Opinion: Kenya’s Endometriosis Crisis Demands More Than Awareness Campaigns

Endometriosis is often described as a women's health issue. In Kenya, it should increasingly be treated as a public-health and healthcare-system issue.

For many women, the condition can mean severe period-related pain, chronic pelvic pain, difficulty conceiving and years of repeated visits to health facilities before receiving appropriate specialist care. International clinical guidance stresses the importance of timely diagnosis and coordinated care because delays can affect quality of life and allow the condition to progress.

Kenya's own Parliament has already recognised the problem. In September 2024, lawmakers debated the shortage of specialised endometriosis treatment facilities. The Ministry of Health told Parliament that it had invested in training gynaecologists and laparoscopic surgeons and in equipment, while also planning wider public-awareness campaigns.

The question now is: what happens next?

Awareness alone will not solve the crisis

Public awareness is important. Women need to know that debilitating period pain should not simply be dismissed as something they have to endure.

But awareness without accessible treatment creates another form of frustration.

A woman can recognise the symptoms, seek help and still encounter long referral pathways, limited specialist services, diagnostic delays or treatment that is financially out of reach.

That is where government intervention becomes critical.

Build specialist services in public hospitals

Kenya should establish designated endometriosis clinics or specialist units within selected county and national referral hospitals.

These centres should bring together gynaecologists, radiologists, pain-management specialists, fertility specialists and surgeons where necessary.

International guidance recommends coordinated specialist services, including access to experienced gynaecologists, specialist imaging, pain management and fertility services.

The model does not require every hospital to become an endometriosis centre.

Instead, Kenya could develop a network:

Primary facility → county hospital → regional specialist centre → national referral centre.

That would make the referral system clearer and reduce unnecessary movement between facilities.

Diagnosis must become faster

One of the biggest challenges is recognising the disease.

Endometriosis cannot simply be ruled out because an initial examination or ultrasound is normal. Specialist guidance notes that further referral may still be necessary where symptoms persist.

Kenya should therefore strengthen training for healthcare workers at primary and county levels so they can recognise warning signs and refer patients appropriately.

The government's proposed national referral-policy reforms could provide an opportunity to build endometriosis into clearer specialist referral pathways. The Ministry says the emerging policy is intended to improve coordination between levels of care, reduce delays and strengthen continuity of treatment.

Put endometriosis inside the UHC conversation

Universal healthcare cannot be measured only by how many people are registered in a health financing system.

It must also be measured by whether patients with chronic conditions can actually obtain the care they need.

Kenya's Social Health Insurance framework should therefore provide clear, transparent pathways for medically necessary endometriosis consultations, investigations, medicines, specialist treatment and appropriate surgery.

The government has already been reviewing healthcare tariffs and benefits under the Social Health Insurance framework.

Endometriosis should be part of that broader conversation about financial protection.

Invest in laparoscopic surgery and specialist training

Surgery is not appropriate for every patient, and treatment should be determined by qualified clinicians according to symptoms, individual circumstances and treatment goals.

However, where surgery is clinically indicated, public hospitals need the equipment, trained personnel and operating-theatre capacity to provide it.

The Ministry told Parliament in 2024 that Kenya had five trained laparoscopic gynaecological surgeons mainly based at national referral hospitals and that the government had invested in laparoscopic equipment.

That is a starting point, not the finish line.

The next step should be expanding specialist capacity geographically so that access is not concentrated in a handful of facilities.

Protect fertility and mental wellbeing

Endometriosis is not only about pain.

For some patients, fertility concerns can become an important part of the disease burden. Kenya's latest National Family Planning Guidelines recognise endometriosis among conditions for which laparoscopic surgery may be used and include fertility treatment pathways such as assisted reproductive technologies where clinically appropriate.

Public hospitals therefore need stronger links between gynaecology, fertility services and appropriate counselling.

Patients should also receive information about their condition and available treatment options rather than being left to navigate the system alone.

County governments have a major role

Healthcare in Kenya is a shared national and county responsibility.

The national government can establish standards, develop treatment guidelines, support specialist training and strengthen financing.

County governments control many of the facilities where patients first seek care.

Counties should therefore identify hospitals capable of becoming regional endometriosis referral centres, equipped with trained personnel, diagnostic capacity and reliable referral links.

This approach would be more realistic than attempting to create expensive specialist centres everywhere.

Create a national endometriosis strategy

Kenya needs a coordinated national approach with measurable targets.

A national endometriosis programme could track:

1. Average time from first presentation to diagnosis.
2. Number of trained healthcare workers.
3. Number of specialist endometriosis centres.
4. Availability of diagnostic imaging.
5. Number of trained laparoscopic surgeons.
6. Surgical waiting times.
7. Access to appropriate pain management.
8. Fertility referrals.
9. Patient complaints and treatment outcomes.

What gets measured can be improved.

The government should listen to patients

Perhaps the most important reform is cultural.

For years, severe menstrual pain has too often been normalised.

A healthcare system should not require a patient to repeatedly prove that she is suffering before taking her seriously.

Endometriosis deserves the same seriousness given to other chronic conditions that can affect a person's education, employment, family life, fertility and overall quality of life.

Kenya has an opportunity to act

The government is already talking about strengthening referral systems, expanding specialised healthcare infrastructure and advancing universal health coverage.

Those reforms should include women living with endometriosis.

The answer is not simply another awareness campaign every March.

Kenya needs a system in which awareness leads to diagnosis, diagnosis leads to treatment, and treatment is accessible regardless of a patient's income or county of residence.

If the government can build that pathway through public hospitals, strengthen specialist capacity and ensure appropriate financial protection, it would turn endometriosis from an overlooked women's health problem into a properly addressed national health priority.

The real test of Kenya's healthcare reforms is not what is announced in Nairobi. It is whether a woman in a county hospital can walk through the doors, be believed, receive the right diagnosis and access appropriate treatment without being pushed from one facility to another.