An Act of Parliament to provide a framework for the delivery, access and management of primary health care.
| PROPOSED PROVISION FOR AMENDMENT | PROPOSED AMENDMENT | OUR COMMENTS |
| Clause 2 Interpretation | “care coordination” means a proactive approach that brings professionals and providers together to address the needs of service users to ensure they receive integrated and person-centered care across various settings. | Care coordination helps in optimizing the use of health care resources. By avoiding duplication of services and streamlining processes, it reduces costs for both health care providers and patients. |
“community health committee” means the functional structure overseeing the operations of a community health unit. | A community health committee comprises of members from the local community. These individuals understand the unique health needs, cultural norms and socio-economic challenges of the community. Their involvement ensures that health care services are tailored to the specific requirements of the community, leading to better outcomes. This representation is clearly stated in clause 20 (1) (b) of the Bill. |
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“community health officer” means a trained health professional who is assigned to supervise the community health promoters under their community health unit. | Supervision ensures that community health promoters adhere to established guidelines and protocols. It guarantees that the health care services provided are of high quality and align with recognized health care standards. This enhances the overall quality of health care in the community. Secondly, supervision helps maintain consistency in the delivery of health care services. Regular oversight ensures that all community health promoters follow standardized procedures, leading to uniformity in health care practices across the community. |
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“community health promoter'' means a member of the community, who is selected by residents and appointed by the County and is trained to provide community health services to defined households. | This ensures that all households have access to health care services. This will be in line with Article 43 (1) (a) of the Constitution. |
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“community health unit” means a group of households not exceeding one thousand within a defined geographical area and formally recognized as level one in the health system for community health service delivery. | The community health unit operates within a clearly defined geographical area. This boundary provides a specific jurisdiction for the community health unit, allowing for targeted health care planning and resource allocation. Geographical delineation ensures that the community health unit serves a localized community, fostering a sense of belonging and community identity among residents. Further, this proposal is in line with section 25 and the First Schedule of the Health Act No. 21 of 2017 (“the Health Act”) which recognizes community health units as level one health care institutions. |
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“household” means a social unit which shares the same socio-economic needs associated with consumption and production. | Parliament can design more effective social and economic policies by considering households as units with interconnected needs. Policies related to taxation, social assistance, healthcare access and employment opportunities can be tailored to support the socio-economic well-being of households as integral units of society. To ensure consistency, the same definition has been included in the Social Health Insurance Bill 2023. |
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“primary health care” means essential health care based on practical, scientifically sound and socially acceptable methods and technology that is made universally accessible to individuals and families in the community at every stage of their development, through their full participation and at an affordable cost to the community and country, in the spirit of self-reliance and self-determination. | Primary health care offers continuous and comprehensive healthcare which ensures that patients receive consistent and coordinated health care services over time. This continuity is essential for treating critical and chronic illnesses. Secondly, primary health care services are usually accessible, convenient and affordable. This accessibility encourages people to seek medical treatment before their health issues worsen. |
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“primary health care workforce” includes health care providers and community health promoters. | The primary health workforce is often the first point of contact for individuals seeking health care services. They are trained to recognize symptoms, conduct preliminary assessments and diagnose common illnesses. Early diagnosis and treatment can prevent the progression of diseases and improve the patients’ health outcomes. |
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“multi-disciplinary team” means a team of health care professionals with diverse expertise and skills who jointly assess, plan and manage health care that matches patients’ needs and those of the catchment population to improve health outcomes. | We propose that this term appears after the definition of “household” in clause 2 of the Bill. An alphabetical arrangement of defined terms provides a clear structure as it allows readers to locate definitions without having to search through the entire document. Secondly, an alphabetical arrangement makes it easy for readers to find specific terms quickly. |
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“Universal Health Coverage” means that all individuals and communities receive the health services they need including the full spectrum of essential, quality health services from health promotion to prevention, treatment, rehabilitation and palliative care without suffering financial hardship. | Universal Health Coverage ensures that essential health care services are accessible to all, irrespective of their socio-economic status, gender, ethnicity or geographical location. It promotes equity by providing equal access to health care services which reduces disparities in health outcomes. Secondly, when people have access to necessary health care services, diseases can be detected and treated early, leading to improved health outcomes. Timely and appropriate medical interventions can prevent the progression of diseases and reduce complications, saving lives and improving the quality of life for individuals. |
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“vulnerable groups” means vulnerable groups as defined under Article 21 of the Constitution. | We propose the deletion of this term as it has not been used in the Bill. |
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Clause 3 Objects | The objects of this Act is to: a. promote and fulfill the rights of all persons in Kenya towards the progressive realization of their right to the highest attainable standards of health care; b. promote the implementation of primary health care through a systemic approach and clear delineation of roles of all stakeholders towards realization of Universal Health Coverage; c. provide for the establishment of primary health care networks, community health units and other stakeholder centered engagement forums for sustainable provision of primary health care services; d. provide for the role of the multi-disciplinary team in the provision of primary health care services; and e. provide for the role of community health officers, community health assistants and community health promoters in the provision of community based primary health care services. | For paragraph (d), the role of the multi-disciplinary team has not been included in the Bill. We propose the addition of a clause to remove the ambiguity present. For paragraph (e), we propose the deletion of the term “community health assistants” as it has not been defined in clause 2 of the Bill. For paragraph (e), the functions of the community health officers have not been included in the Bill. We propose the addition of a clause listing their functions. Incorporating this proposal enhances clarity. |
PART II – PRIMARY HEALTH CARE SERVICES |
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Clause 4 Primary health care services | Primary health care services shall be accessed at the community or at a health facility in accordance with this Act and any other written law. The services referred to in subsection (1) shall include health promotion, prevention, curative, rehabilitation and palliative services. | Primary health care offers continuous and comprehensive health care which ensures that patients receive consistent and coordinated health care services over time. This continuity is essential for treating critical and chronic illnesses. |
Clause 5 Community health care services | Community health care services commence at the household. The community health care services referred to in subsection (1) include: a. health education and promotion; b. disease prevention and control to reduce morbidity, disability and mortality; c. family health services in the community; d. environmental health and hygiene in the community; e. provision of first aid and treatment of minor illnesses and injuries; f. community-based surveillance; g. psychosocial support, rehabilitation and palliative care in the community; h. referrals; and i. management of health data in the community. | Community health care services focus on preventive measures such as vaccinations, health screenings and health education. By identifying health risks early and promoting healthy behaviours, these services prevent the onset of diseases and reduce health care costs in the long run. |
Clause 6 Facility health care services | Facility health care services commence at the health facilities. The facility health care services referred to in subsection (1) include: a. promotive; b. preventive; c. curative; d. rehabilitative; and e. palliative. | Facility health care services are essential for maintaining community health, preventing diseases and providing timely medical interventions to patients throughout the various stages of their lives and health conditions. |
Clause 7 Delivery of primary health services | Each county government shall facilitate the service delivery of primary health care by: a. adopting supportive and innovative modern approaches for disease identification, monitoring, surveillance, early warning, research, community education and information sharing; b. providing community and stakeholder support to the respective primary health care facilities to facilitate optimal service provision; c. enhancing the availability of quality services, accessibility and predictability of standardized primary health care services through effective leadership and governance, resourcing, private public partnerships, sharing of essential health products and technologies and integrated health information systems; d. ensuring that there is continuous community engagement, training and registration of households within community health units in each primary health care network; and e. guaranteeing that primary health care services are optimally financed and resourced to offer quality care to all patients and residents in the republic of Kenya. | For the heading of this clause, we propose the addition of the word “care” immediately after the word “health”. The rationale for this is that the term “primary health care” has been defined in clause 2 of the Bill. Secondly, clearly stating the county government’s role in primary health care helps in the efficient allocation of resources. For example, resources for personnel and infrastructure can be efficiently allocated. This ensures that resources are optimally utilized. Thirdly, specifying the county government’s role in primary health care fosters accountability. This ensures that the county government can be questioned when they fail to facilitate the service delivery of primary health care in the county. |
PART III – PRIMARY HEALTH CARE WORKFORCE |
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Clause 8 Primary health care workforce | Primary health care workforce includes: a. community health promoters appointed in accordance with this Act; and b. health care providers. Each county government shall take all necessary measures to build the capacity of community health promoters for the proper and efficient implementation of this Act. | We propose the deletion of sub-clause (1). The term “primary health care workforce” has already been defined in clause 2 of the Bill. |
Clause 9 Recruitment of community health promoters | A community health promoter shall be selected by the community through a public participation forum and appointed by the county government. A person qualifies for selection and appointment as a community health promoter under subsection (1) if the person: a. is a citizen of Kenya; b. is above the age of 18 and is of sound mind; c. is a responsible and respected member of the community; d. understands the role of a community health promoter; e. is a resident of the respective community for a continuous period of not less than five years prior to the appointment date; f. is literate and can read and write in at least one of the national languages or the local language; and g. is not disqualified for appointment to office by the above criteria of by any other law. A community health promoter shall be appointed on such terms and conditions as the respective county public service board shall determine. Each county executive committee member shall prescribe, in the county legislation, guidelines for the conduct of the public participation forum under subsection (1). | For sub-clause (2), specifying qualifications in the Bill provides clear and standardized criteria for eligibility in a particular position. This clarity helps both applicants and decision makers understand the minimum requirements for the role. |
Clause 10 Functions of community health promoters | A community health officer shall assign to each community health promoter households in such localities in such a manner as shall be prescribed by the county for the purpose of facilitating access to and ensuring the effective delivery of community health services at the community. In the performance of the functions under subsection (1), a community health promoter shall: a. sensitize the community on the importance of healthy lifestyles and of quality health services; b. provide community disease surveillance by reporting early signs of imminent health disasters or emergencies; c. enroll and monitor the health status of members of the households assigned to the community health promoter; d. keep and maintain a record of members in all households assigned to the community health promoter; e. monitor the rehabilitation and integration of persons who require such services in the community; f. provide appropriate health advice to an assigned household in a language that the members of the household understand, including advice on: i. appropriate sanitation and hygiene techniques including household water treatment; ii. good nutrition; iii. maternal and postnatal care including advice on breastfeeding, immunization, child health care and family planning; iv. the prevention, transmission and management of communicable diseases; and v. the prevention and management of non-communicable diseases; g. render first aid services to an assigned household and where necessary, make referrals to the link facility; h. monitor the growth of children under the age of five years in an assigned household; i. provide support to the assigned household on quality family-based care and support for a patient; j. submit reports, at such intervals as shall be determined by the county director of health, on the health of each member of an assigned household and the barriers to health and health care in the household to the community health officer; k. collect information on the health status of the assigned households; l. report incidence of side effects of drugs; and m. perform such function as may be assigned by the county executive committee member in county legislation or under any other law. A community health promoter shall, in the conduct of the functions specified under subsection (1) and (2): a. be ethical; b. inform the household of the use to which the information shall be put; c. ensure confidentiality; d. ensure accuracy of the information captured; e. transmit the information within the timelines specified by the county director of health; and f. ensure access to personal data by persons to which that data relates in accordance with the Data Protection Act No. 24 of 2019. | Clearly defined functions provide a basis for evaluating the performance of community health promoters. It establishes benchmarks against which their work can be assessed, ensuring accountability and quality in the provision of health care services. Secondly, knowing their specific functions enables community health promoters to efficiently plan and deliver health care services. They can focus on their core responsibilities, leading to more effective and targeted health care initiatives. By knowing the specific functions of community health promoters, the county government can allocate resources more effectively. This targeted approach ensures that resources such as training and supplies are channelled to support the community health promoters in performing their roles. For sub-clause (2) (g), we propose that a definition of “link facility” is included in clause 2 of the Bill. The rationale for this is that the term has been used throughout the Bill without a definition being provided. |
Clause 11 Register of community health promoters | Each county director of health shall keep and maintain a register of all community health promoters working in the county. The county director of health may designate a community health officer within the county public service as a registrar to keep and maintain the register under subsection (1). The register under subsection (1) shall include: a. bio data information on community health promoters including their: i. name and identification details; and ii. contact details; b. information on the link facility to which the community health promoters report; c. the training database for the community health promoters; d. the households assigned to each community health promoter; e. all community health promoters who have been de-registered; and f. such other information as the county government shall prescibe. There shall be kept and maintained, by the community health officer responsible for overseeing the delivery of community health services in each community health unit, an extract of the register under subsection (1) with respect to the community health promoters deployed to households in the respective community health unit. A community health promoter shall notify the community health officer in the respective community health unit of any changes to their particulars and the information shared with the registrar under subsection (2) within fourteen days of such change. The registrar shall, within seven days of receipt of the change in particulars under subsection (5): a. verify the information; and b. update the change of particulars in the register. | The use of a register is a good proposal. A register provides valuable data for resource allocation. It helps the county government understand the number of community health promoters in specific areas, allowing them to effectively allocate resources. |
Clause 30 Entry and inspection | An inspector or a person duly authorized in writing in that behalf by the Board may, at all reasonable times and upon production of such authority to any person so requesting: a. enter any land or buildings occupied by the holder of a licence issued under this Act, or a person registered under this Act; b. make such inspection and enquiries as the person may deem necessary for ascertaining whether the provisions of this Act or the terms and conditions of the respective licence are being complied with; and c. may require any person found thereon to give such information as the person may require. | Crop inspectors play a crucial role in safeguarding food safety by inspecting sugar processing facilities. They need access to these premises to check on the proper handling, storage, and transportation of sugar to prevent contamination and ensure food safety standards are met. |
Clause 12 Retention of community health promoters | Each county government shall ensure that community health promoters are adequately supported to perform their functions, including through: a. training; b. provision of working tools; c. stipend; and d. supervision. | The addition of paragraph (a) is a good proposal. Training equips the community health promoters with essential skills and knowledge related to health care, disease prevention and health education. This knowledge enables them to provide high quality health care services to various households. For paragraph (b), equipping community health promoters with essential working tools ensures that they can effectively carry out their duties. Tools such as thermometers, first aid supplies and educational materials enable them to provide immediate health care services and health education to various households. |
PART IV – MANAGEMENT OF PRIMARY HEALTH CARE SERVICES |
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Clause 13 Role of the ministry responsible for health | The Ministry responsible for Health shall, in the management of primary health care services: a. formulate, develop and disseminate primary health care policies, guidelines and other relevant frameworks; b. in consultation with the county governments, provide standards and guidelines to ensure equitable primary health care service delivery; c. consolidate and analyze national primary health care data from the counties and ensure its timely transmission to stakeholders for use in decision making and resource allocation; d. facilitate knowledge sharing and dissemination of best practices in the provision of primary health care services; e. provide capacity development and technical assistance and monitor implementation for the effective management of primary health care across the Republic of Kenya; and f. coordinate with the National Treasury and other development partners for the mobilization and allocation of adequate resources to support the realization of accessible, acceptable and equitable primary health care services. | The functions of the ministry responsible for health have been clearly stated to ensure that it does not perform tasks that are ultra vires. |
Clause 14 Primary health care advisory council | There is established a Primary Health Care Advisory Council appointed by the Cabinet Secretary and which shall consist of: a. the Principal Secretary responsible for health matters or their representative; b. the Director-General for health or their representative; c. the Chairperson of the Council of County Governors or their representative; d. the Principal Secretary responsible for the National Treasury or their representative; e. the Chairperson of the county executive committees caucus for health; f. the Chairperson of the vice-chancellors caucus or their representative; g. the Chairperson of the county directors of health caucus or their representative; h. the head of primary health care at the national level, who shall be the Secretary; and i. any other person co-opted as the Council may determine from time to time. The members of the Council shall, in the first meeting, elect a chairperson from amongst themselves. The Council members in subsection (1) shall be appointed in writing by the Cabinet Secretary and shall serve for a period of three years. The functions of the Council shall be to: a. advise the Cabinet Secretary and county governments on matters related to delivery of primary health care services; b. monitor, conduct periodic reviews and share information on the implementation of primary health care services; c. provide guidance for effective inter-county delivery of primary health care services; and d. identify and make recommendations towards effective implementation of shared primary health care facilities, services and address the social determinants of health. In the execution of its functions, the Council shall be guided by the principles under the Constitution, health laws, policies, guidelines and the relevant international instruments applicable to Kenya. | We propose the addition of a sub-clause stipulating timelines for filling vacant positions in the Council. This ensures that vacant positions are filled within a prescribed period without delays to allow the Council to effectively perform its functions. Secondly, we propose that the remuneration of members of the Council is determined by the Salaries and Remuneration Commission. This proposal will be in line with Article 230 (4) (a) of the Constitution which gives the Salaries and Remuneration Commission power to set and review the remuneration and benefits of all public officers. |
Clause 15 Role of county governments | Each county government shall, in the management of primary health care services: a. oversee the implementation of the national policies, guidelines and standards on primary health care services; b. mobilize and allocate adequate resources necessary for the delivery of primary health care services in the respective county; c. allocate adequate funds and resources necessary for the facilitation and remuneration of the community health promoters, including payment of stipends, within the respective county; d. develop the necessary technological infrastructure required by the primary health providers for effective delivery of primary health care services; e. put in place mechanisms to facilitate access to timely primary health care services including community and family-based care and support for patients within the respective county; f. facilitate access to information regarding appropriate healthy behavior including basic information on the prevention, promotion and treatment of communicable and non-communicable diseases; g. co-ordinate the implementation of training programmes for the community health-care promoters; h. provide the community health promoters with the required tools of work including kits and reporting tools; and i. undertake monitoring and evaluation through supportive supervision. | The functions of the county government have been clearly stated to ensure that it does not perform tasks that are ultra vires. |
Clause 16 County Primary Health Care Advisory Committee | Each county government shall establish a County Primary Health Care Advisory Committee. A County Primary Health Care Advisory Committee shall consist of: a. the county executive committee member responsible for health, who shall be the chairperson; b. a representative from the county department responsible for environment; c. a representative from the county department responsible for social protection; d. a representative from the county department responsible for education; e. a representative from the county department responsible for finance and planning; f. a representative from the county department responsible for the county public service board; g. a representative from the county department responsible for water and sanitation; h. a representative from the county department responsible for roads; i. a representative from the county department responsible for agriculture; j. the county commissioner or their representative designated in writing; and k. the county director of health who shall be the secretary to the committee. The Committee members in subsection (1) shall be appointed in writing by the county executive committee member and shall serve for a period of three years. A County Primary Health Care Advisory Committee shall, in each respective county, perform the following functions: a. promote oversight, monitor and evaluate the implementation of primary health care; b. identify and advocate for key primary health care issues with the respective county health departments; c. receive, work constructively and address applicable community primary health care issues, care coordination and develop innovative ideas for service delivery; d. promote communication between the health department, other stakeholders and the community; e. provide beneficiary input on departmental activities, policies, plans and projects at the individual, program, organization and system levels in the county; f. propose further opportunities for community engagement that will promote primary health care improvements in the county; g. provide advice and input into primary health care issues; h. carry out advocacy and resource mobilization; i. fairly represent the views of the community; j. gather the views of the community they represent through their primary health care networks; k. provide feedback after meetings to members of the community; l. provide leadership and advice in relation to the beneficiary and community views on primary healthcare and primary health care network service delivery, planning and development in the relevant county; and m. submit quarterly reports to the Council. | The addition of sub-clause (2) is a good proposal as the Committee will have an odd number of members. When there’s an even number of members who can vote, there’s a greater risk of deadlocks. This makes it difficult for the Committee to make decisions, resolve conflicts or move forward with its agenda. An odd number ensures that there will always be a majority decision. Secondly, we propose the re-numbering of the sub-clauses in this clause. Proper re-numbering ensures that references made within the Bill are accurate. |
Clause 17 Primary health care networks | Each county executive committee member for health shall, subject to subsections (2) and (3) and by notice in the Gazette, establish a primary health care network at the sub-county level. A primary health care network shall serve a catchment population as shall be determined by the County Primary Health Care Advisory Committee. A primary health care network shall comprise of a hub and spokes. A primary health care network shall facilitate delivery and access to primary health care services from the community, as well as coordinate with health facilities in order to improve the overall operational efficiency of the network. Every person shall be registered as a member of a primary health care network. | For sub-clause (5), we propose that a template of the registration form is included in the Schedule of this Bill. A template provides a standard format that is easy to understand and use. Further, the use of a template enhances uniformity. Secondly, sub-clause (5) is silent on the mode of registration. We propose that registration is done either physically or online. Physical registration allows for face-to-face interactions between the applicant and registration personnel. This facilitates a more personalized experience and provides clarifications directly. On the other hand, online registration is beneficial as applicants can register at any time at the comfort of their homes. Thirdly, we propose the addition of timelines in sub-clause (5). This ensures that the registration form is reviewed within a prescribed period without delays. |
Clause 18 Primary health care network committee | Each primary health care network may have a committee which shall comprise of: a. five representatives of the sub-county health management team, nominated by the county executive committee member; b. a representative of the faith based health providers; c. a representative of the private sector providers; d. a representative from a community health committee; e. a representative of development partners; and f. the sub-county commissioner. The members of the committee shall, in the first meeting, elect a chairperson from amongst themselves. The committee members in subsection (1) shall be appointed in writing by the county executive committee member and shall serve for a period of three years. The committee shall perform the following functions: a. coordinate the implementation of programmes for optimal functioning of the primary health care network; b. support the primary health care network to set targets in line with agreed county targets and local health needs; c. lead prioritization of service package or range of services to be offered through the primary health care network; d. ensure equitable distribution of resources and health services within the primary health care network; e. reference and implement human resource management plans to ensure availability and equitable distribution of health care workers and community health promoters as per level of care; f. support supervision and coordination of mentorship and training activities by the multi-disciplinary teams; g. consolidate and analyze the Health Management Information System data including community health for completeness and validity from the Primary Care Network to make timely decisions at the sub-county level; and h. mainstream and facilitate integration of services to optimize on available resources and avoid duplications. | For sub-clause (1), we propose that the Committee’s number of members is increased by an odd number. Currently, the Committee has ten members. When there’s an even number of members who can vote, there’s a greater risk of deadlocks and this will hinder the Committee from making decisions. Further, the Committee will be unable to arrive at a majority decision when electing a chairperson in sub-clause (2) as it has an even number of members. For sub-clause (1) (b), we propose that the term “faith-based health providers” is defined in the Bill to enhance clarity and remove the ambiguity present. The term “development partners” in sub-clause (1) (e) is ambiguous. We propose that the term is defined in clause 2 of the Bill to enhance clarity. For sub-clause (4) (g), we propose that the term “Health Management Information System” is defined in clause 2 of the Bill. The term has been used in the Bill without a definition being provided. |
Clause 19 Community Health Units | Each county government shall establish and operationalize community health units in accordance with the Kenya Community Health Policy. A community health unit shall serve a catchment population of up to five thousand persons in accordance with national guidelines. A community health unit shall comprise of approximately one thousand households in accordance with national guidelines. A community health unit shall, under the coordination of a Community Health Committee, be linked to a health care facility to facilitate delivery and access to primary health care services for the community. | We propose the deletion of sub-clause (3) as it’s a repetition of the term “community health unit” as defined in clause 2 of the Bill. |
Clause 20 Community health committee | Each community health unit shall have a community health committee which shall comprise of: a. a representative of faith based organizations; b. a representative of the community; c. a representative of special interest groups; d. a representative of the community health promoters; e. any other co-opted member as per community health needs; and f. the community health officer, who shall be the secretary. The members of the committee shall, in the first meeting, elect a chairperson from amongst themselves. The committee members in subsection (1) shall be appointed in writing by the county executive committee member and shall serve for a period of three years. The functions of the community health committee shall be to: a. provide leadership and oversight in the implementation of health and other related community services; b. coordinate the selection of community health promoters within the community health unit in a public participation forum; c. prepare and present the Community Health Unit annual work-plans and operational plans to the link facility health committee; d. plan, coordinate and conduct community dialogue and health action days; e. work with the link facility to promote facility accountability to the community; f. hold quarterly consultative meetings with the link facility; g. create an enabling environment for implementation of community health services; and h. mobilize resource for sustainability. | The functions of the Committee have been clearly stated to ensure that it does not perform tasks that are ultra vires. |
PART V – MISCELLANEOUS PROVISIONS |
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Clause 22 Offences and penalties | A community health promoter shall not: a. conduct any procedure that is beyond their training and approved scope of work; b. administer to a person medication that is not authorized by clinical standards and guidelines under this Act or any other applicable law; c. conduct deliveries for pregnant women; d. negligently handle property entrusted to them; e. use tools, gadgets or properties under their custody for purposes other than the delivery of community health services authorized under this Act and any other applicable law; f. solicit financial or other rewards for personal gain whether or not in recognition of effort in delivering services to the community; g. withdraw services as community health promoters without giving notice of intention to do so, except in a case of emergency; h. falsify any records or data collected by them in course of duty; i. engage in other activities that may conflict with their duty; and j. disclose the client’s health information to an unauthorized person. Any community health promoter who contravenes the provisions of this section shall be subject to disciplinary actions as prescribed by law. | This clause acts as a deterrence in ensuring that a person complies with the provisions of this Bill. |