Hospitals contracted by Kenya’s Social Health Authority (SHA) have been put on notice: provide emergency treatment to every patient, regardless of their ability to pay, or risk losing your contract.
In a directive issued by SHA Chief Executive Officer Dr Mercy Mwangangi, the authority reminded healthcare providers that emergency medical care is a constitutional right and cannot be delayed because of financial concerns, insurance verification or the absence of a deposit.
The warning comes amid mounting public concern over reports that some patients have been turned away or left waiting for urgent treatment while hospitals sought confirmation of SHA benefits or demanded upfront payments.
“The right to emergency medical treatment is guaranteed under Article 43(2) of the Constitution,” Dr Mwangangi said, stressing that contracted facilities must not refuse, delay or withhold emergency care because a patient cannot immediately pay or lacks proof of insurance coverage.
She added: “No patient requiring emergency medical treatment should be denied care, referred or transferred solely on financial grounds.”
The directive reinforces one of the country’s most fundamental healthcare protections. Under Kenya’s Constitution, every person has the right to receive emergency medical treatment. SHA says that obligation applies to all healthcare providers under its network, regardless of administrative or financial challenges.
To support hospitals, SHA said eligible emergency treatment during the first 24 hours will be financed through the Emergency, Critical and Chronic Illness Fund (ECCIF). After that period, qualifying services will be covered under the Social Health Insurance Fund (SHIF) or other approved payment arrangements.
The authority also outlined what hospitals should do when they cannot continue treating a patient. Facilities must first stabilise the patient before arranging a referral to another contracted hospital, following Ministry of Health referral guidelines.
SHA warned that hospitals found violating the directive could face enforcement measures, including de-empanelment and termination of their contracts. Regulatory bodies may also take additional action where necessary.
Hospital administrators, medical superintendents and emergency department managers have been instructed to immediately communicate the directive to clinical, admissions and finance teams to ensure consistent compliance.
The renewed warning follows growing criticism of Kenya’s new social health insurance system. Patients and families have reported delays in receiving emergency care, while some hospitals have cited reimbursement delays, verification difficulties and financial pressures as challenges affecting service delivery.
SHA acknowledged those operational concerns but maintained that they cannot override patients’ constitutional rights.
The latest directive seeks to draw a clear line: financial processes must never stand between a patient and life-saving treatment.
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