Career advice · Updated November 2026

Pre-Employment Medical Examination in Kenya: Who Needs It and Who Pays

A pre-employment medical examination in Kenya is required by law for workers in jobs that expose them to specific health hazards. The Occupational Safety and Health (Medical Examination) Rules, 2005 (Legal Notice No. 24 of 2005) say employers must make sure these workers have both pre-employment and periodic medical examinations by a Designated Health Practitioner (DHP). The employer pays for the examinations, and workers must not lose earnings because of them. This guide explains who needs the exam, who does it, what happens to the results and what to do if you are found unfit.

Checked on 8 November 2026 against the text of the Medical Examination Rules, 2005, made under the Occupational Safety and Health Act, 2007. Many employers also ask for a general medical check before hiring. This guide covers the legal rules for hazardous work, not every employer’s own medical policy.

Who must have a pre-employment medical examination

Rule 4 says employers must ensure that everyone employed in the occupations listed in the Eighth Schedule to the Act has pre-employment and periodic medical examinations, as set out in the First Schedule to the Rules. The First Schedule lists hazardous work, with the tests and how often to repeat them. It includes work:

• handling animals, animal products and carcasses, and veterinary, laboratory and health work;
• with arsenic, asbestos, benzene or lead and their compounds;
• in compressed air;
• handling fossil oils;
• exposed to ionising radiation.

For most of these, the schedule requires a clinical examination before employment and then at regular intervals, often every year. Some hazards also need specific tests. Lead work, for example, includes blood and urine lead levels.

The Minister may add other work that puts workers’ health at risk by notice in the Kenya Gazette.

Who carries out the exam

The examination must be done by a Designated Health Practitioner. The Rules define this as a medical practitioner, in public service or private practice, whom the Director of Occupational Safety and Health Services has authorised in writing to examine workers. The Directorate (DOSHS) publishes a list of approved DHPs. Ask the clinic to show its designation before the exam. A normal hospital check-up by a doctor who is not designated does not meet the requirement for hazardous work.

Who pays

Rule 5 is clear:

• the employer pays the costs of the examination;
• the examination must take place without any loss of earnings for the employee, and within normal working hours where possible;
• employees and former employees must undergo examinations required by the Rules.

If an employer tells you to pay for a required pre-employment medical examination yourself, ask whether it falls under the Rules. A DHP’s fees are set by the Director.

What happens to your results

• Medical record: the DHP records the results in your individual medical record and updates it after each repeat test (rule 6).
• Summary report: the DHP sends a summary report for each hazard to the Director within 30 days, with a copy to the employer.
• Certificate of fitness: for people entering employment, and people returning from sick leave caused by an occupational disease, results go on a certificate of fitness. The DHP keeps it and gives you a copy (rule 8). If you are exposed to more than one hazard, you get a separate certificate for each one.
• Repeat tests: abnormal results must be repeated within two weeks to confirm them (rule 7).

If you are found unfit or need redeployment

If the DHP finds that you should be removed from further exposure to a hazard, rule 7 requires a certificate of redeployment. It is filled in triplicate and copies go to the employer, the employee and the Director within seven days of the examination. Redeployment means moving you away from the hazard. It is not automatically a reason to dismiss you. Abnormal results linked to work are also treated as occupational disease notifications under section 22 of the Act (rule 9).

If you are dismissed after a medical, ask for the reasons in writing. Kenya’s Employment Act protects workers from unfair termination and discrimination. If you developed a disease at work, read our guide to work injury compensation in Kenya.

Pre-employment medicals outside hazardous work

Many employers in offices, retail, hospitality and security also ask new staff for a medical report before they start. The Medical Examination Rules do not set the terms for these general checks, so the employer’s own policy applies. You can still ask what the exam will cover, who will see the results and who pays. Food handlers are a separate case: county public health rules usually require food handlers to hold a valid medical certificate, so ask your county health office which tests apply.

Whatever the job, an employer should not use medical information to discriminate against you. A pre-employment medical examination in Kenya should look at whether you can safely do the work, not at matters that have nothing to do with the job.

Checklist for job seekers

1. Ask whether the job involves any hazard in the First Schedule.
2. Confirm the clinic is a Designated Health Practitioner.
3. Do not pay for a legally required exam yourself without asking HR first.
4. Ask for your copy of the certificate of fitness.
5. Keep copies of all results for future jobs and any compensation claim.

Checklist for employers

1. List the hazards at your workplace and match them to the First Schedule.
2. Use an approved DHP and pay the cost.
3. Schedule periodic examinations at the intervals the schedule sets.
4. Act on redeployment certificates within the time allowed.
5. Keep medical information confidential and use it only for health and safety purposes.

Contravening the Rules is an offence under rule 10, with penalties under the Occupational Safety and Health Act. Workers moving abroad may also need a separate pre-travel medical. Our guide on recruitment agencies versus direct hiring explains what licensed agents should arrange, and our fake job adverts guide covers medical-fee scams.

Frequently asked questions

Is a pre-employment medical examination required in Kenya?

For hazardous occupations, yes. The Medical Examination Rules, 2005 require pre-employment and periodic exams by a Designated Health Practitioner.

Who pays for the medical examination?

The employer pays, and the exam must not cause the employee any loss of earnings (rule 5).

Who can carry out the exam?

A Designated Health Practitioner authorised in writing by the Director of Occupational Safety and Health Services.

What happens if I am found unfit?

The DHP may issue a certificate of redeployment within seven days so you are moved away from the hazard. Abnormal results are repeated within two weeks.