•According to the categorization by the Kenya Medical Practitioners and Dentists’ Council, at the community level are Level 1 facilities
•These facilities are run by any registered and licensed health workers, a Community Health Extension Worker or Community Health Volunteers
Image: WANGECHI WANG'ONDU
Health is a devolved function as per the Constitution of Kenya 2010.
This means that county governments are entrusted with all functions related to healthcare while the national government is responsible for health policy.
The national government is also responsible for the national referral health facilities such as Kenyatta National Hospital and Moi Teaching and Referral Hospital.
Generally, healthcare facilities in the country are grouped into six different levels.
The first five are managed at the county level, the sixth level by the national government.
In this system, the patients may move from one level to the next by using a referral letter.
Level 1
According to the categorisation by the Kenya Medical Practitioners and Dentists’ Council, at the community level are Level 1 facilities.
These facilities are run by any registered and licensed health workers, a Community Health Extension Workers or Community Health Volunteers.
They are mandated with the preventive aspect of healthcare which involves health promotion and education on early detection of conditions, screening and referral, enforcing adherence to care and defaulter tracing
Level 2
The facilities in this category include dispensaries and are run by a clinical officer.
They do not have inpatient facilities but offer basic essential outpatient services in dental, eye care, mobile clinics, VCT services, laboratory services, Antenaetal and Postnatal services, counseling services and baby wellness clinics.
They also offer home-based care services and in some cases, a standalone funeral facility where dead bodies can be stored, and undergo autopsy before cremation or burial.
Where need be, they issue referral letters to other facilities.
Image: HILTON OTENYO
Level 3
According to Action for Transparency(A4T)—a pioneering project that fights corruption and mismanagement of government funds, these are small hospitals with minimal facilities, yet they offer services like the big hospitals.
They comprise health centres and are run by at least one doctor, clinical officers and nurses.
These facilities generally offer preventive and curative services appropriate to local needs.
Basically, they offer comprehensive curative, preventive, promotive and rehabilitative health services including maternity theatre services.
These services include maternity in-patient, TB, diabetes and hypertension clinics, pharmacy, comprehensive care clinics for patients living with HIV and laboratory services.
They then do referral letters for patients who need advanced treatment in other health facilities.
Level 4
These are county hospitals and have the same services as the Level 3 hospitals, plus X-Ray services.
They also include specialist standalone medical centres, medical surgical, diagnostic and clinical laboratory centres.
They offer holistic services and are ran by a director who is a medic and at best a doctor by profession.
According to KMPDC, these facilities act as the principal primary referral hospital and offers services that complement primary health care services to allow for a delivery of a more comprehensive care.
Image: FILE:
Level 5
These are the county referral hospitals, are run by a CEO who is a medic by profession and have over 100 beds capacity for their in-patient.
They provide services offered in a Level 4 facility and more comprehensive set of services together with internship services for medical staff, research and serve as training centres for paramedical staff.
Some of the advanced healthcare services they provide include ultrasound, CT-Scan, surgery, physiotherapy, Orthopaedics and occupational therapy. Where need be, they issue referral letters to patients to seek further medical attention in other facilities.
Level 6
These are the national referral hospitals which offer the same services as those offered at Level 5 but also offer specialised treatment services not just within the country but also serve the needs of ptients from across the region.
They include the National Spinal Injury Referral Hospital and Mathari Teaching and Referral Hospital.