Yes. The health service delivery system in Kenya is organized across six levels of care, with the first level at the community level and continuing through primary care services, which include dispensaries (level 2) and health centres (level 3), and county referral health services (level 4 & 5) all the way to the national referral health services (level 6). Higher health care facilities act as referral centres for lower-level facilities. For instance, level 1 is the foundation of health care service delivery and referral to a higher level of care is performed to seek additional services such as diagnosis, treatment, admission or to seek expert opinion (Ministry of Health, 2014d). However, sometimes patients bypass the low-level facilities depending on proximity and go directly to higher levels of care resulting to high caseloads. In some circumstances, referral by a health worker from higher to lower levels of care (except level 1) is made, particularly if the higher health facility is far from the client’s home and the client has been prescribed medicines that are available at a nearby lower health facility.

In terms of private health care, the referral chain is not structured as access to health services is based on proximity and the ability to pay for the services. Some community members access the services of community health providers (residing within their communities) while others visit nearby private clinics where referral to a specialist is made if necessary. However, patients can go directly to a specialist without a referral.

References:

Ministry of Health. (2014d). Kenya Health Sector Referral Strategy. Ministry of Health Division of Emergency and Disaster Risk Management Afya House. https://www.measureevaluation.org/pima/referral-systems/referral-strategy