Pregnant mothers seeking maternity services at healthcare facilities will be forced to look for alternative hospitals or pay out of their pockets. 

This follows an unlawful recategorisation of Level 2 and 3 health facilities by the Kenya Medical Practitioners and Dentists Council (KMPDC), according to the Rural and Urban Private Hospitals Association of Kenya (RUPHA). 

The changes executed by the Social Health Authority (SHA) through its portal administrator, Digital Health Authority (DHA), from last month saw the erasing of maternity and inpatient bed capacity in those facilities. 

“These changes, reportedly implemented based on guidance from the Kenya Medical Practitioners and Dentists Council, have had unintended but severe consequences on patient access, SHA reimbursement, and facility functionality-especially in underserved rural and urban poor areas,” RUPHA Chairman, Dr Brian Lishenga said on July 30, 2025, revealing that he has written to the Director General of Health, Dr Patrick Amoth calling on him to advise against this move. 

Council’s Act 

He accused KMPDC of going against Regulation 269 of the Council’s Act, which covers areas such as the operation of clinical radiological laboratories, fees, and the general conduct of practitioners in private practice.  

Affecting maternity services especially in Mandera, Turkana, Wajir, Garissa, Marsabit, and in urban informal settlements, the changes in the SHA portal eliminate 1,278 beds from Level 2 and 2,200 from Level 3B-totalling 3,478 maternity beds. RUPHA estimates this to be an 18.6 per cent loss of the national maternity bed capacity. 

Delivery beds 

“It also means that 1,080 delivery beds are erased, and that’s about 28.6 per cent of the national total,” noted Dr Lishenga, indicating that the move, which KMPDC says was an instruction from Afya House, sees up to 10,000 inpatient beds, eroded by the downgrading of 1,138 Level 3B inpatient facilities.  The key impacts of this policy shift are based on the 2023 Kenya Health Facility Census. 

According to Dr Lishenga, this means that access to essential services at Level 2 and 3B health facilities will be negatively impacted, including poor maternal and neonatal outcomes, and rising out-of-pocket expenditure for poor households.

Level 2 and 3 facilities serve as the de facto primary access points for maternity and inpatient care. 

“Dear Dr Amoth, I write to you in your capacity as the Director General and Chief Technical Advisor to the Ministry of Health on a matter with significant implications for the continuity of essential services under the SHA and the broader trajectory of Kenya’s Universal Health Coverage (UHC) reforms,” he wrote in a letter dated July 29, 2025, raising the grave consequences that pregnant mothers face if the move is not reversed. 

In the letter, he informed Dr Amoth that the said facilities are no longer compensated by SHA, meaning that services—if still offered—require out-of-pocket payment.

“This defeats the objectives of social health protection and UHC,” he stated.  

He noted that Gazette Notice No. 269 of 2021 amended the KMPDC Medical Institutions Rules to recognise KEPH Level 3C facilities that have inpatient capacity but without theatres; recognise certain Level 2 facilities, such as dispensaries, as eligible to provide maternity and immunisation services based on their service scope and infrastructure.