KELIN condemns the unlawful detention of new mothers in public hospitals across Kenya, calling it a grave human rights violation that demands immediate government intervention. At Moi Teaching and Referral Hospital in Eldoret (MTRH), women have been held for more than three months after childbirth due to unpaid hospital fees, an alarming trend now being reported in other public facilities including Thika Level 5 Hospital .
One of the patients at MTRH, Melvin Nyogoha aged 22 years, brought light to this through her TikTok account after being held for over three months with her bills accruing to Kshs 84,000. She states that there are dozens of mothers being held there. They sleep in shifts with three people sharing one bed with others sleeping on the floor. Additionally, they do not have basic necessities such as diapers and soap.
This practice constitutes obstetric violence, a form of gender-based violence experienced by women during pregnancy, childbirth and post-partum. It is a grave violation of women’s rights and an affront to their dignity. Detention of women in health facilities for non-payment of fees reflects long-standing systemic violations of women’s right to the highest attainable standard of health, right to human dignity, freedom from discrimination, freedom from cruel, inhuman and degrading treatment, and freedom of movement. These rights are guaranteed under Articles 43(1)(a), 28, 29, 27, and 39 of the Constitution of Kenya 2010. They are also protected and included in international and regional human rights instruments to which Kenya is a party, including the Maputo Protocol and the Convention on the Elimination of All forms of Discrimination Against Women.
It is unfortunate that such violations persist despite clear judicial pronouncements outlawing the detention of patients for inability to pay medical fees. In the case of M A & ANOTHER V ATTORNEY GENERAL & 4 OTHERS [2015] EKLR, the High Court condemned the detention of women at Pumwani Maternity Hospital, finding that it amounted to unlawful confinement and degrading treatment. The Court directed the Government to take necessary steps to protect all patients from detention in health care facilities by laws and policies and taking affirmative action to prevent future violations. It further directed the City Council of Nairobi, the Minister for Medical Services and Pumwani Maternity Hospital to develop clear guidelines and procedures for implementing the waiver system in all public hospitals and to take the necessary administrative, legislative and policy measures to eradicate the practice of detaining patients who cannot pay their medical bills.
In 2016, the Ministry of Health instituted the provision of free maternity services by the National Health Insurance Fund (NHIF) through the ‘Linda Mama Programme’. It further expanded the benefit package to include a range of procedures covering nine months of pregnancy and three months postdelivery. However, with the transition to the Social Health Authority and the discontinuation of the Linda Mama scheme, there has been a regression in maternal healthcare access, resulting in renewed instances of detention and mistreatment of women after delivery.
This shift represents a regressive measure that undermines Kenya’s constitutional and international obligations. Under Article 21(2) of the Constitution of Kenya, the State bears a duty to “take legislative, policy, and other measures to achieve the progressive realization of the rights guaranteed under Article 43.” The elimination of Linda Mama without a sustainable alternative violates this duty and perpetuates structural injustices against vulnerable women.
KELIN takes note of the Health (Amendment) Bill, 2025 which proposes to create an offence for detaining patients in hospitals as lien over an outstanding fee and to develop regulations on recovery of outstanding hospital charges. While this is a commendable and progressive step, we urge that any resulting regulations be developed through meaningful public participation and reflect realities of women, particularly those from low-income backgrounds, when accessing maternal health services. The regulatory framework must be sensitive to socio-economic barriers and designed to enhance access to care, not restrict it. KELIN will continue to monitor the implementation of this amendment to ensure it aligns with constitutional and human rights standards.
“Detaining mothers simply because they are poor is both unlawful and inhumane,” said Allan Maleche, Executive Director of KELIN. “This practice not only violates the Constitution and international human rights obligations, it strips women of their dignity at one of the most vulnerable moments in their lives. The government must act decisively to end this cruelty.”
CALL TO ACTION
In light of these grave violations, KELIN calls upon the Government of Kenya, the Ministry of Health, and all relevant authorities to take immediate and concrete measures to end the unlawful detention of women in health facilities and ensure dignified maternal care. Specifically, KELIN urges:
- Immediate cessation of detention of mothers for inability to pay hospital fees and the release of all women currently held in public hospitals.
- Adequate budgetary allocation to the health sector to ensure facilities can deliver quality maternal services without resorting to unlawful detention.
- Reinstatement or replacement of the Linda Mama programme or introduction of an equivalent comprehensive maternal health benefits package under the SHA to prevent further regression in access to maternal health.
- Training and sensitization of healthcare providers on patients’ rights, ethical obligations, and respectful maternity care.
- Monitoring and auditing of hospitals to ensure compliance with constitutional and legal standards regarding the right to health, dignity, and liberty.
- Legislative and policy reforms to explicitly prohibit the detention of patients in healthcare facilities and to classify such practices as unlawful and punishable under the law.
CONCLUSION
The detention of women for inability to pay maternity fees is a gross violation of human rights and a reflection of persistent systemic inequality within Kenya’s health system. It constitutes discrimination on the basis of socio-economic status, undermines the principle of equity and non-discrimination, and erodes public confidence in the country’s commitment to universal health coverage.
KELIN reiterates that no mother should ever be detained, abused, or degraded in the very institutions meant to safeguard her life and that of her child. We will continue to monitor violations, pursue legal remedies where necessary, and work with partners to ensure accountability. We call on the government and all stakeholders to act urgently and decisively to end obstetric violence once and for all.
