Pregnancy
Kenya abolished user fees for delivery in public facilities in 2013 and later folded the policy into a national programme covering antenatal care, delivery and postnatal care, including in accredited private and faith-based facilities. Skilled attendance at birth rose sharply as a result. Maternity leave is three months, with two weeks of paternity leave.
Kenya abolished user fees for deliveries in public facilities in 2013 under the Linda Mama free maternity programme, which was later folded into the national insurer, and facility deliveries rose sharply as a result. The remaining costs are indirect: transport, supplies, and the informal charges that persist in some facilities.
Key points
| Free maternity programme | Covers antenatal care, delivery and postnatal care |
|---|---|
| Accredited facilities | Includes private and faith-based facilities, not only public ones |
| Maternity leave | Three months, with two weeks of paternity leave |
| Antenatal care | Eight contacts recommended; first visit in the first trimester |
| Skilled attendance | Rose substantially after fees were abolished |
| HIV | Testing and treatment integrated into antenatal care |
| Remaining barriers | Transport, informal charges and distance in arid counties |
In practice
- Register for the national programme early: it covers accredited private facilities too.
- Informal charges are not lawful under the programme; ask for an official receipt.
- Community health promoters can arrange transport in some counties.
Cost and coverage
Antenatal care, delivery and postnatal care are covered by the national programme.
Recent changes
The free maternity programme has been absorbed into the reformed national health insurance framework, with registration now digital; coverage of antenatal and postnatal visits has been extended.
Where to go
- Public health facilities and accredited private and faith-based facilities.
- County health departments.
- Community health promoters.
Worth knowing
The programme covers accredited private and mission facilities as well as public ones. Many women pay privately without realising the same care is covered.
Frequently asked questions
Is delivery free in Kenya?
In public facilities and accredited private ones under the national maternity programme, yes, covering antenatal visits, delivery and postnatal care. Registration is required, and in practice families still pay for transport and sometimes for supplies, which is the main remaining barrier.
How long is maternity leave?
Three months of paid maternity leave under the Employment Act, and two weeks of paternity leave, for employees. Annual leave cannot be set off against it.
The general article: Pregnancy · Compare with another country
Periods and period products
Kenya exempted menstrual products from VAT in 2004 — the first country in the world to do so — removed the excise duty on imported products in 2011 and exempted raw materials for local manufacture in 2016. The Basic Education (Amendment) Act 2017 obliges the government to provide free, sufficient and quality sanitary towels to every girl registered in a public school who has reached puberty, with safe disposal; distribution began in 2018 through the National Sanitary Towel Programme, whose funding has fluctuated. A Menstrual Hygiene Management Policy covers 2019 to 2030.
There is no menstrual leave in the Employment Act; a bill has been discussed without passing.
Endometriosis is treated in the gynaecology departments of county and national referral hospitals and in private clinics in Nairobi and Mombasa; the Social Health Authority covers care in public and empanelled facilities. Awareness is low and diagnosis late; patient groups have grown in recent years.
Reusable pads and cups are exempt like disposables and are promoted by many school and NGO programmes.
Key points
| VAT | Exempt since 2004; import excise removed 2011; raw materials exempt 2016 |
|---|---|
| Schools | Basic Education (Amendment) Act 2017: free sanitary towels for girls in public schools; distribution since 2018 |
| Policy | Menstrual Hygiene Management Policy 2019–2030 |
| Endometriosis | County and referral hospitals; Social Health Authority in empanelled facilities |
In practice
- Ask the school head whether the government towels have arrived: supply depends on the annual budget.
- For pelvic pain, county hospital gynaecology clinics are the affordable route; ask for referral to a national hospital if needed.
- NGO programmes distribute reusable pads and cups in many counties.
What it costs
A cycle costs roughly 100 to 300 shillings in disposables, VAT-exempt. Free pads in public schools by law; nothing otherwise reimbursed.
What has changed recently
Funding for the school programme fell in the 2022–2023 budget and has been contested since; the legal obligation remains.
Where to find help
- Ministry of Education and State Department for Gender: National Sanitary Towel Programme.
- Ministry of Health: Menstrual Hygiene Management Policy.
- County hospital gynaecology clinics.
- Endometriosis Foundation of Kenya and patient groups.
Worth knowing
Exemption at the border and the factory does not always reach the shelf: prices in informal shops can exceed supermarket prices. Compare, and use school supplies where they exist.
Frequently asked questions
Is there VAT on pads in Kenya?
No, not since 2004 — Kenya was the first country to remove it.
Are pads free in schools?
By law, yes, for girls in public schools since the 2017 amendment; actual supply depends on the budget.
Is there menstrual leave in Kenya?
No. Sick leave with a certificate applies.
Sources
- Kenya Law — Basic Education Act — free sanitary towels in public schools
- Ministry of Health — Menstrual Hygiene Management Policy — policy 2019–2030
The general article: Periods and period products · Compare with another country
Sex therapy
“Counsellor” and “psychologist” are protected titles since the board began licensing in 2022; “sex therapist” is not; the Social Health Authority covers mental health in empanelled facilities only.
Kenya protects the titles of counsellor and psychologist under the Counsellors and Psychologists Act, enforced by a board operational since August 2022; practising without a licence is an offence. Doctors are registered with the Kenya Medical Practitioners and Dentists Council. “Sex therapist” is not a distinct licensed title: a legitimate practitioner holds a counselling or psychology licence, or a medical registration, and has added sexology training, usually abroad.
Sexual-health care in the public system runs through county hospitals — psychiatry, urology and gynaecology clinics — and through the national referral hospitals in Nairobi, Eldoret and Mombasa. Non-governmental clinics such as those of the family-planning and HIV organisations offer counselling at low cost. Private psychologists and counsellors with sex-therapy training are concentrated in Nairobi and Mombasa.
Since October 2024 the Social Health Authority has replaced the old hospital insurance fund and includes mental-health services in its benefit package, but only in public and empanelled facilities; a session with a private therapist outside the panel is not paid. A private consultation or therapy session costs roughly 2,000 to 6,000 shillings in Nairobi. Employer medical schemes sometimes include a counselling benefit.
Adverts for “sexologists” and herbalists promising cures are widespread; none of them is licensed, and erectile-dysfunction drugs sold without prescription are frequently counterfeit.
Key points
| Title | “Counsellor” and “psychologist” protected (Counsellors and Psychologists Act); “sex therapist” not |
|---|---|
| Regulators | Counsellors and Psychologists Board; Kenya Medical Practitioners and Dentists Council |
| Who is trained | Licensed counsellors and psychologists, psychiatrists, urologists, gynaecologists with sexology training |
| Social Health Authority | Mental-health services in public and empanelled facilities since October 2024; private therapists outside the panel not covered |
| Public hospitals | County and national referral hospitals: psychiatry, urology, gynaecology |
| Private cost | About 2,000–6,000 shillings a session in Nairobi |
In practice
- Check the practitioner's licence on the Counsellors and Psychologists Board register or the medical council's.
- Ask whether the facility is empanelled with the Social Health Authority if you intend to use it.
- Use county hospital clinics for medical evaluation; referral to national hospitals is possible.
- Ask your employer's medical scheme about counselling benefits.
Cost and reimbursement
Public and empanelled facilities: covered by the Social Health Authority within its rules. Private therapist: 2,000–6,000 shillings a session, out of pocket unless an employer scheme applies.
What has changed recently
The board's licensing has given patients a register to check since 2022, and the Social Health Authority's package, launched in October 2024, formally includes mental health — with teething problems in enrolment and payments widely reported.
Where to go
- Counsellors and Psychologists Board: register of licensed counsellors and psychologists.
- Kenya Medical Practitioners and Dentists Council: register of doctors.
- County hospitals and national referral hospitals: psychiatry, urology and gynaecology clinics.
- Kenya Counselling and Psychological Association.
Worth knowing
A licence from the board is now the minimum; a “sex therapist” without one is practising illegally. Herbal clinics and street adverts are not health care.
Frequently asked questions
Is sex therapy a licensed profession in Kenya?
Not by itself. Counsellors and psychologists must be licensed by the board; sex therapy is practised within those licences or by doctors.
Does the Social Health Authority cover therapy?
Mental-health services in public and empanelled facilities are covered; a private therapist outside the panel is not.
How do I check a therapist?
On the Counsellors and Psychologists Board register, or the medical council's register for doctors.
Sources
- Counsellors and Psychologists Board — register of licensed counsellors and psychologists
- Social Health Authority — benefit package and empanelled facilities
The general article: Sex therapy · Compare with another country
Mental health
A 2022 amendment modernised the law, and the treatment gap remains among the widest in the world.
Kenya amended its mental health legislation in 2022, strengthening patients' rights and shifting the emphasis towards community care.
Kenya amended its Mental Health Act in 2022, replacing outdated language, strengthening consent and creating a board to oversee services — a significant modernisation on paper. Delivery has not followed at the same pace: there are very few psychiatrists for the population, most are in Nairobi, and counties differ enormously in what they provide. Integration into primary care and a national suicide prevention strategy are the current direction.
Frequently asked questions
What changed in the 2022 amendment?
It replaced stigmatising terminology, strengthened the rules on consent and involuntary treatment, provided for care at county level and established a mental health board. It also framed mental health as part of universal health coverage rather than a separate institutional matter.
Where can someone get help?
At county referral hospitals, which have psychiatric units, at Mathari hospital in Nairobi for specialist care, and through a growing number of helplines and online counselling services. Attempted suicide was decriminalised by the High Court in 2022, which removed a real barrier to seeking care.
The general article: Mental health · Compare with another country
Dental care
The Social Health Authority scheme has limited dental benefits, and restorative care is mostly private.
Dental care is organised around the Social Health Authority scheme that replaced the NHIF, with limited dental benefits.
The general article: Dental care · Compare with another country
HIV and AIDS
Free treatment and one of the first public PrEP programmes in Africa, launched in 2017.
Kenya has an extensive treatment programme, free at public facilities, and was among the first countries in Africa to make pre-exposure prophylaxis available through the public sector, in 2017. Self-testing has been actively promoted, and treatment is offered to everyone on diagnosis.
Kenya provides free antiretroviral treatment through public facilities and has made PrEP available nationally, including through pharmacies in pilot programmes. Self-testing kits are sold in pharmacies and distributed through outreach. The programme is mature; the difficulty is reaching adolescents and young women, where incidence remains disproportionate.
Key points
| Treatment | Free at public facilities, offered on diagnosis |
|---|---|
| PrEP | Public programme since 2017, among the first in Africa |
| Self-testing | Actively promoted and widely available |
| Testing | Free at public facilities and through community outreach |
| PMTCT | Long-established, with high antenatal testing coverage |
| Adolescents | Can consent to testing from a defined age under the health law |
| Funding | Substantial reliance on international financing |
In practice
- Ask for PrEP by name at a public facility: it is part of the national programme.
- Self-test kits are available in pharmacies and through community distribution.
- Community health promoters can link you to services discreetly.
Where to go
- Public health facilities and comprehensive care centres.
- National AIDS and STI Control Programme services.
Worth knowing
Kenya's PrEP programme is public and free, but awareness among health workers is uneven.
Frequently asked questions
Can you buy an HIV self-test in Kenya?
Yes, self-test kits are available in pharmacies and through outreach programmes, giving a result in minutes at home. A reactive result must be confirmed at a health facility, which also provides counselling and links to treatment the same day.
Hepatitis B
Infant vaccination in the routine schedule, but no universal birth dose — a significant gap.
Kenya includes hepatitis B in the routine infant schedule from six weeks in the combined vaccine, but has not implemented a universal birth dose. Since mother-to-child transmission at delivery is what produces most chronic infections, that gap matters: the six-week dose protects against later exposure but not against perinatal transmission.
Kenya includes hepatitis B in the pentavalent vaccine given from six weeks, but does not routinely give a universal birth dose, which leaves the perinatal transmission route open. Antenatal screening for hepatitis B is not universal either. Prevalence is intermediate, and the combination of these two gaps is the focus of current policy discussion.
Key points
| Infant vaccination | In the routine schedule from six weeks, in the combined vaccine |
|---|---|
| Birth dose | Not universally implemented |
| Consequence | Perinatal transmission is not fully prevented |
| Antenatal screening | Not routine in all facilities; ask for it |
| Prevalence | Intermediate |
| Treatment | Available in referral hospitals, often at the patient's cost |
In practice
- Ask specifically for hepatitis B testing during pregnancy — it is not automatic everywhere.
- If you are a carrier, discuss what can be done for the newborn before delivery.
- Have household contacts tested and vaccinated.
- Chronic carriers should be monitored even if treatment is not started.
Where to go
- Public health facilities and immunisation clinics.
- Referral hospitals with gastroenterology services.
Worth knowing
Because there is no universal birth dose, knowing your status before delivery is what protects the baby. Ask for the test rather than waiting to be offered it.
Frequently asked questions
Is hepatitis B screening part of antenatal care in Kenya?
Not universally. It is offered in some facilities and to women with risk factors, but it is not a routine part of the antenatal package everywhere. If you are pregnant, ask for the test specifically — knowing the result is what makes protection of the baby possible.
HPV
HPV vaccination in routine immunisation since 2019, and screening built into primary care.
Cervical screening is offered at public facilities, principally through visual inspection with acetic acid, with HPV testing expanding. Cervical cancer remains the leading cause of cancer death among women.
Kenya introduced HPV vaccination into routine immunisation in 2019 for girls aged ten, delivered through health facilities and schools, after overcoming significant misinformation. Screening is provided through county facilities, largely using visual inspection with acetic acid, with HPV testing expanding in the larger centres.
Key points
| Vaccination | In routine immunisation since 2019 for girls aged 10 |
|---|---|
| Doses | Schedule aligned with international recommendations |
| Screening | Visual inspection with acetic acid at public facilities; HPV testing expanding |
| Age group | Women aged 25 to 49 targeted |
| Women living with HIV | Screened more frequently |
| Burden | Leading cause of cancer death among women |
| Cost | Vaccination and public screening are free |
In practice
- Have 10-year-old girls vaccinated through routine immunisation: it is free.
- Ask for screening at a public facility; it is free and gives an immediate result.
Where to go
- Public health facilities and immunisation clinics.
- National cancer control programme.
- Comprehensive care centres, which integrate screening for women living with HIV.
Worth knowing
Rumours about the vaccine have circulated widely and reduced uptake in some communities. The evidence on safety is extensive and consistent, and the alternative is a cancer that kills more Kenyan women than any other.
Frequently asked questions
What is visual inspection with acetic acid?
A simple screening method in which acetic acid is applied to the cervix and abnormal areas turn white, visible to the naked eye. It gives an immediate result and allows treatment in the same visit, which suits settings where laboratory access is limited.
General sources
- eCitizen — official government services portal