Towards a net-zero healthcare system in Kenya: Stakeholder perspectives on opportunities, challenges and priorities

Introduction: Kenya's healthcare system committed to achieving net-zero greenhouse gas emissions by 2030 as part of the UNFCCC COP26 Health Program. To turn these ambitious commitments into outcomes and share learnings with other nations, a comprehensive assessment of the perspectives of key stakeholders likely to be involved in implementing the transition of the healthcare system is needed. Methods: This study employs qualitative methods, including 21 semi-structured interviews with key stakeholders and a Delphi consensus process, to explore stakeholder perspectives on Kenya's journey to a net- zero healthcare system. Results: Stakeholders identified and validated 14 process components crucial for this transformation, ranging from leadership and financing to behavioral change and monitoring. Critical barriers, such as infrastructure limitations, competing health priorities, financial constraints, and gaps in strategy coordination, were highlighted. Stakeholders ranked three interventions as the highest priority: implementing clean energy solutions in healthcare facilities, developing national sustainable healthcare policies that are informed by existing evidence on climate benefits, and generating localized data to guide actionable policies. Ranking interventions based on feasibility, however, produced different results that favored simpler, more immediately actionable measures like hospital vegetable gardens and the creation of guidelines for health facilities. Conclusion: While the transition to net-zero poses challenges, stakeholders expressed optimism about the potential of current strong leadership, strategic partnerships, and the growing momentum for action on climate change and health. This research provides actionable insights and recommendations to guide Kenya's transition to a sustainable, resilient healthcare system, while offering valuable lessons for other countries facing similar challenges. (c) 2025 The Authors. Published by Elsevier Masson SAS. This is an open access article under the CC BY-NC license (http://creativecommons.org/licenses/by-nc/4.0/)