1. Introduction
Healthcare delivery in Kenya is structured in a tiered system designed to provide services at different levels of complexity and specialization. This system ensures that patients receive care appropriate to their needs, while also allowing for referrals to higher levels of care when necessary.
Kenya’s healthcare system is organized into six levels of healthcare facilities, ranging from community-based healthcare units at the lowest level to national referral hospitals at the highest. These facilities include:
- Level 1: Community Health Units
- Level 2: Dispensaries & Clinics
- Level 3: Health Centers
- Level 4: Primary Referral (County Hospitals)
- Level 5: Secondary Referral (County Referral Hospitals)
- Level 6: Tertiary Referral (National Referral Hospitals)
Understanding how these healthcare levels function is crucial for patients, healthcare workers, and policymakers as it promotes efficient use of resources, ensures timely referrals, and improves patient outcomes.
2. Levels of Healthcare Facilities in Kenya
A. Level 1: Community Health Services (Community Health Units – CHUs)
🔹 Definition: Level 1 healthcare is provided at the community level by Community Health Workers (CHWs). It focuses on preventive and promotive health services rather than curative treatments.
🔹 Key Functions:
✔ Health education on topics such as nutrition, hygiene, sanitation, family planning, and immunization awareness.
✔ Home-based care for minor illnesses.
✔ Referral services to higher-level facilities when required.
✔ Disease prevention campaigns (e.g., malaria control, vaccination programs).
📌 Example Programs: Kenya’s Community Health Strategy and WHO’s Universal Health Coverage goals.
📌 Further Learning: Ministry of Health – Community Health Strategy
B. Level 2: Dispensaries and Clinics
🔹 Definition: These are the first formal healthcare contact points for many Kenyans. They provide basic medical services and are mostly run by clinical officers and nurses.
🔹 Key Functions:
✔ Diagnosis and treatment of minor illnesses (e.g., malaria, respiratory infections, diarrhea).
✔ Basic maternal and child healthcare services (antenatal and postnatal care).
✔ Immunization programs.
✔ Provision of essential medications and referrals for advanced care.
🔹 Example Facilities: Government dispensaries, Faith-Based Dispensaries (e.g., Mission Clinics), and private clinics.
📌 Further Learning: Kenya Health Information System (KHIS)
C. Level 3: Health Centers
🔹 Definition: Health centers provide a wider range of outpatient and inpatient services than dispensaries. They serve as referral facilities for dispensaries.
🔹 Key Functions:
✔ Outpatient medical services for more complex cases.
✔ Maternity services, including deliveries and postnatal care.
✔ Inpatient wards for short-term hospitalization.
✔ Minor surgical procedures (e.g., stitching wounds, circumcision).
✔ Management of common chronic illnesses like diabetes and hypertension.
📌 Example Facilities: Government-run health centers in rural and peri-urban areas.
📌 Further Learning: Kenya Health Policy
D. Level 4: County Referral Hospitals (Primary Hospitals)
🔹 Definition: These are the main hospitals in each county, providing comprehensive medical services and acting as referral centers for lower-level facilities.
🔹 Key Functions:
✔ Emergency and critical care services.
✔ Advanced diagnostic services (X-rays, CT scans, lab tests).
✔ Major surgeries (e.g., C-sections, orthopedic surgeries).
✔ Specialized services, such as pediatrics, gynecology, and internal medicine.
🔹 Examples: Machakos Level 5 Hospital, Kakamega County Referral Hospital.
📌 Further Learning: Kenya County Health Services
E. Level 5: County Teaching and Referral Hospitals (Secondary Hospitals)
🔹 Definition: These are regional referral hospitals that provide specialized healthcare services and act as training institutions for healthcare professionals.
🔹 Key Functions:
✔ Advanced medical care, including specialized cancer, kidney, and heart treatments.
✔ Teaching and research programs for medical students.
✔ Higher-level surgical and critical care services.
🔹 Examples:
✔ Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH).
✔ Embu Level 5 Hospital.
📌 Further Learning: Teaching & Referral Hospitals in Kenya
F. Level 6: National Referral Hospitals (Tertiary Hospitals)
🔹 Definition: These are top-tier hospitals that provide highly specialized medical services and conduct medical research and training.
🔹 Key Functions:
✔ Treatment of rare and complex diseases, such as cancer, neurological disorders, and organ transplants.
✔ Highly specialized surgeries, including heart surgeries and neurosurgery.
✔ Medical research and innovation.
✔ Training of medical professionals and specialists.
🔹 Examples:
✔ Kenyatta National Hospital (KNH) – Nairobi
✔ Moi Teaching and Referral Hospital (MTRH) – Eldoret
✔ Kenyatta University Teaching, Referral & Research Hospital (KUTRRH) – Nairobi
📌 Further Learning: Kenyatta National Hospital (KNH)
3. Summary: Key Takeaways
✔ Kenya’s healthcare system follows a six-tier structure, with increasing specialization at each level.
✔ Level 1: Community Health Units focus on preventive and home-based care.
✔ Level 2: Dispensaries provide basic outpatient services and referrals.
✔ Level 3: Health Centers offer maternity care, inpatient services, and minor surgeries.
✔ Level 4: County Referral Hospitals provide specialized services and major surgeries.
✔ Level 5: Teaching & Referral Hospitals offer training, research, and advanced healthcare.
✔ Level 6: National Referral Hospitals deliver top-tier medical services and research.
4. End of Lecture Quiz
1. What is the primary role of Level 2 healthcare facilities in Kenya?
A) Performing complex surgeries
B) Providing basic outpatient and maternal health services
C) Conducting medical research
D) Training doctors
Answer: B) Providing basic outpatient and maternal health services. Dispensaries handle minor illnesses and offer primary maternal and child healthcare.
2. Which hospital category provides the highest level of specialized medical care in Kenya?
A) Dispensaries
B) County Referral Hospitals
C) National Referral Hospitals
D) Health Centers
Answer: C) National Referral Hospitals. These hospitals provide specialized treatments, complex surgeries, and advanced research.
5. Further Learning Resources
📌 Kenya Ministry of Health: www.health.go.ke
📌 Kenya National Health Information System (KHIS): hiskenya.org
📌 Kenya Medical Research Institute (KEMRI): www.kemri.go.ke
