ABSTRACT:
Background Despite global commitments to universal health coverage, persons with disabilities and survivors of violence remain systematically excluded from health systems. Traditional governance structures often fail to embed equity and accountability. This study explores how survivor centered, disability inclusive governance models can strengthen health systems and advance public health equity. Methods A mixed methods design was employed, combining participatory action research, autoethnographic documentation, and policy analysis. Data were collected from 120 participants across three Kenyan counties through structured interviews, focus groups, and community dialogues. Quantitative data were analyzed using SPSS to assess service utilization trends, while qualitative narratives were thematically coded to identify governance innovations, barriers, and pathways for scale. Results Implementation of survivor centered governance models led to a 34% increase in health service uptake among persons with disabilities over two years. Communities reported enhanced trust in health institutions, citing transparent decision making and trauma informed facilitation as critical enablers. Policy analysis revealed gaps in national frameworks, particularly in financing and accountability, but demonstrated that locally adapted models can influence broader health system reforms. Conclusions Survivor centered, disability inclusive governance offers a replicable pathway to strengthen health systems by embedding equity, accountability, and resilience. Scaling these models requires investment in participatory structures, recognition of indigenous epistemologies, and integration into national health policies. This work contributes to global debates on health systems strengthening by foregrounding marginalized voices and presenting evidence based strategies for inclusive governance.