Kenya’s healthcare system is structured across six levels, from community-based care to health centers that provide inpatient services.
The Kenya Medical Practitioners and Dentists Council (KMPDC) on Tuesday detailed how inspections and monitoring ensure that facilities meet these standards and offer safe services to the public.
Dr. David Kariuki, CEO of KMPDC, said inspections are necessary because having equipment alone is not enough.
“Because, well, sometimes that may happen, and that is the reason we undertake these inspections to confirm that what somebody indicated they had at the beginning, they still have it and are providing the services. But again, even having the machines is one thing, but having the people to use them and provide services is also another thing,” he explained during an interview at Radio Generation.
The CEO further said that new facilities often start with the right equipment but not the full number of health workers.
These staffing gaps are gradually filled over time.
“That’s why we allow like a new facility to operate for about six months, so on the first day, they may not have all the workers, but we go back within six months to confirm that now they have all the workers, and that’s how now the issues around downgrades and closures come in, yes,” Kariuki noted.
He added that the inspections are guided by national standards outlined in the Kenya Essential Package for Health and the Kenya Health Policy, which form the basis for service requirements across the country.
When asked to explain how the standards are developed and what services each level offers, Kariuki said,” Generally, in the country, we have six levels of healthcare service delivery. These were documents developed in the early 2000s by the Ministry of Health and came up with something called the Kenya Essential Package for Health. From this, we also have now the Kenya Health Policy.”
“The current one is the Kenya Health Policy 2014 to 2030. The Health Act also defines one of its schedules, defines the levels of health care in the country, and each level defines the highest skill of services that is going to be provided at that level,” he added.
The first level is the community level, which covers services that can even be provided at home.
“That is the service you can even get at home. You know, basic. What do I do if I first aid, first aid and all that?” Kariuki pointed out.
This level is managed by community health promoters, formerly called community health volunteers, and technical staff known as community health extension workers.
These health workers, who are mostly nurses, clinic officers, or public health technicians, supervise services at home and ensure water, sanitation, and hygiene standards are maintained.
Level two is the dispensary, which is designed to be easily accessible, often within walking distance.
“This is because it is you who starts feeling either that there is something I’m not feeling well, there’s pain here, there’s no pain there. So the level two now is a dispensary that you can walk to. Usually, we say it should be the closest you know, you can walk to. You may not need, actually, any form of transport, except those very sick, will always need transport from home to the facility,” Kariuki added.
Dispensaries provide basic outpatient services beyond home remedies, including simple tests like blood sugar and blood pressure checks, and treatments for minor illnesses.
Staff usually include nurses, clinic officers, and laboratory technicians, depending on the services offered. Some level two facilities may also include small dental or physiotherapy clinics.
There are no inpatient services at this level.
Level three refers to health centers, which may provide outpatient services only or both outpatient and inpatient services.
These facilities serve as referral points for more complex cases and are held to higher standards to ensure comprehensive care.
Dr. Kariuki emphasized that these inspections and standards are essential to safeguard public health. Facilities that fail to meet the required criteria may be downgraded or closed to protect patients and ensure quality healthcare across the country.
Level 4 hospitals offer holistic services and are managed by a director who is a medical professional, typically a doctor.
Level 5 hospitals are county referral facilities with a bed capacity exceeding 100. They are overseen by a chief executive officer who must be a qualified doctor.
Level 6 hospitals in the Kenyan health system include national referral hospitals as well as large private teaching or mission (faith-based) hospitals.