UNIT 2
ORGANIZATION OF HEALTH
INFORMATION SYSTEM IN KENYA
Organization of Health Services
in Kenya
• The KHSSP III 2012 – 2017 defines the Kenya Essential
Package for Health (KEPH) as consisting of the following
cost-effective health services organised by:
• Type (4): promotive, preventive, curative & rehabilitative;
• Target group (cohorts – 5+1):
– Pregnancy and the new born (up to 28 days),
– early childhood (29 days – 59 months),
– late childhood and youth (5 – 19 years),
– adulthood (20 – 59 years),
– elderly (60 years and over), cross cutting interventions
(all cohorts).
TIERS OF CARE
• KEY CHANGES: To align to county system, the levels
were reduced from 6 to 4.
• Dispensaries and Health centres combined into one
(Primary Care Level)
• Provincial level is not in existence
TIER1: Community Level:
• This is the a community unit as defined in the previous
Kenya Essential Package of Health (KEPH) Level 1 unit.
This is the foundation of the health service delivery
system. Referrals at this level are initiated by
Community Health Workers (CHWs) in community units.
Community units (CU) are linked to primary health care
facilities to which majority of referrals from this level
are made.
TIER2: Primary Care Level
• Primary Care Level: health services provide primary
care services and form the interface between the
community and the rest of the health system. Level 2
facilities include dispensaries. Dispensaries & health
centres which are managed by a small number of staff,
a large majority being nurses.
TIER3: County Level-
• consist of sub-county hospitals that provides primary
referral services-previous KEPH level4. Tier3 facilities
are the first-level hospitals whose services complement
the primary care level. Together with level 5 facilities,
these form the county referral hospitals. Majority of the
referrals to this level are from levels 1 &2. Facilities at
this level offer in- and out-patient services and have
large laboratories that offer diagnostic services that
otherwise would not be available at the primary care
facilities.
TIER4:National Level
• provision of secondary and specialized services-
previous KEPH levels 5&6. It comprises the tertiary-
level hospitals whose services are highly specialized.
These are the ultimate referral points, mainly national
teaching referral hospitals. The entire cascade and
network of referrals in the Kenyan health system is to
this level where very specialized skills, expertise and
services are offered and linkages with local and
international universities, facilities, and staff are forged
and maintained
Organisation of Health Services Delivery
Illustrated
LEVELS DESCRIPTION FOCUS
All PGH’s, and National • Highly specialised health care, for area / region of
NATIONAL Referrals specialisation
REFERRAL Are general, regional, or • Training and research services on issues of
FACILITIES discipline specialists national importance
Referral
services
• Comprehensive in-patient diagnostic, medical, surgical
and rehabilitative care, including reproductive health
All district, sub-district
COUNTY hospitals, including NGO /
services
• Specialised outpatient services
REFERRAL private, form network of • Facilitate, and manage referrals from lower levels, and
FACILITIES County Referral Services other referrals
in a county • With other County Referral Facilities, form the County
Referral System Referral
• Disease prevention and health promotion services
services
All dispensaries, health • Basic outpatient diagnostic, medical surgical &
centres, clinics, rehabilitative services
PRIMARY CARE • Inpatient services for emergency clients awaiting
maternity homes
FACILITIES Catchment area:
referral, clients for observation, and normal delivery
services
30,000 persons • Facilitate referral of clients from communities, and to
referral facilities Referral
services
• Facilitate individuals, households and communities adopt
appropriate healthy behaviours
COMMUNITY • Provide agreed health services
No physical facilities • Recognise signs and symptoms of conditions requiring
UNITS
referral,
• Facilitate community diagnosis, management &referral.
