Since devolution, public healthcare expenditure has risen substantially as a percentage both of GDP and of government expenditure. Local level spending has been constrained by delayed and lower-than-budgeted transfers from national to county level. Devolution of responsibilities to counties has meant that decisions can be made closer to the point of need, but significant challenges remain. Even before devolution, health systems were quite weak, particularly in northern areas. When counties took over provision of healthcare, they received insufficient guidance for their new role, including guidance on budget lines. Nevertheless, there have also been some successes in refocusing healthcare provision to the needs of local communities, and increasing the prioritization of preventive and promotive interventions rather than curative services. Counties are currently at different levels of institutionalization, planning, prioritization and implementation, and this largely depends on the capacity and commitment of health managers. Community health volunteers support maternal and newborn care, parent support groups, timed and targeted counselling, nutrition support, referral of children for immunization, and treatment of certain ailments by providing essential information and medical supplies, and acting as a referral mechanism. Kenya has managed to introduce new vaccines: the inactivated polio vaccine, rota, measles and rubella: 19 million children aged below 14 years were vaccinated against measles and rubella in 2016 and nine million children under five years were vaccinated against polio between 2013 and 2017. The number of healthcare facilities providing immunization increased from 5,300 to 6,900 between 2011 and 2016.

As part of Vision 2030, the President outlined the “Big Four” development priority areas for his final term as President. The Big Four will prioritize manufacturing, universal healthcare, affordable housing and food security.

Kenya is piloting a prototype of an accessible digital textbook that follows Universal Design for learning. Primary and secondary schools remain the responsibility of the national Government, but pre-school has been transferred to county governments. Including spending at the county level, almost 40% of government expenditure was on social sectors in 2015-2016, of which education accounted for more than half. Between 2011 and 2015, the number of educational establishments at all levels rose, with the largest rises in public primary and secondary schools and in private secondary schools. Teacher distribution is very inequitable, with schools with 500 pupils having as few as five or as many as 40 teachers. Children with disabilities are still largely taught in separate schools or units, despite inclusive education being a principle of the 2014-2018 National Education Sector Plan. At more than 14 per cent of total government expenditure, public spending on education is slightly higher than for comparable East African counties. Almost all this spending (92 to 95%) is on recurrent expenditure, such as salaries.