The Tea (Amendment) Bill (Senate Bill No. 1 of 2023)

REPUBLICOFKENYA SENATE

SENATEBILLS

(Bill No. 1 of 2023)

THETEA(AMENDMENT)BILL,2023

(ABillpublishedin theKenyaGazetteSupplementNo.1of6thJanuary,2023and passedbytheSenate,withamendments,onTuesday,8thOctober,2024

THE TEA(AMENDMENT)BILL,2023

ABill for

ANACTofParliamentto amend theTeaActtoprovidefordirect sales of tea, the payment of tea proceeds, and for connected purposes

ENACTEDbytheParliamentofKenya,asfollows

• 1.This Act may be cited as the Tea (Amendment) Act, 2023.

2. Section 2 of the Tea Act, in this Act referred to as "the principal Act",isamended—

• (a) by deleting the definition of the word "export" and substituting therefor the following new definition

"export"means to take tea or cause tea tobe taken out of Kenya into a foreign country, a Special Economic Zone or an ExportProcessing Zone;

• (b) by deleting the definition of the word "import" and substituting therefor the following new definition

"import'"' means to bring tea or cause tea to be brought into Kenya from a foreign country, a Special Economic Zone or an Export Processing Zone;

• (c) in the definition of the word "tea" by deleting the word "tea" appearing immediately after the words "whether green" and substituting therefor the word "leaf";
• (d)in the definition of the word "value addition" by inserting the words "into a packet or a container holding not more than ten kilograms" appearing immediately after the word "branding";
• (e) by inserting the following new definitions in the proper alphabetical sequence

"direct sales" means a contractual arrangement between a factory or its management agent and an overseas buyerorlocalbuyerforthesaleofmadeteabasedon mutually accepted terms and conditionsenforceableinlaw;

Short title.

Amendment of section2 ofCap343

"direct settlement system" means a banking facility providedby acommercialbankregulatedby theCentral Bank of Kenya for the clearing and settlement of tea sales proceeds;

"green leaf' means leaf detached from tea plants but not dried or processed in any way and includes purple leaf'; and

"tea factory limited company" means a tea factory collectivelyownedthroughsharesbysmallscaletea growers or medium scale tea growers.

• immediately after the words"commercial tea nurseries".

Amendmentofsection 5ofno23of2020

4. The principal Act is amended in section 7 by - 2. (a) (i) deleting subsection 1(d); 3. (ii)inserting the efollowing new subsection immediately after subsection(1h)— 4. (ha)onepersonelectedbytheIndependent Producers Association of Kenya. 5. (b)deletingsubsection(2)andsubstitutingtherefor the following new subsection—

• (2) The Cabinet Secretary shall appoint the members under subsection (1)(e), (f), (g),(h) and (ha) by notice in the Gazette.

7. (c) deleting subsection (3) and substituting therefor the following new subsection—— 8. (3)The appointmentof thechairperson ormembers of the Board under subsection (1)(a), (e), (f), (g), (h) and (ha) and shall take into account the gender, regional and other diversities of the people of Kenya. 9. 5.The principal Act is amended in section 8 by — 10. (a) deleting subsection (1) and substituting therefor the following new subsection—

• (1) The persons appointed under section 7(1)(a), (e), (f),(g), and (h), shall serve for a term of three years renewable once on account of good performance.

12. (b) deleting subsection(2) and substituting thereforthe following new subsection ——

• (2) The persons appointed under section 7(1)(a), (e), (f), (g), and (h) shall be appointed at different times so that their respective expiry ofterms of office shall fall atdifferent timesbutnot more than sixmonths shall lapse between one appointment and another.

6. Section 22 of the principal Act is amended in subsection (4) by inserting the word "factory" immediately after the words "their duties the".

Amendment ofsection7 ofCap343

Amendmentof section8 ofCap343

Amendmentofsection 22ofCap343

7. Section 23 of the principal Act is amended—

• (a) by inserting the following new subsection immediately after subsection (1) —

(1A) A large scale tea grower shall notify the Board of any intended sale or transfer of ownershipof itsholding six monthsbeforethetransactioniseffected.

• (b) in subsection (2) by inserting the words "procedure for transfer of for the".

8. Section 31 of the principal Act is amended by inserting the following new subsection immediately after subsection (1)—

• (1A)All teabroughtintoaSpecial EconomicZoneor an ExportProcessing Zone shallbedeclared to theBoard in the prescribed form.

9. Section 34 of the principal Act is amended in subsection (4) by after the words "shall not exceed" and substituting therefor the word "two per centum" 10. Section 34 of the principal Act is amended in -

• (a) subsection(2)by deleting the words "limited tea factory";
• (b) subsection (7)by inserting the words"limited company"immediately after the words"A tea factory",
• (c) subsection(8)by inserting the words "limited company" immediately after the words "tea factory";
• (d) subsection(9)byinserting the words"limited company"immediately after the words"tea factory"; and

Amendment of section 23ofCap343

Amendment of Section 31ofCap343

AmendmentofSection 34ofCap343

Amendment of Section 34ofCap343

• (e) subsection (10) by inserting the words "limited company"immediately after the words "tea factory".

11. The principal Act is amended by inserting the following new sections immediately after section 34—

Insertionof new.section 34AinCap343

Tea sales. 34A.(1)Kenyan tea shall be traded through

• (a) the auction; or

• (b) direct sales.

• (2) All tea processed and manufactured in Kenya for the export marketshallberegisteredwith theBoard prior to exportation.

AmendmentofSection 36ofCap343

12. Section 36 of the principal Act is amended -

• (a) by deletingsubsection(1)and substituting therefor the followingnew subsection—

• (1) Tea processed and manufactured inKenya for the exportmarketmaybeofferedforsaleattheteaauction floor.

• (b)by deleting subsection(2)and substituting therefor the following new subsection—

• (2)A tea factory that intends to participate in a tea auctionshall—

• (a) register with theBoard and the auction organizer; and

• (b) participate in the auction directly or through a management agent approved under section 34.

• (c)in subsection(5) byinserting the words “and paid to the tea growers” immediately after the words “tea factory accounts"

• (d) by deleting subsection (6)

• (e) by inserting the following newsubsection immediately after subsection (7)—

• (8) The Cabinet Secretary shall,in consultation with the county governments prescribe regulations

for theprocedureforauctionsalesoftea andforthe establishment of auctioncentresinthe teagrowing counties.

13. The principal Act is amended by inserting the following new sections immediately after section36—

Insertionof newsection 36AinCap343

Direct sales of tea.

• 36A. (1) A licensed factory or a management agent approved undersection34may undertakedirectsales.

• (2) The prices offered at the direct sales shall be competitive and shall besold at a price above thehighest price recorded at the auction within the three months preceding the sale.

• (3) The Cabinet Secretary shall, in consultation with county governments,prescriberegulationsfor the procedure of direct sales of tea.

Amendment of Section 37of Cap343

14. Section 37 of the principal Act is amended

• (a) in subsection (1) by deleting the word “Board"” appearing immediately after the words “register with the”and substituting therefor the words “respective county government'; and

• (b) by deleting subsection (3)and substituting therefore the following new subsection—

• (3)A countyAssemblyshallenact countylegislation to providefor theprocedurefor registrationof commercial green leaf transporters and the appeal process in case of denial of registration.

15. Section 53 of the principal Act is amended by —

Amendment of Section 53ofCap343

• (a) inserting thefollowingnew subsectionimmediately after subsection (2)——

• (2A) Specialty tea and value added tea packed into packets or containers holding not more than ten kilograms" shall be exemptedfrom tea levy.

• (b) deleting subsection(5)andsubstituting therefor the followingnewsubsection—

• (5) The tea levy collected under subsection (2) shall be apportioned as follows—

• (a) sixty per centum shall be applied by the Board in the furtherance or exercise of any function or power of theBoard;and
• (b) fortypercentumshallberemitteddirectlytothe Tea ResearchFoundationforexecutionofthefunctionof theFoundation.
• 16.Section 74 of the principal Act is amended in subsection (1) by deleting the word "if' appearing immediately after the words "carrying out"and replacing with the word"of'.
• 17.Section 76 oftheprincipalAct is amended by-
• (a) numbering the existing provision as subsection (1); and
• (b)inserting the following new subsection (2)—
• (2) All assets of the former Tea Board of Kenya and the former Tea ResearchFoundation of Kenyawhichwerevested in the Agriculture and Food Authority and Kenya Agricultural and LivestockResearch Organization upon thecommencementof the CropsAct and theKenyaAgricultural and LivestockResearchAct shall by virtue of this paragraph vest in the Board and the Foundation respectively."

AmendmentofSection 74 ofCap343

AmendmentofSection 76ofCap343

Cap318 Cap319

1heTea(Amendment) Bll.2023

Ieetify that this pinted impression isn tue copy of the Bill as passed by the Senate on Tuesdny.8hOctober,2024.

ClerkoftheSenate

Endorscd forpresentation to theNational Assenblyin accordancewiththeprovisions of standingorder161oftheSenateStandingOrders.

SpeakeroftheSenat

PRINTEDBYTHECLERKOFTIIESENATE

REPUBLICOFKENYA

PARLIAMENT

SENATEBILLS

(Bill No.17 of2023)

THE MATERNAL, NEWBORN AND CHILD HEALTH BILL, 2023

(A Bill published in the Kenya Gazette Supplement No. 63 of 5th May, 2023 and passed by the Senate, with amendments, on 8th October,2024.)

THEMATERNAL,NEWBORNANDCHILDHEALTHBILL,2023

ARRANGEMENTOFCLAUSES

PART1-PRELIMINARY

Clause

• 1 一 Short title.

• 2 Interpretation.

• 3 一 Objects.

• 4 Principles for service delivery.

PARTII-MATERNAL,NEWBORNANDCHILDHEALTH SERVICES

• Right to health services.

• 6 Services for a non-pregnant woman.

• 7 Servicesforpregnantwoman.

• 8 Services in theneonatal period and children up to twelveyears.

• 6 Services for women with special needs.

• 10 Courteoustreatment.

• 11 Accesstohealthservices.

PARTIII-ROLEOFTHENATIONALGOVERNMENT

• 12 Role of the Cabinet Secretary.

• 13 Report to Parliament.

PARTIV-ROLEOFCOUNTYGOVERNMENTS

• [ ] 14 — Functions of the county executive committee member.

1

• 15 — County government collaboration.

• 16 Awareness and public participation.

• 17 — Publication of information on maternal, newborn and child health.

• 18 Financing of maternal,newborn and child health services.

• 19 一 Annual reporting by the county executive committee member.

PARTV-MONITORINGANDEVALUATION

• 20 Identification andinterventionsforvulnerablegroups.

• 21 Monitoring and evaluation.

• 22 Quality assurance.

PARTVI-GENERALPROVISIONS

• 23 Maintenance of register.

• 24 Procedures, standards, ethics and guidelines.

• 25 Regulations.

• 26 Amendment to section 226 of Cap.63.

• 27 Amendment to section 2 of Cap.258A.

• 28 Amendment tosection17ofCap.258A.

Short title.

Interpretation.

ActNo.13of2023

Cap.141.

THEMATERNAL,NEWBORNANDCHILDHEALTHBILL,2023

ABill for

• ANActofParliament toprovideforacoordinatedsystemfor theprovisionof quality maternal, newborn and child health services; to provide for response to maternal and child morbidity and mortality in the country;to providefor ahealthcaresystem thatfacilitatestheattainmentofhcalth rights for mother and child; and for connected purposes.

ENACTED by Parliament of Kenya, as follows-

PART1-PRELIMINARY

1. This Act may be cited as the Maternal, Newborn and Child HealthAct,2023. 2. 2.In this Act --

"adolescent"' means a person aged between ten and nineteen years;

"at risk persons" means a person susceptible to mistreatment or neglectbecause of their inabilitytoobtain servicesnecessaryfor their own health, safety or welfare due to age or disability;

"Cabinet Secretary" means the Cabinet Secretary responsible for health;

"community health promoter" has the meaning assigned to it under section 2ofthePrimaryHealth CareAct;

"consent" means the voluntary agreement by a patient to undergo a specific medical procedure or treatment after being fully informed of the risks, benefits, alternatives and potential outcomes;

"county executive committee member"means the county executive committec member responsible for health in the respective county;

"child" has the meaning assigned to it under section 2 of the Children

Act;

*"health care provider” has the meaning assigned to it under section 2 Cap. 241. of theHealth Act;

"intersex child” means a child with a congenital condition in which thebiologicalsexcharacteristicscannotbeexclusivelycategorisedinthe commonbinaryoffemaleormaleduetoinherentandmixedanatomical patternswhichcould be apparentpriorto,at birthorin childhood;

"intra partum care” means the correct diagnosis of child birth, appropriate examinations, screening for and management of childbirth and thecomplicationsduringtheperiodfromthe startof thechildbirth to expulsion oftheplacenta;

“"marginalised community” has the meaning assigned to it under Article 260 of the Constitution;

"maternal” means relating to, belonging to, or characteristic of the health of a woman during her pregnancy, childbirth and the period ending forty two days after childbirth;

"National Social Assistance Authority” means the National Social AssistanceAuthorityestablished under section3of theSocialAssistance Act;

Cap.258A.

"neonate”refers to a child from birth until twenty eight days of life;

"person with specialneeds”means anindividual with additional health needs and who requires assistance above the regular health needs of the general population occasioned by physical, medical, mental, psychological or financial challenges and includes a person from a marginalised area, registered refugee and internally displaced person; and

"postpartumcare”means thecareandservicesoffered toamother immediatelyafterchildbirth and endingfortytwodaysafterdeliverywitha focus to promoting recuperation and ensuring restoration of health of the mother while preventing ill-health andincludes thescreening for and managementofcomplications.

Objects.

3. The objects of this Act are to --

4

Principlesfor service delivery.

• (a) provide a framework for the delivery of comprehensive quality health services to meet the health needs of mothers, newborns and children;
• (b) establish a coordinated and structured system for the provision of quality maternal, newborn and child health care services;
• (c) provide a framework that is responsive to causes of maternal, newborn and child morbidity and mortality;
• (d) ensurc that maternal, newborn and child health care interventions, services and supplies are available and accessibletothepublic;
• accessibility of maternal, newborn and child health services;
• f promotelinkagesamongexistingprogramstoexpandand improve the availability of,and accessto,comprehensive community maternal, newborn and child health services;
• (g) promote the provision of proper care andassistance to mothers,newborn children and children with special necds tobecomeproductiveindependent contributorstofamily and communitylife;
• (h) promote the utilisation of maternal,newborn and child healthservices;and
• (i)promotei innovative, comprehensive eandintegrated approaches to the delivery of maternal, newborn and child health services.
• 4.A person shall, in the performance of their functions under this Act,beguided by thefollowingprinciples 一
• (a)universalaccess andequityinthedeliveryof health services and the recognition of persons with special needs;
• (b)availability and access toservices and timely andreliable

• information necessary to make an informed decision regarding one's health and treatment;
• (c) coordinated publicparticipation and collaboration between the National Government, county governments andtherelevantstakeholders;
• (d)equity and inclusivity in the delivery of health services under this Act;
• (e)recognition of,and sensitivity towards,the cultures of variouscommunitiestoensurethatinterventionsare adaptable and acceptable to the recipients;
• transparencyintheimplementationofprogrammes and activities in the delivery of maternal,newborn and child health services;
• (g)targetedempowermentandcapacitybuildinginitiatives for both atriskpersons andpersons with special needs through the eimplementationofStatesponsored programmes;
• (h)access to safe and affordablefamilyplanning servicesfor womenand menincludingaccesstoadequate informationtoenablethemtomakeinformedchoiceson family planning;
• ensure that interventions arebased on objective information and methods,and monitoring mechanisms and regular evaluations are established, thus ensuring transparencyinthepublicmanagementandsocial audit and that theneeds of the populationare takeninto account; and
• 1 continuous improvement and the monitoring and evaluation of policies, strategies and plans related to the provision of maternal, neonatal and child health services under this Act.

SERVICES

Right tohealth services.

5. (1) Every person has the right to the highest attainable standard of maternal, newborn and child health services including the right to—

• (a) timely and appropriate hcalth care;

• (b)reasonable and affordablefee,if any,for health services and whichdoes notimpede access tohealthcare;

• () treatment with dignity, respect and privacy;

• (d)treatmentwithrespect andtheprovisionofinformation necessary tomakeinformed decisions;

• (e)be free from non-consensual medical treatment and experimentation;

• (f) emergency trcatment and essential medicines; and

• (g)thebest attainable state ofphysical and mcntal health.

• (2) The right to health shall include the progressive access to promotive,preventive,rehabilitative and curative care.

• (3) For the enjoyment of the right to maternal, newborn and child health, the National and county governments shall -—-

• a respect,protect and fulfil the right to maternal,newborn and child health and guarantee mechanisms for its enforcement;

• (b) putinplacemechanismsthatensure the availabilityof the infrastructureandfacilitiesnecessarytoensurethe effectivedeliveryofhealthservicesat theNational and county levels ofgovernment;

• put in place measures to facilitate access to maternal and child health services including access tohealthfacilities, mobilehealth services and e-health services;

• (d) formulate and implement thefamily supportprogramme

and other appropriate programmes targeting

• (i)marginalised communities and thosewhoareunableto access hospital facilities within the county; and

• (ii)at risk persons andpersons withspecialneeds requiring health servicesunder this Act;

• (e) put in place strategies andthe necessaryfacilitiesto ensurethecontinuedeffectivedeliveryof maternal, newborn andchildhealthservices including inremote areas and duringa pandemic or disaster;

• (f) ensureprovision of specialized services and facilitiesfor persons with special needs;

• (g) ensuretheavailabilityandadaptabilityofhealthcare interventionstoensurethat theyarechildfriendly and sensitivetotheculturalsettingsofthevarious communities;

• (h) train traditional birth attendants and integrate them in the delivery of prenatal, postpartum and neonatal health care;

• (i) realisation of the right tobe freefrom hunger and theright to adequate food; and

• putinplacethenecessarystructures toenablemembers of the public and the existing community health workforce to develop the understanding, skills and capacity necessary for achieving equitable and effective participation in the formulation, implementation and monitoring of any policies, strategies or programme interventions aimed at realizing the right to maternal, newborn and child health.

Services for a non- pregnantwoman.

• 6.(1) A woman who is not pregnant is entitled to the following services that relate to the occurrence and course of future pregnancy-

• (a) family health education;

8

Servicesforpregnant woman.

Cap. 141.

• (b) preconception care services,including hormonal profiling and the provision of prenatal vitamins, as may be prescribed from time to time;
• ? appropriatecounsellingservices as may be prescribed by the Cabinet Secretary;
• (d)health information and education;and
• (e) referral to adoption services that comply with Part XIV of the Children Act.
• (2) The Cabinet Secretary may prescribe standards for the effective delivery of services regarding the safe occurrence of future pregnancy.
• 7.(1) The Cabinet Secretary shall put in place measures to ensure access, by every pregnant woman, to health services aimed at ensuring optimal health conditions for the woman and every foetus throughout the pregnancy and after the birth of the child.
• (2) Thehealth services under subsection (1) shall include--
• (a) early detection of pregnancy;
• b) free prenatal care as may be prescribed by the Cabinet Secretary;
• ? referral to childbirth preparation classes as desired;
• (d) referral to adoption services at an adoption society registered under section 208 of the Children Act;
• e health care services in the intrapartum period;
• healthcareservicesduringthepostpartumor postnatal period;
• (g) mental health care services from prenatalto twelve months after birth;
• (h) training in the feeding and care of infants including breastfeeding support practices; and

• any other services relating to prenatal, intrapartum and postpartum period that may be prescribed.

• (3) The Cabinet Secretary may,for purposes of subsection (1), prescribe standards and guidelines for the provision of maternity health careservicestopregnantwomen.

Services in the neonatalperiod and children upto twelve years.

8. (1) Every health care provider shall provide to a child from the time ofbirthto the age of twelveyears-

• (a) comprehensivenewborncareincludingpostnatalfollow up as may be prescribed;

• (b) health services that ensure child survival,growth and development including optimal child nutrition, childhood vaccination, growth promotion and monitoring,developmental promotion andmonitoring andchildprotection services;

• (c) comprehensiveassessment, diagnosis, treatment, rehabilitationor referralandfollow-upasmaybe prescribed;

• (d) immunizations in accordance with the prescribed standards and guidelines;

• (e) assessment,counselling and anticipatoryguidance with referralsandfollow-upasncededregardingchild development, behaviour counselling and support services thatmayberequired by childrenwithchronic illnessesor disability;and

• (f anyotheressentialhealthservicethat theCabinet Secretarymayprescribe.

• (2)Where the child under subsection (1) is severely malformed at the time ofbirth,thehealthcareprovidermayreferthe childtoa relevant medical practitioner for comprehensive assessment, diagnosis and treatment.

• (3) Where the child under subsection (1) has special needs,the healthcareprovidershallensurethatthechildreceives--

• (a) health care services, as may be prescribed, that are responsive to the needs of a child with the relevant special needs; and
• (b) respectful and dignified care.

(4)Ahealthcareprovider shall notprovidehealth care servicesto the child under subsection (l) unless the health careprovider has obtained consentfrom theparent orguardian of thechild.

(5) The consent under subsection (4) shall not be required where

• (a) there is a documented report of child abuse by the parent or guardian who is required to provide consent;
• (b) the parcnt or guardian required to provide consent practises religious or cultural practices thatrisk the health of the child;or
• (c) theparent orguardianrequiredtoprovideconsent has been diagnosed with mental incapacity.
• (6) The Cabinet Secretary shall--
• (a) prescribestandardsfor the deliveryof theneonataland child careservicestothevariouscategoriesofchildren uptothe age of twelveyears;and
• (b) prescribe guidelines and standardsfor theprovision of thehighestavailablestandardsofhealthservicesthat are responsive tothe needs of children with special needs.

(7)The Cabinet Secretary shall,in prescribing the standards under subsection (6), take into account the requirement for parental supervision and consent prior to provision of neonatal and child services.

(8)For purposes of this Act, a child with special needs includes a child with disability, a child with mental illness and a child in a marginalized area.

Services for women with special needs.

9. (1) The Cabinet Secretary shall put in place mechanisms to ensurethatwomenwhoarepregnant andwhohavespecial needsreceive

• (a) appropriate pregnancy related services as may be prescribed;

• (b) maternalhealthservicesthat areresponsive to theneeds ofpregnantwomenwithspecialneeds;

• (c) diagnosisandtreatmentorreferralandfollow-upof mental health problems, both acute and chronic, includingemotional andlearningdisorders,behavioural disorders, alcohol and drug related problems, and problems with family and peer group relationships;

• (d) in the case of pregnant adolescents--

• (i)adolescent friendly health services; and

• (i) counsellingand anticipatoryguidancewithreferrals andfollow-upoftheadolescentwomanor guardian as may be appropriate;

• (e) in the case of women with disability, disability friendly health services; and

• (f) respectful and dignified care.

(2) The Cabinet Secretary shall, for purposes of subsection (1), put in place strategies and plans to --

• (a) establishareferralnetworkofcommunity-bascd workers to provide support services to women who are pregnant and have special needs;and

• (b) facilitate capacity building of health care providers who serve women who are pregnant and who are at risk; and

• (C) ensure thatpersonswithspecialneedshaveaccessto specializedfacilitiesthat accommodatetheir needs.

Courteoustreatment.

Access tohealth services.

• (3)The Cabinet Secretary shall put in place mechanisms to ensure that adolescents undergoing postpartum care receive counselling services to encourage them tomaintain and carefor their children.
• (4) The Cabinet Secretary may prescribe guidelines and standards for the provision of the highest available standards of health services that areresponsive to the needs of women with special needs.
• 10.A person seeking maternal, newborn,and child health services in anyhealthcarefacilityis entitled tobetreatedwith courtesy andrespect irrespective of their race,marital status,health status,ethnic or social origin, colour, age, disability, religion, conscience, belief, culture, dress, language or birth.

11. The National Government and county governments shall, in respect of maternal,neonatal and child physical and mental healthcare,put inplacemeasures tofacilitate theprovision of

• (a)reasonable e maternal, neonatal, and child health care services;
• (b)prenatal, intrapartum and postpartum health services;
• ? emergency or ambulanceservices;
• (d) counselling services for pregnant women who intend or are consideringnot carrying theirpregnancies to term;
• e) post abortion health care services;
• () counselling services for adolescents undergoing postpartum caretoencouragethemtomaintainandcarefortheir children;
• g) human resource for maternal,newborn,and child health services;
• (h) essential supplies,commodities and equipmentformaternal, newborn, and child health services;
• (i)facilities thatpromote the safety of newborn children in

health institutions;

• G lifesaving commodities for maternal,neonatal and child health services; and
• (k)t the infrastructure necessary to support the delivery of basic and comprehensive emergency obstetric and neonatal care services.

PARTIII-ROLEOFTHENATIONALGOVERNMENT

Role ofthe Cabinet. Secretary.

• 12.The Cabinet Secrctary shall,for the effective performance of thefunctionsof theNational Governmentunder section11—

• (a) develop a comprehensive national policy,strategies and plan of action on maternal,newborn and child health caretopromotetherealisation of theright tohealth;

• (b) developstandardsandguidelinesfortheeffective delivery of specialised maternal,newborn and child health services to persons with special needs;

• (c) developstandardsandguidelinesfortheeffective delivery of maternal,newborn and child health care services in the country;

• (d) facilitatethecoordinationofvariouspublicinstitutions and stakeholders dealing with maternal,newborn and childhealthissues inthe countryinensuring that adequatemeasures areputinplace toensureaccess to and theeffectivedelivery of maternal,newborn and child health care services;

• (e) put in place the necessary infrastructure and collaborate with countygovernmentsinestablishing and implementing an effective system of referral from one level ofgovernmenttoanother;

• ( ensurethatallnationalreferralhealthfacilitiesthat offer maternalhealthcare designate resourceswithin therespectivefacilityforprovisionof physicaland mentalhealthcaretowomenwhohavelostchildren

through stillbirth or during delivery;

• (g) facilitatetheprovisionofmentalhealthcaretomaternal women in national referral health facilities;
• (h) monitor and evaluate access to, and theimplementation of, policies, plans and strategies on the effective delivery of maternal,newborn and child health care services at the National and countylevels of government;
• (i) foster a multi-sectoral approach between the health and non-health sectors in ensuring access tomaternal, newborn and child health care services and addressing factors thathinder the access tohealth services;
• () collaborate with county governments in establishing a database and e-health platform to facilitate the delivcry of, and access to, health services by all persons requiring maternal, newborn and child health care services;
• (k) mobilizc resources for the effective andefficient delivery of maternal, newborn and child health services;
• (I1) ensure continuous public sensitisation and capacity buildingfor efficient and effective delivery of maternal, newborn and child healthservices at theNational and county levels;
• (m) in collaboration with county governments, facilitate the implementationofpoliciesandstrategiesaimedat reducing maternal,newborn and child morbidity and mortality in the country including-
• (i)publiceducation campaigns sonhealthy pregnancies;
• (ii)education programs for health care providers;
• (i) promotion of community support services for pregnant women;and

• (iv)promotion of physical,mental and behavioral health during and after pregnancy, including treatmentformentalhealthdisordersand substance use disorder;

• (n) undertake and facilitate research and health surveillance, and implement programmes for the continuousadvancementandeffectivedeliveryof maternal, newborn and child health services;

• o) periodicallyreviewstandards,practicesandguidelines in the delivery of maternal,newborn and child care services;and

• (p) perform any other functions that are necessary for the achievement of the objectives of thisAct.

Report toParliament.

• 13.(1) Within three months after the end of each financial year, the CabinetSecretary shall prepare and submit to theNationalAssembly and the Senate an annual report on the status of maternal, newborn and child health services inKenya.

• (2) A report under subsection (1) shall include

• (a)a description of the activities andinterventionsundertaken by the Ministry inrespect of maternal,newborn and child health services;

• (b)recommendationsonlegalandadministrativemeasures required to address specific concernsidentified by the Ministry;

• (c) maternal and neonatal deaths recorded in each county with an analysis ofroot causes andrecommended interventions to addressthecauses;and

• (d) suchother informationrelating toitsfunctions thatthe Ministry considers relevant.

• (3)Where anyrecommendation contained in anypreviousreport hasnotbeen implemented,the CabinetSecretary shall report toParliament onthereasonfornon-implementation and actiontobetakentoimplement therecommendation.

Functions of the countyexecutive committeemember.

Cap.258A.

• (4)The CabinetSecretary shallpublish thereport in the Gazette and in at least one newspaper with national circulation.
• (5) The National Assembly or the Senate may at any time require the Cabinet Secretary to submit a report on a maternal, newborn and child health issue.

PARTIV-ROLEOFCOUNTYGOVERNMENTS

• 14.Each county exccutive committeemember shall
• (a)coordinatetheimplementationofpolicyonmaternal, newborn and child health care services in the county;
• (b)facilitate community engagement and accountability in the promotion and utilisation of maternal,newborn and child health services;
• (c)implementthepoliciesandstandardsonmaternal,newborn and child health in the county;
• (d)establish, in collaboration with the Cabinet Secretary, an chealth platform in the respective county for the effective delivery of maternal,newborn and child health carc services in the county;
• (e)liaise with the National Social Assistance Authority established under theSocial AssistanceAct andsuchother entities as may be necessary for the identification of, and implementation of maternal,newbornand child health programs amongst, marginalised and vulnerable groups in the county;
• (f) formulate programmes and implement strategies aimed at reducinginfant mortalityrates and maternal mortalityratio in the county;
• (g)implement programmes for the acceleration of infant immunization;
• (h) develop and implement training programmes for skilled

and traditional birth attendants in the county;

• (i) develop and implement training programmes for the care of womenwithspccialneedsforskilled andtraditionalbirth attendants;
• G) put in placemeasures tofacilitate training of health care providers in the provision of physical and mental health care services;
• (k)ensure equitable access to maternal,newborn and child health services in the county and improve responsiveness to the needs of the mother and the child;
• (l)ensurethatallcountyhealthfacilitiesthatoffermaternal health care designate resources within the respective facilities for the provision of physical and mental health caretowomenwhohavelost children through stillbirth or during delivery;
• (m) put in place measure to facilitate the provision of mental health care tomaternal women in countyhealthfacilities;
• (n)ensurethattherearesufficientambulancestoprovide emergency prenatal,postpartum and neonatal evacuation services within the county;
• (o)ensure that respectivehealthfacilities are accessible and can provide specialised care to persons with special needs;
• (p)facilitate community engagement in the promotion and delivery of maternal,newborn and child healthservices in the county;
• (q)avail andputinplacemeasures toimprove thequalityof integrated maternal, newborn and child health services;
• (r) promote best nutritional practices for mothers,newborns and children within the county and for this purpose, conduct sensitization programs on food and nutrition among pregnant and lactating mothers;
• (s)facilitate the training of skilled health care providers in the

County government collaboration.

Awareness and public participation.

countyintheprovisionphysicalandmentalhealth care services;and

• (t) perform such other functions that are necessary for the achievement of theobjectives of thisAct.

15. The county executive committee member shall, for the effectivedeliveryofmaternal,newbornandchildhealthservicesinthe respectivecounty,collaboratewiththe CabinetSecretary and therelevant stakeholdersincluding--

• (a) health care providers;
• (b)academic institutions;
• communityhealthpromoters;
• d communitybased organisations;and
• e religious organisations.

16.(1) The county cxccutive committeemember shallpromote publicawarenessandcommunityparticipationintheformulationand implementationofpolicies,strategies,plansand communityprograms on the provision of maternal,newborn and child healthservices.

(2) The county executive committee member shall, for purposes of subsection (1), ——-

• (a) developthehuman resourcesinthefieldofmaternal, newborn and childhealthservices througheducation and training activities;
• (b) facilitatetheparticipationofcountyandcommunity health force in the provision of human resources developmcntactivitiesandimproving the capabilityof thelocalcommunityhealthworkers in theprovision of maternal, newborn and child health care services;
• C developandimplementpublicawarenessandcommunity participation campaigns targeting persons with special needs and informing them of their rights under the Act;
• (P) promote awareness ofthe rightsunder thisActand the bodies responsible for effecting and protecting the rights;

Publicationof information on maternal,newbom and child health.

• (e) stimulateanddirect theparticipationof professional associations and organizations inthefield of maternal, newborn and child healthcare services;
• promote the cooperation of health workers,community socialworkers and communityhealth workersin the provision of maternal,newborn and child health care services;
• g monitor and evaluatetheimplementation and effectiveness of policies, strategies, programs and plans under this Act; and
• h ensure diversificationinthe conduct of maternal, newborn and child health care services and sensitization programmes to ensure the widest reach to women in the wholecounty.

17. (1) The county executive committee member shall design civic education programmes and, using the most appropriate means, publish information regarding maternal, newborn and child health.

• (2)The civic education programmes and information under subsection (1) shall include —-
• (a)health complications occurring in new-borns and mothers and during pregnancy, labour, childbirth and the postnatal period;
• (b) causes of maternal,newborn and child morbidity and mortality and the danger signs;
• (c) emergency preparedness and complication readiness;
• (d) the unique health issues affecting infants born prematurely;
• (e)needs and proper carefor premature babiesincluding methods,vaccines and other preventative measures for protectingpremature newbornsfrom infectious diseases;
• (f)information on successful breastfeeding,weaning of infants

Financing of maternal, newborn and child health services.

Annual reporting by thecounty executive committee member.

andnutritionalneedsofmothers,infantsandchildren;and

• (g) themanagement ofemotional,financialandother challenges experienced byparents andfamilymembersof premature infants and those with palliative care needs and information aboutcommunityresources availablefortheir support.
• (3) The information under subsection (1) shall-
• (a) be easily accessible and published in an accessible format;
• (b) written in clear language to educate the public of maternal,newborn and child health issues across all residents of the county regardless of their socioeconomicstatus;
• containdisaggregateddatadistinguishingbetwcen minorsfromadults;and
• (P where necessary,betranslated to therespectivelocal languages anddisseminated tomediaoutlets and in outreachprogrammesthat cater toilliteratepeople within the county.
• (4)In determining theinformation that is most beneficial to the public,the county executive committee member may consult with maternal, newborn and child health service health care providers, community organizations and other relevant experts.
• information is accessible to children's health providers,maternal care providers,hospitals,public health departments and medical organizations within the county.

18. Every county government shall, in its annual budget, allocate sufficient funds for the provision of maternal, newborn and child health services in the county. 19. (1) Within three months of the close of every financial year, the county exccutive committec member shall submit to the county

assembly,a report on the status of maternal,newborn and child health services in county.

(2) The report shall contain -

• (a)a report on funding of maternal, newborn and child health services in the county;
• (b)the availability and state of health facilities,medications and supplements relating to maternal, newborn and child health services in the county;
• the number of health care providers in respective health facilities within the county and measures taken to enhance their number;
• (d) maternaland neonataldeaths recorded ineachcounty facilitywithananalysisofrootcausesandrecommended interventions to addressthe causes;
• e recommendations onspecificactions tobetakenin enhancing access to quality maternal, newborn and child health services in thecounty;and
• f any other information relating to maternal, newborn and child health services.

(3)Where anyrecommendationscontainedinanypreviousreport submitted under subsection(1)have not beenimplemented,the county executivecommitteemembershallreporttothecountyassemblythe reasons for non-implementation and action tobe taken toimplement those recommendations.

(4) The county executive committee shall publish thereport in the countyGazetteandinsuchother medianecessaryforthewidest dissemination of the report within the county.

(5)The county assemblymayat anytime require the county executivecommitteemembertosubmit areport onaparticularissue.

(6)Thecountyexecutivemember shallsubmitthereportunder subsection (1) to the Cabinet Secretary within three months of the close of every financial year.

Identificationand interventionsfor vulnerablegroups.

PARTV-MONITORINGANDEVALUATION

• 20.(1) Each county executive committee member shall identify vulnerable and marginalised communities in the respective county to —-
• (a) identify the unique needs of the identified persons;
• (b) determine the gaps that exist in the provision of hcalth services to themarginalised andvulnerable persons in the county;
• (c) formulate the most appropriate interventions necessary to address the needs identified under paragraph (a);
• (d) establishamechanismtoensurecontinuousservice deliveryofmaternal,newbornandchildhealthservices during a pandemicto theidentifiedpersons;and
• (e) generate the information necessary to develop and strengthen the capacity of health workers in the county to respond and address the health needs of vulnerable and marginalised.persons under this Act.
• (2) In performing the functions under subsection (1), the county executivecommitteemembershall-
• (a) collaborate with the Cabinet Secretary and the Cabinet Secretary responsibleforsocial development;
• (b)systematicallyundertakedisaggregatedanalysisonthe existinggaps inthedelivery of maternal,newborn andchild health services,the levels of need and vulnerability of different groups in the county,with particular attention to assessing anyform of discrimination thatmaymanifest itself inlack of accessto ormarginalization in the delivery of health services among specific population groups;
• (c)develop and identify correctivemeasures for thepurpose of addressing and prcventing causes of poor health amongst pregnant women,newborns,lactating women and children

Monitoring and evaluation.

under this Act;

• (d)establish systems toensurethefeedbackofinformation in such formats as it may consider appropriate on the delivery of health services under this Act topriority groups at the national, county and community level through the appropriate media;
• (e) establish risk management and vulnerability mapping systems;
• (f) establish and coordinate sector specific roles and mandates related to vulnerability and emergency response; and
• (g) undertake a baseline and impact assessment at all levels of governance to guide vulnerability and emergency response.
• 21.(1) The Cabinet Secretary shall undertake annual monitoring and evaluation--
• (a)of the services rendered in the maternal,newborn and child health services in the country; and
• (b)the implementation of and adherence to the standards and guidelines issued under this Act.
• (2)In addition to the monitoring and evaluation under subsection (1), the Cabinet Secretary shall,in collaboration with the Kenya National Bureau of Statistics,undertake
• (a) a quarterly inquiry into maternal,neonatal and child deaths;
• (b)quarterlynationalmaternalmortalitydatacollectionand surveillance to identify and address pregnancy-associated deaths and pregnancy-related deaths that occur during, or within one year following, pregnancy;
• (c)in each quarter, the collection and analysis of data on neonatal and child mortality,identify and put in place measurestoaddressthecausesforneonatalandchild deaths;

Qualityassurance.

Maintenance of register.

Procedures,standards, ethics andguidelines.

• (d)studies toidentifythedeterminantsofdisparitiesin maternal care,neonatal and child health care,health risks and health outcomes; and
• (e)the identification of groups of women with disproportionatelyhighratesofmaternalmorbidityand mortalityduetolackof accesstomaternalhcalthcare servicesanddevelopstrategiesforthereductionof
• (3)The Cabinet Secretaryshallensure that thedata collected under subsection (2) is disaggregated to clearly distinguish between minors and adults.
• (4)The Cabinet Secretary shall prescribe the procedure and requirementsforundertaking themonitoring and evaluation process.

22. (1) The Cabinet Secretary shall ensure the implementation andadherencetostandards andguidelinesonqualityinmaternal, newborn and child health services in hospitals,institutions or at any facility offeringmaternal,newborn and child health services both at the national and county level in accordance with the national standards and guidelines.

• (2)The CabinetSecretary shall undertake continuousreview of the standards and guidelines under subsection (1).

PARTVI-GENERALPROVISIONS

• 23.(1) Every hospital or approved health facility shall maintain a register,in a prescribed form, for recording the details of the maternal, newborn and childcare cases reported anddealt with in the hospital or facility.
• (2) The Cabinet Secretary shall make regulations on the form of the register to be kept and maintained under subsection (1).

24. (1) Any person, hospital, institution or health facility offering maternal, newborn and child health care services shall adhere to procedures, standards, code of ethics and guidelines as may be prescribed under this Act or any other written law.

• (2) A person offering maternal, newborn and child health care

Regulations.

services whoknowingly contravenes subsection(1) commits an offence and is liable,on conviction,to a fine not exceeding five hundred thousand shillings or to a term of imprisonment not exceeding two years or to both.

• (3)The county executive committeemember, theKenya Medical Practitioners and Dentists Council,the Clinical Officers Council,the Nursing Council of Kenya and theKenya Health Professions Oversight Authority shall, where they suspect a person to have committed an offence under subsection (2),refer the matter to the Directorate of CriminalInvestigations forinvestigation.
• (4)A hospital,institution or health facility offering maternal, newbornand childhealthcareserviceswhichknowinglycontravenes subsection (1) commits an offence and the members of its governing body are jointly and severally liable,on conviction,to a fine not exceeding onemillionshillingsor toa term of imprisonmentnot exceedingtwoyearsortoboth.
• 25.(1) The Cabinet Secretary,in consultation with the Council of County Governors and other relevant stakeholders,maymakeregulations for thebettercarrying out of thisAct.
• (2) Without prejudice to the generality of subsection (1), the cabinet secretary may,byregulations,prescribe minimum standards for ——
• (a)the establishment of maternal, newborn and child health care premises and facilities;
• (b) notification, response and reporting of maternal and neonatal deaths;
• the delivery of programmes of maternal, newborn and child health services;
• p) staffing in maternal,newborn and child health carefacilities;
• maternal, newborn and child health care, health and safety;
• prenatal health services;
• g prenatal, postpartum and neonatal counselling health services;

• (h) prenatal, postpartum and neonatal check-ups and follow-ups;

• referral of persons in prenatal,postpartum and neonatal care to referral health facilities; and

• the records to be kept by hospitals and other facilities offering 1 maternal,newborn and child health services.

• (3)For thepurposesof Article94(6)of theConstitution

• (a)the authorityof theCabinetSecretary tomakeregulations is limited to bringing into effect the provisions of this Act and thefulfilmentof theobjects specifiedunder section3 of this Act; and

Cap. 2. Cap. 2A.

• andGeneralProvisionsActandtheStatutoryInstruments Act,in relation to subsidiary legislation shall apply to regulationsmadeunder thisAct.

Amendmenttosection 226 of Cap. 63.

• 26.Section226of thePenal Codeis amended by renumbering the existing provision as subsection(l)and inserting the following new subsection after therenumbered subsection(1)

• s () () postpartum care under the Maternal, Newborn and Child Health Act.

Amendment tosection 2 ofCap.258A.

• 27.Section 2of theSocial Assistance Act is amended in thc paragraph immediately after paragraph (d)

(da) care and welfare of children;

Amendmenttosection 17 ofCap.258A.

• 28.Section17of theSocialAssistanceActisamendedin subsection(3)by inserting the following new paragraph immediately after paragraph (b)—-

(ba) poor women caring for their children;

eMaematNwbonndChild ealhBn2o

Icerf ha this punted ipression is a te copy of the Bill as pased by the Senate on 1410e1.2024

ClerkoftheSenate

Endorscd for prescntation to the National Asscmbly in accordancc with thc provisions of standingorder16lofthcScnateStandingOrdcrs.

PRINTED BYTHE CLERK OFTHE SENATE

SpeakeroftkeSenute