Sakaja Signs New Health Law to Give Hospitals More Control Over Their Operations

Nairobi County Warns Businesses Over Permit Renewal

Nairobi Governor Sakaja Johnson has signed a new health law giving the county’s Level Five hospitals greater control over their finances, staffing, and day-to-day operations while introducing stronger measures on accountability, quality of care, and patients’ rights.

According to a statement dated August 20, the Nairobi City County Health Services and Management Act, 2026, was assented to by Sakaja on August 14 and came into force on August 19, marking a great change in the management of the county’s public hospitals.

“Nairobi’s public health system is set for a major management overhaul following the commencement of the Nairobi City County Health Services and Management Act, 2026, which gives Level Five hospitals greater institutional and financial responsibility while introducing stronger layers of oversight, accountability and patient protection,” read part of the statement.

Sakaja Law Gives Level Five Hospitals Greater Management Responsibility

Under the new framework, Level Five hospitals will be governed by Hospital Management Boards and headed by Chief Executive Officers appointed competitively by the County Public Service Board.

The CEOs will serve as accounting officers and take charge of the day-to-day administration of their respective facilities.

Sakaja stated that the hospitals will be required to develop and implement strategic plans, annual work plans and budgets in order to bring decision-making closer to the hospitals while maintaining county oversight.

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The law also allows hospitals to receive, administer, and account for funds allocated to them or accruing to the facilities.

However, the new autonomy does not exempt hospitals from public financial controls, as the facilities will continue to operate under the Public Finance Management Act, 2012, and remain subject to audit and other accountability requirements.

New Rules Protect Patients and Strengthen Informed Consent

Furthermore, the legislation introduces several provisions aimed at protecting patients. Under the new Act, every patient is entitled to the highest attainable standard of health, professional care, dignity and privacy, as it guarantees access to emergency treatment.

Doctors who have the capacity to provide emergency care but fail to do so could face a fine of up to Ksh1 million, imprisonment for up to 12 months, or both.

The legislation also requires healthcare providers to respect patients’ dignity and privacy while maintaining professional standards of care.

Sakaja noted that the Act also strengthens the requirement for informed consent before healthcare services are provided.

As a result, doctors must explain available treatment options, including their benefits, risks, costs and consequences, and patients must be informed of their right to refuse treatment, subject to exceptions provided under the law, including certain emergencies.

Healthcare Workers Get New Workplace Protections

The county governor added that the new law also seeks to improve the working environment for healthcare personnel.

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Healthcare workers are entitled to a safe working environment that minimises the risk of disease transmission, injury or damage to their health and property.

They are allowed to refuse treatment of patients who are physically or verbally abusive or sexually harassing them. However, this protection does not apply during emergencies where no alternative healthcare worker is available.

Sakaja’s new law further introduces mandatory quality-management systems across health facilities.

It provides for regular inspections and audits while requiring the development of integrated digital health information systems.

The legislation also strengthens community participation in healthcare management and requires the equitable distribution of health facilities.

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