On August 11, 2025, Public Health Principal Secretary Mary Muthoni delivered a stern directive to administrators of Level 2, Level 3, and sub-county hospitals: do not charge patients for outpatient services. The order comes straight from President William Ruto, who insists that these facilities must treat patients without demanding any payments.
PS Muthoni emphasized that the Ministry of Health will be vigilant, ensuring that Kenyans access necessary care in these hospitals without paying a single cent. Any health professional disregarding this presidential directive risks having their license cancelled.
However, the policy is clear: the free outpatient services in Kenya apply only to Level 1 through Level 3 facilities. Patients must pay only if referred to Level 4 or Level 5 hospitals.
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PS Muthoni also encouraged all Kenyans to register with the Social Health Insurance (SHI) program to benefit from improved healthcare under ongoing reforms. The government will cover outpatient costs at these lower-level facilities through the Universal Health Coverage (UHC) initiative.
President Ruto further directed Governor Kimani Wamatangi of Kiambu County to address instances where hospitals were charging outpatient fees despite the UHC program already covering these services.
Summary of Key Points:
- Directive Date: August 11, 2025
- Who Issued It: President William Ruto, communicated by PS Mary Muthoni
- Affected Facilities: Level 1–3 hospitals and sub-county facilities
- Core Message: No fees for outpatient services in these facilities
- Consequences: Healthcare workers who defy the directive risk losing their licenses
- Referral Cases: Payments only apply for treatment in Level 4 and Level 5 hospitals
- Support Needed: Register with SHI; government will handle the costs via UHC
- Enforcement: Governor of Kiambu County instructed to correct noncompliant hospitals
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