Kenya: Nairobi Health Act Ushers in New Era of Hospital Autonomy As Sakaja Signs 2026 Health Services Law

The Nairobi City County Health Services and Management Act, 2026 has ushered in a new era of hospital autonomy in Kenya's public health system. The law, signed by Nairobi Governor Sakaja Johnson on August 14 and enacted on August 19, grants Level Five hospitals greater institutional and financial responsibility. Each hospital is now a county entity, managing its financial, human, and physical resources.

Hospital Management Boards, led by competitively appointed CEOs, will oversee day-to-day administration, including financial management, budgets, procurement, staffing, and performance. The Act establishes a framework for hospitals to receive, administer, and account for funds allocated to them, adhering to public finance laws and audit requirements.

Hospitals will also develop and implement strategic plans, annual work plans, and budgets. This law aims to strengthen patient rights and protections, ensuring access to emergency treatment, dignity, privacy, and professional care. Hospitals are required to obtain informed consent before providing healthcare services, except in emergencies.

Healthcare workers are now guaranteed a safe working environment and the right to refuse treatment of abusive or harassing patients, except in emergencies. The law introduces mandatory quality-management systems, regular inspections, audits, digital health information systems, and community participation mechanisms. By redistributing hospital management, finances, and performance responsibilities, and placing patients' rights, quality of care, and accountability at the forefront, the law marks a significant shift towards a more self-governing, accountable, and patient-centered healthcare system in Nairobi.