Entrepreneurship Ecosystems and Health Care Innovation in Kenya: An Analysis of Enablers, Barriers, and Impact on Health Service Delivery

Aim: The paper aims to analyse the enablers and barriers within Kenya’s healthcare entrepreneurship ecosystem and assess how these conditions influence the adoption, diffusion, and scaling of innovations that impact health service delivery outcomes. Methods: An integrative review was undertaken using 27 academic publications supplemented by contextual policy and sector documents. Thematic synthesis mapped ecosystem enablers, barriers, and impacts to a conceptual framework linking conditions to innovation trajectory and service outcomes. Results: Policy clarity, interoperable digital foundations, sustainable financing approaches, and cross-sector networks consistently emerge as the strongest predictors of successful innovation adoption and scale. Barriers include regulatory uncertainty, procurement complexity, fragmented health information systems, limited sustainable revenue models, workforce capacity constraints, and geographic-equity divides. Conclusion: Kenya’s health innovation outcomes do not depend on ideas alone. They depend on whether ecosystem conditions are strong and aligned enough to support adoption, scale, and long-term use in routine service delivery.