Kenya remains a young country by most measures, but new government data show its older population is expanding rapidly, even as the risk of mothers dying in childbirth stays starkly unequal across the 47 counties.  

The Population Situation Analysis (PSA) 2025, compiled by the National Council for Population and Development (NCPD), paints a picture of a health system that must fight on two fronts at once: protecting mothers and children today while preparing for a population that will live longer with chronic illness tomorrow.  

The numbers on ageing are striking. Kenya’s population aged 60 and above has grown from about 587,000 in 1969 to 1.34 million by 1999, and 2.74 million in 2019. It is projected to reach 2.99 million this year, 3.45 million by 2030 and 6.38 million by 2045, more than doubling between 2019 and 2045. For now, older Kenyans still make up a small share of the population, roughly 5.7 per cent in 2019, meaning the country is not yet ageing on the scale of Japan or much of Europe, but the PSA says the window to prepare pension, health and social protection systems is closing. 

Garissa records the highest maternal mortality ratio in the country 

On maternal health, the gaps are just as dramatic. Kenya’s national maternal mortality ratio stands at 355 deaths per 100,000 live births, far above the Sustainable Development Goal target of under 70 by 2030.  

Garissa records the highest ratio in the country at 641, followed by Tana River (586), Bomet (554), Kericho (543) and Kilifi (532). Nyeri, at 67, is the only county to meet the SDG target, meaning a woman in Garissa faces a risk of maternal death roughly nine times higher than one in Nyeri. 

The PSA attributes the ageing shift to Kenya’s ongoing demographic transition, marked by declining fertility, falling mortality and rising life expectancy. Population pyramids for 2019, 2025 and 2030 show the country moving gradually away from the broad, youth-heavy structure of the past towards one with a thicker middle and more older people.  

The report calls for stronger social protection, expanded pensions and elder care, age-friendly health services, and the integration of ageing into national development planning. It also flags older women as particularly vulnerable, since they tend to live longer than men and often face greater economic insecurity, especially where widowhood limits access to income. 

Cardiovascular diseases, diabetes and hypertension account for 40 per cent of deaths  

The stakes are raised further by Kenya’s disease burden. Non-communicable diseases, chiefly cardiovascular diseases, diabetes and hypertension, already account for close to 40 per cent of deaths in the country.  

As more Kenyans live into old age, demand for the prevention, diagnosis and long-term management of these conditions is expected to rise. The challenge is therefore not simply a growing number of older people, but a growing number of people living longer with conditions that require sustained care. 

Kenya’s overall dependency ratio, the number of dependants for every 100 working-age people, fell from 108 in 1969 to 75 in 2019, reflecting the demographic dividend of a large working-age population.  

That national figure, however, hides sharp county-level differences. Nairobi has a dependency ratio of just 46 and Mombasa 53, while Mandera stands at 129 and West Pokot at 117. These are total dependency ratios rather than measures of old-age dependency alone, but they illustrate how unevenly demographic pressures fall across the country. 

Mandera has the highest proportion of poor households, followed by Wajir 

A similar pattern of inequality runs through maternal health. North-Eastern Kenya, comprising Garissa, Wajir and Mandera, has an average maternal mortality ratio of about 476, while Central Kenya has the lowest regional average at 284 and Nairobi sits at 326. Yet counties such as Bomet, Kericho, Narok and Homa Bay also record ratios above 500, complicating any assumption that Kenya’s maternal health crisis is confined to the North East. 

Distance, poverty and difficult terrain play a part, but so do staffing levels, quality of care, referral systems, the availability of emergency obstetric services and facilities’ ability to manage complications. 

Poverty tracks closely with these outcomes. Mandera has the highest proportion of poor households at 59.1 per cent, followed by Wajir (39.2 per cent), Tana River (37.8 per cent) and Turkana (37.2 per cent), against a national average of 10.3 per cent. Vihiga, at 27 per cent, is a notable exception, showing that severe deprivation is not confined to the arid and semi-arid north. Nairobi and Kiambu record much lower poverty levels. 

Some regions face severe health workforce shortages than others  

Health workforce numbers do not always follow the same pattern. Nakuru has fewer than 0.25 medical officers per 10,000 people, alongside Tana River and Turkana, yet it does not appear among the counties with the highest poverty or maternal mortality figures.  

By contrast, Kirinyaga, Kisumu, Laikipia, Lamu, Murang’a, Nyeri and Taita Taveta all fall within the highest medical officer density band. 

Taken together, the PSA shows a country making genuine progress, its overall dependency ratio has fallen, and its population is still comparatively young, but one where that progress is deeply uneven. A national maternal mortality ratio of 355 conceals a range from 67 to 641 between counties, while some regions face severe health workforce shortages even as others enjoy far greater staffing density. 

Sources: National Council for Population and Development (NCPD), Kenya Population Situation Analysis (PSA) 2025; Kenya National Bureau of Statistics; World Health Organization; WHO Regional Office for Africa; UNICEF; UNFPA; World Bank Group. 

Data analytics and visualisation: Stanley Njihia  

Text: Yvonne Kawira.