Built for the women
Kenya forgot to diagnose.
The 1 in 10 Initiative, also known as the Beyond the Bed Initiative, is a Kenya-based health education and advocacy organisation dedicated to closing the endometriosis care gap for women across East Africa. We were founded on a simple, urgent truth: 1 in 10 women lives with endometriosis, yet most wait 7–10 years for a diagnosis.
The Kenya picture
Sources: WHO global prevalence estimate; Kenya National Bureau of Statistics (KNBS) 2019 Census; ESHRE Endometriosis Guideline 2022; local clinical data.
Why Kenya, why now
Kenya has approximately 13 million women of reproductive age (KNBS 2019 Census). Applying WHO's global prevalence estimate of ~10%, roughly 1.3 million Kenyan women are living with endometriosis at any given time.
Yet endometriosis is not yet included in Kenya's National Health Insurance Fund (NHIF / SHA) benefit package, meaning diagnostic laparoscopy — which can cost KSh 80,000–150,000 in a private facility — is entirely out-of-pocket for most patients.
Specialist gynaecologists are concentrated in Nairobi and a handful of urban centres, leaving women in rural counties with virtually no pathway to diagnosis.
The cost of delay
A 7–10 year diagnostic delay means years of untreated pain, lost schooling, lost income, and — for many women — preventable fertility complications.
Studies in East Africa suggest that up to 30–50% of women presenting at fertility clinics have undiagnosed endometriosis as a contributing factor (East African Medical Journal, 2021).
The economic cost is significant: chronic pelvic pain is one of the leading causes of absenteeism and reduced productivity among working-age women in Kenya, yet it remains largely invisible in occupational health policy.
Our theory of change
We believe the endometriosis care gap in Kenya is not a medical mystery — it is a systems failure. Closing it requires action at three levels simultaneously: awareness among women and communities, access to affordable diagnosis and care, and advocacy for policy change. Each level reinforces the others.
We publish evidence-based educational content in English and Swahili, reaching women across Kenya's 47 counties through digital and community channels.
Women recognise their symptoms earlier and seek medical help sooner.
We fund subsidised diagnostic consultations and specialist referrals for low-income patients, and train healthcare workers to identify endometriosis at primary care level.
The average 7–10 year diagnostic delay in Kenya is reduced.
We engage policymakers, the Kenya Medical Association, and insurers to include endometriosis in the National Health Insurance Fund (NHIF/SHA) benefit package.
Endometriosis becomes a recognised, covered condition in Kenya's public health system.
Who we are
The 1 in 10 Initiative was founded in 2026 by Effie Nyaga, whose background in International Relations and her own diagnostic journey, spanning years of dismissed symptoms and misdiagnoses, became the catalyst for building the resource she wished had existed.
The initiative operates at the intersection of health education, patient advocacy, and systems change. Our team combines lived experience of endometriosis with expertise in public health communications, digital media, and community organising.
We are not a hospital or a clinic. We are the bridge between the women who are suffering in silence and the healthcare system that should be serving them, providing the information, the language, and the referral pathways that make the difference between a 10-year wait and a timely diagnosis.
Credibility & affiliations
Our commitment to accuracy
All clinical content on this platform is reviewed against current ESHRE, NICE, and WHO guidelines. We cite sources, acknowledge uncertainty, and update content when evidence evolves. We do not offer medical advice; we offer the information that helps women have better conversations with their doctors.
Where we're headed
These are our near-term targets for the current funding cycle. Each is measurable, Kenya-specific, and tied directly to our theory of change.