ABSTRACT:
Economic accessibility is an essential element of the right to health. It is grounded in equity. In this context, equity demands that poorer households should not be disproportionately burdened with health expenses. To achieve this public and health insurance are created. Health insurance involves the pooling of health risks and spreading costs across populations. Yet many schemes rely on age-based ideas of dependency that recognize only children as dependants but overlook financial dependency of older persons on their adult children. In Kenya, as in many African countries, population ageing is increasing alongside chronic illness and long-term care needs for older persons. Many older persons, particularly after retirement, have limited income, weak pension coverage and depend on their adult children for healthcare support. This support is deeply rooted in cultural and traditional expectations of intergenerational care, where adult children act as the main welfare system. Despite this, health insurance schemes recognize children as dependants under parental insurance but exclude older parents who depend on their adult children. These parents are therefore required to obtain separate insurance or pay out-of-pocket, even these payments are made by their adult children. This paper adopts a human rights-based approach to examine how economic accessibility under the right to health is put into practice through health financing for dependent parents in Kenya. The paper argues that the current age-based definitions of dependency creates a structural gap between cultural practices of intergenerational care and formal health financing. Consequently, this undermines the equity principle of the right to health, fragments financial protection, and increases risks of catastrophic health spending for older persons and the adult children who support them. Redefining dependency in health financing to include parents not only respects culturally rooted family care practices, but also strengthens equity and financial protection across generations.