Quick Answer
Kenya’s health system is organised in levels, from community health units up to national referral hospitals. You are generally expected to start at the lowest appropriate level and be referred upward — except in emergencies.
Key facts
- Care is organised from Level 1 (community) to Level 6 (national referral).
- You usually start low and are referred upward.
- Lower levels handle primary care; higher levels handle specialised care.
- Emergencies are exempt from the referral rule.
The levels of care
The system is a pyramid:
- Level 1 — community health units (community health promoters at household level).
- Levels 2–3 — dispensaries and health centres (primary care).
- Levels 4–5 — county and sub-county hospitals, and county referral hospitals.
- Level 6 — national referral hospitals, for the most specialised care.
How referral works
You are generally expected to start at your primary (Level 2–3) facility and be referred upward when specialist care is needed. Under SHA, this referral pathway is also tied to how care is paid for.
Emergencies are different
In a genuine emergency, the referral rule does not apply — and the Constitution guarantees that no one may be denied emergency medical treatment (Article 43).
Why this matters to you
Knowing the levels saves time and money — you go to the right facility first — and knowing the emergency exemption means you (or a relative) cannot lawfully be turned away when life is at risk.
Frequently asked questions
Where should I go first when sick?
Usually your nearest primary facility (Level 2 or 3), which can refer you upward if needed.
What is a national referral hospital?
A Level 6 facility offering the most specialised care.
Do I need a referral in an emergency?
No — emergencies are exempt, and emergency treatment cannot be denied.
Sources & references
- Ministry of Health (Kenya Essential Package for Health) — health.go.ke
- Constitution of Kenya 2010, Article 43 — klrc.go.ke