Welfare Futures Recap: Ruth Prince on Solidarity, Precarity, and the Limits of Social Protection in Kenya

Policy and Reality

Prince began her lecture by discussing recent health policy initiatives in Kenya, where the government is striving to achieve universal health coverage. While these goals are promising, she highlighted the persistent gap between policy ambitions and everyday realities. Public healthcare, which is meant to be freely available to millions, faces major challenges in practice—such as shortages in infrastructure, corruption, and inefficient allocation of resources.

These tensions are made worse by the growing presence of private actors, including tech companies offering their insurance schemes and healthcare services. This has led to a hybrid system where public resources are increasingly entangled with private interests—creating new forms of exclusion.

Neoliberal Logic and the National Health Insurance Fund

One clear example of this shift is the National Health Insurance Fund (NHIF). Although originally designed to support universal health coverage, Prince showed how in practice it has contributed to the privatization of care. Access to healthcare now depends more on market dynamics than on public solidarity. As a result, inequality is growing: the people who need care the most are often the ones left without it.

Prince warned against systems that prioritize private investors over public needs, arguing that this approach systematically overlooks the needs of the poorest citizens.

She also noted how structural problems in African countries are often ignored, especially by international organizations that prefer to highlight success stories and progress. In reality, healthcare systems are increasingly moving toward hybrid models where private actors dominate—undermining the very idea of solidarity. Social protection, once aimed at reducing inequality, is becoming something you have to pay for—accessible only to those who can afford it.

Informal Care Networks as a Safety Net

In this context, Prince pointed to the crucial role of informal networks. In the absence of effective public systems, families, friends, and communities often step in to provide care. This kind of solidarity is essential for the survival of many—but it comes at a cost.

Prince described this burden as the "invisible load”: the hidden weight carried by individuals—often women—within these informal care systems. While such networks offer vital support, they are fragile and dependent on personal resources, contributing to burnout and exhaustion.

Activism and Alternative Models

Prince ended her talk by reflecting on the future: how can African countries build fairer systems of social protection? She stressed that reforms often clash with deeply rooted political, social, and economic structures and that market-based solutions do not automatically lead to inclusive care.

She therefore called for more serious attention to grassroots initiatives and activist knowledge. In the archives of community-based organizations lie valuable insights into how people have resisted exclusion and built alternative care systems.

For Prince, these activist archives are not only of historical interest—they also offer tools for shaping future policy. They remind us that social protection is not just a technical matter, but also a moral and social project in which solidarity must remain central.