"Game-changer": Nairobi Health Act ushers in new era of hospital autonomy
This story has significance for readers across Kenya and beyond.
- Governor Sakaja Johnson assented to the Nairobi City County Health Services and Management Act on August 14, 2026
- The law establishes Level 5 county hospitals as independent county entities governed by Management Boards and competitive CEOs
- Healthcare providers who deny emergency treatment face fines of up to KSh 1 million or up to 12 months in prison
Amos Khaemba, a journalist at TUKO.co.ke, brings over three years of experience covering politics and current affairs in Kenya.
Nairobi's public hospitals are entering a new era of institutional management following the coming into force of the Nairobi City County Health Services and Management Act, 2026, which took effect on August 19, five days after Governor Sakaja Johnson signed it into law.
The legislation formally designates every Level Five county hospital as a county entity, granting each facility direct responsibility over its financial, human and physical resources.
Each hospital will be governed by a Hospital Management Board and led by a Chief Executive Officer appointed through a competitive process by the County Public Service Board.
Hospital governance under the new law
CEOs will serve as accounting officers with oversight over daily hospital operations, including budgets, procurement, staffing and performance management.
Hospitals will also be required to develop strategic plans and annual work plans while remaining subject to public finance legislation and audit obligations.
"Every County Hospital (Level 5) shall be a County entity… managed in accordance with this Act by the respective Hospital Management Board and the Chief Executive Officer… [and] be responsible for the efficient, effective and economical management of its financial, human and physical resources," the Act states.
On financing, hospitals will be authorised to receive, administer and account for allocated funds in line with the Public Finance Management Act, 2012, maintaining public financial controls while giving facilities more direct authority over their budgets.
Patient Rights and Provider Accountability
The Act introduces enforceable patient rights, guaranteeing access to emergency treatment, dignity, privacy and professional care. No health provider may turn away a patient requiring emergency attention.
A provider who refuses emergency treatment where the capacity exists faces a fine of up to KSh 1 million, imprisonment for up to 12 months, or both.
Informed consent is also now a legal requirement before health services are administered, with exceptions for emergencies. Providers must explain treatment options, including their benefits, risks, costs and consequences, and must inform patients of their right to refuse.
"Every patient has the right to the highest attainable standard of health… to be treated with professional standard of care… and to be treated with dignity, respect and have their privacy respected," the law reads.
The Act also extends protections to healthcare workers, guaranteeing them a safe working environment and recognising their right to decline treatment of abusive or harassing patients, except in emergencies where no alternative provider is available.
Additional provisions mandate quality-management systems, regular facility inspections and audits, integrated digital health information systems and mechanisms for community participation in health governance.
The law was enacted against the backdrop of the Kenya Health Summit, held at the Kenyatta International Convention Centre on August 18 and 19 under the theme "Reforms Delivered, Health as a Right," which focused on translating national health-sector reforms into measurable improvements in access, quality and accountability.
Source: TUKO.co.ke
Reporting originally appeared via TUKO. Read the full source for additional context.