19/12/2025
For many Persons with Disabilities, access to health care is not an abstract policy discussion—it is a daily struggle marked by pain, uncertainty, and hard choices between health and survival. It is against this lived reality that the above circular, purporting to limit free health access for Persons with Disabilities (PWDs) to Levels 1–4 health facilities while excluding higher-level public hospitals, must be understood and challenged. Such a position is not only legally flawed; it is deeply disconnected from the real lives and medical needs of PWDs.
The Constitution of Kenya, 2010, recognises health as a fundamental human right. Article 43 guarantees every person the highest attainable standard of health, without qualification or hidden conditions. For a person living with a disability, this promise is especially significant. Many PWDs live with chronic conditions, secondary complications, or progressive illnesses that require specialised care, referrals, rehabilitation, or long-term treatment—services that are often only available at Level 5 and Level 6 hospitals. To suggest that free access ends at Level 4 is, in effect, to tell a person in pain that their condition is too complex, too expensive, or too inconvenient for the system to care.
Persons with Disabilities are not an afterthought in the Constitution. They are expressly recognised as a vulnerable group deserving of special protection and priority. Articles 21, 27, and 54 speak to dignity, equality, reasonable accommodation, and the duty of the State to place vulnerable persons at the centre of public policy. When a circular draws an invisible line across the health system and tells PWDs they may only be treated freely on one side of that line, it creates discrimination in practice, even if it is dressed up as policy. It ignores the reality that disability-related health needs do not neatly fit into administrative categories or facility levels.
Behind every referral to a higher-level hospital is a human story: a child who needs specialised surgery, a wheelchair user requiring orthopaedic intervention, a person with psychosocial disability in need of advanced psychiatric care, or a patient whose condition has worsened because primary care was not enough. For such individuals, higher-level public hospitals are not a luxury; they are a lifeline. Restricting free access at these levels does not save resources—it transfers suffering to families already struggling with poverty, stigma, and exclusion.
The Constitution is also clear that no person shall be denied emergency medical treatment. Emergencies do not respect policy circulars. They happen at night, on weekends, and often far from home. They are handled in referral and specialised facilities. Any directive that introduces financial barriers for PWDs at this level places lives at risk and undermines the very heart of the right to life and dignity. Progressive realisation of rights cannot be used as an excuse to step backwards or to narrow protections for those who need them most.
It is important for Persons with Disabilities to know that their rights do not come from ministerial statements or administrative memos. They come from the Constitution itself. A circular cannot reduce a constitutional right, and it cannot redefine who deserves care and who does not. Where a circular contradicts the Constitution, it is the circular—not the right—that must give way.
We therefore appeal, not only as a matter of law but of humanity, to the Government to refrain from issuing directives that confuse, mislead, or undermine constitutional guarantees. Policies on health access must reflect the real lives of Persons with Disabilities, respect their dignity, and uphold the Constitution in both letter and spirit. Equally, we urge PWDs and their families to remain informed, to speak up, and to stand firm in the knowledge that their right to health is not a favour to be granted or withdrawn, but a promise made by the Constitution to every person.
At its core, this is about fairness, dignity, and life itself. A health system that turns away Persons with Disabilities at the point of greatest need is not only unconstitutional—it is unkind. And Kenya can, and must, do better.
