Every child who receives a measles jab, every mother who takes her infant for a polio drop, and every community health worker who runs a mobile clinic in a remote village relies on the same thing: a physical place where a vaccine can be safely stored, administered and recorded. 

In Kenya, a newly compiled national dataset has, for the first time, brought together a comprehensive picture of exactly where those places are. The dataset, titled Kenya’s Immunising Health Facilities, catalogues 8,822 facilities delivering routine immunisation services across all 47 counties and roughly 321 sub-county areas. This is not a sample or an estimate. It is an attempt at a full census of every dispensary, health centre, hospital and clinic in the country that administers vaccines as part of its routine work. 

Of these facilities, around 73 per cent, some 6,410 sites, are run by the public sector, meaning county or national government health services. The remainder is shared between private providers, faith-based organisations (FBOs) such as mission hospitals, and non-governmental organisations (NGOs).  

This roughly three-to-one split matters because it speaks to equity of access. Public facilities are typically the most affordable, and often the only, option in rural and lower-income areas, while private and faith-based providers tend to cluster in urban centres and along the country’s more developed transport corridors. 

The result is a snapshot of a health system that is both impressively vast and, in places, frustratingly hard to pin down on a map. Of the 8,822 facilities, 8,299, around 94 per cent, have been placed on the map in some form. Roughly 7,979 facilities, around 90 per cent of the total, have been mapped at true facility level, meaning the coordinates point to the actual building. A further 178 facilities are only mapped to village level, and 142 more only to the level of the nearest postal town, useful for a general sense of location, but not precise enough for, say, planning a supply-chain delivery route or dispatching an ambulance. 

Faith-based hospitals have a long history in Kenya of filling gaps in underserved regions 

The information has been assembled from several authoritative sources, including the Kenya Master Facility List, the Kenya Medical Practitioners and Dentists Council (KMPDC), Google Places, OpenStreetMap and the Esri East Africa Ministry of Health facility layer. Bringing together data from five separate systems is no small feat, and the compilers have been admirably transparent about the limitations this creates.  

Notably, the sub-county field in the source data is something of a patchwork. It mixes genuine administrative sub-counties with constituencies, old colonial-era divisions, and even refugee camps. As a result, only 234 of the 321 recorded “sub-county areas” correspond to an official sub-county, a reminder that even foundational administrative data in a country of this size can be messier than it first appears. 

Faith-based hospitals, in particular, have a long history in Kenya of filling gaps in underserved regions, especially in areas such as the former Nyanza and Rift Valley provinces, where mission hospitals were established decades before government infrastructure caught up. 

Scroll through the county-by-county breakdown and Kenya’s uneven development becomes immediately visible. Nairobi, unsurprisingly, tops the list with 578 immunising facilities, reflecting both its dense population and its concentration of private healthcare providers. It is followed by a cluster of populous counties: Kitui (330), Machakos (323), Nakuru (299), Homa Bay (295), Makueni (291), Meru and Turkana (both 277), Kajiado (261) and Kwale (250). 

At the other end of the scale sit counties such as Lamu, with just 45 facilities, alongside Tana River (66), Isiolo (69), Taita Taveta (84) and Kirinyaga (88). These are generally the country’s more sparsely populated or geographically challenging counties, coastal, arid or semi-arid regions where building and staffing a dense network of clinics is simply harder and more expensive. 

Turkana has a high facility count, reflecting years of donor and NGO investment in the remote pastoralist region 

A county with fewer facilities is not automatically worse served, because population size, geography and settlement patterns all affect how many clinics are genuinely needed. Turkana, for example, has a relatively high facility count (277) for its remoteness, likely reflecting years of donor and NGO investment in a historically underserved pastoralist region. What the numbers do reveal clearly, though, is the sheer scale of the logistical challenge involved in running a functioning immunisation programme across a country that ranges from Nairobi’s dense estates to the deserts of the north. 

The dataset also highlights which counties are lagging furthest behind in coordinate precision, valuable information for anyone planning to close these gaps.  

Turkana has the largest absolute shortfall, with 69 facilities still lacking coordinates (75 per cent mapped), followed by Homa Bay (54 facilities unmapped, 82 per cent mapped) and Mandera (31 facilities, 74 per cent mapped). Nairobi, despite its enormous facility count, also has a meaningful number of gaps, 28 facilities, or 95 per cent mapped, simply because it has so many facilities in total. 

Kenya has made strides in childhood immunization over the decades, but pockets of under-vaccination persist 

Other counties with comparatively high proportions of unmapped sites include Kajiado, Narok, Machakos, Kwale, Wajir, Nakuru and West Pokot, several of which combine large populations with challenging terrain or historically weaker administrative record-keeping. Encouragingly, many smaller counties, including Nyeri, Kilifi, Mombasa, Nyamira, Kericho and Makueni, among others, have already reached, or are very close to, complete facility-level mapping, suggesting that closing these gaps nationally is an achievable, if uneven, task. 

Kenya has made significant strides in childhood immunisation coverage over the past two decades, but pockets of under-vaccination persist, often in precisely the counties where this dataset shows the greatest mapping gaps: the arid and semi-arid north, and parts of Nyanza and the Coast. A clinic that isn’t accurately mapped is a clinic that is harder for planners to supply reliably, harder for outbreak responders to reach quickly, and, in some cases, harder for a mother in a neighbouring village to even know exists. 

Kenya’s 8,822 immunising facilities represent an enormous and largely public-sector-led infrastructure, reaching into every one of the country’s 47 counties. The dataset shows a health system that has grown organically over decades, shaped by government investment, missionary history, private enterprise and, in the more remote counties, sustained humanitarian support. 

Data analytics and visualisation: Stanley Njihia 
Text: Yvonne Kawira