Across East Africa, governments are taking over refugee health services once run by humanitarian agencies. A new IRC report finds the shift only works when it's properly financed.

The IRC delivers refugee health services in Kenya, Uganda and South Sudan and works closely with governments and donors on these transitions. Our report compares how each is faring as humanitarian funding shrinks fast:

Kenya is registering camp health facilities with the Ministry of Health and enrolling refugees in national insurance—but county systems aren't yet strong enough to absorb the load.

Uganda has the region's most advanced transition, yet funding cuts are steep: government-backed health worker support is set to drop from 1,766 staff to 558 in 2026, and preventable deaths are already rising.

South Sudan shows what happens when transition outpaces capacity: only 38% of the refugee response was funded in 2025, and supply shortages are leaving hospitals unable to provide basic care.

Integration isn't a cost-saving move, it's an investment that must be funded and sequenced carefully, or it risks the very services it's meant to sustain. The report recommends predictable multi-year financing, fair pay for health workers, protected specialized care, readiness-based sequencing and early community engagement.

Read the full report for the complete analysis.

Available documents & links