ensuring expectant mothers received the services they needed. These frameworks are not just policy wins–they are structural commitments to dignity, equity, and access for a people-centered health system across Kenya.
“Health for all cannot be realized by any one organization or institution alone. When efforts are aligned, the result is not just progress, but lasting, systemic change.”
- Ash Rogers, Lwala Co-CEO
A blueprint for centering communities
The success of CHU4UHC offers a replicable model for countries worldwide striving to strengthen community-led health. “At the Skoll World Forum, CHU4UHC demonstrates that when governments and partners unite behind a shared vision, community health systems can be both resilient and scalable,” says Emilie Chambert, CEO of Living Goods. At Skoll, CHU4UHC shared learnings on collective action and system-wide reforms for universal health coverage, while elevating the pivotal role of CHWs in Kenya’s health system. “The visibility at Skoll sparked a ripple effect, spotlighting community health in Africa and paving the way for funding and policy exchanges to help other nations strengthen primary health care,” says Emily Bancroft, CEO of VillageReach.
CHU4UHC stands on the shoulders of global movements like Community Health Impact Coalition, which works to make professional CHWs the norm worldwide–and recently won the 2025 Skoll Award for Social Innovation. “It was inspiring to see how our efforts fit into a bigger picture,” says Millicent Miruka, a Lwala-supported CHW who attended the forum. “What we do every day truly matters in the push for stronger health systems.”
Coalition-building is also key for weathering challenges and forging ahead during moments of intense change and uncertainty. Years of advocacy helped build a better path for communities in Kenya. However, real lasting progress requires strong local partners and flexibility to handle change. Major changes to US foreign assistance have disrupted the health system, bringing unexpected challenges and slowed progress in several areas.
CHU4UHC has responded by working with the Ministry of Health to understand the gaps left by the shifting landscape, helping to shape how government can reprioritize and seek alternative funding. Together, we are ensuring that community health remains a top priority, reforms and commitments made to CHWs do not slide, and momentum is maintained. These actions demonstrate CHU4UHC’s adaptability and strength in navigating periods of uncertainty.
“When the government leads with the support of committed partners, the coalition grows stronger and more enduring. By valuing every contribution, we build trust, unity, and a collective power that drives lasting change."
- John Wanyungu, Deputy Head of the Division of Community Health Services at Kenya’s Ministry of Health.
Looking ahead, the coalition’s 2027 strategy is focused on strengthening health systems by empowering frontline health workers, bolstering governance structures, improving health financing, and scaling digital health innovations. This will ensure that progress toward universal health coverage remains resilient and sustainable. “As we look to the future of community health in Kenya, our priorities for growth and sustainability must be rooted in local ownership,” says Derick Lung’aho, Chief Program Officer of Medic. “By strengthening governance structures, CHW training and supervision, supply chains, and financing mechanisms, while sustaining advocacy efforts and leveraging innovative digital systems—together, we can meet the evolving needs of the national government, the counties, and all Kenyans.”
