Ageing Populations and Governance: Enhancing Healthcare Access for the Elderly in Kenya, a Case Study of Meru County

Aging populations in low- and middle-income countries are growing rapidly, stressing health systems constrained by limited resources and weak governance. Effective governance frameworks ensure elderly adults receive timely care. This study analyzes how governance structures affect healthcare access for seniors in Meru County, Kenya. Review of twelve studies and thirteen policy documents identified fragmented policy execution, inadequate infrastructure, low insurance coverage, and high out-of-pocket costs as major barriers. Despite devolution’s goal of boosting local decision-making and resource allocation, accountability gaps, underfunded primary care units, and weak risk-pooling exacerbate inequities. Comparative analysis of Brazil, Thailand, and Vietnam models underscores community-based care, structured financing, and robust monitoring as promising strategies. This paper recommends Meru County strengthen transparency through digital procurement and budget-tracking, fully empower CHUs, and adopt innovative financing like subsidized premiums and performance-based incentives. Investing in geriatric workforce training and piloting digital health innovations will build a more inclusive resilient system.