Feminist Evaluation of Universal Health Coverage Programs in Kenya: A Conceptual Analysis

Abstract

The conceptual analysis evaluates the applicability of feminist principles of evaluation to the gender-transformative potential of Universal Health Coverage (UHC) programs in Kenya. With the help of a conceptual research design, the study synthesizes Kenyan health policy documents and secondary evidence using an integrated feminist political economy and intersectionality perspective. The frameworks that inform this approach include analyzing actor-power and ideas in policy prioritization. The main finding was that Kenya has gender integration in its health policy, which is inconsistent and politically mandated. There is also a positive correlation between the presence of strong advocacy coalitions and gender integration and vice versa, which validates the actor-dependence of equity. The analysis also revealed serious systemic flaws in the UHC design, including systematic exclusion of unpaid care work as a standard indicator. The paper’s major contribution lies in a new conceptual framework that shifts the technical measures of UHC evaluation into examining the redistribution of power, participatory governance, and intersectional equity. The paper concludes that unless this feminist lens is applied, UHC reforms are likely to continue reinforcing the gendered inequities it is expected to address. The key recommendations are the official integration of feminist evaluation standards into the monitoring systems and the pilot of the framework through county-level assessments. The study also makes a major contribution to monitoring and evaluation (M&E) by introducing a context-sensitive and structured tool that connects feminist theory with health systems practice. Finally, it seeks to make the Kenya UHC agenda deliver the promise of substantive rather than just nominal universalism.