Kenya's hospital levels explained: what KEPH Level 2 to 6 actually means
Kenyan health facilities are not simply hospitals or clinics. Every one of them sits somewhere on a six-tier ladder set by the Kenya Essential Package for Health (KEPH), and that level decides what a facility is allowed to do, who pays for it, and where a patient gets sent next. Of the 23,111 Kenyan facilities Veligraph tracks, 17,603 carry a KEPH level in the register. Here is what each tier means, and every Level 5 and Level 6 facility on record.
The six levels, and how many sit at each
| Level | What it is | On record |
|---|---|---|
| Level 2 | Dispensaries and small clinics: the first formal point of care | 14,621 |
| Level 3 | Health centres, maternity and nursing homes | 2,140 |
| Level 4 | Primary and sub-county hospitals: the first level with inpatient surgery | 817 |
| Level 5 | County referral hospitals: specialist care for a whole county | 19 |
| Level 6 | National referral hospitals: the top of the referral chain | 6 |
Level 1 is not a building. It is the community health unit: volunteers and community health promoters working from households, which is why it rarely appears as a facility in any register.
The shape of that table is the shape of Kenyan healthcare. Nearly all facilities sit at Levels 2 and 3, where care is outpatient and there is no operating theatre. Inpatient capability begins at Level 4. Above that the numbers collapse to a handful of institutions serving tens of millions of people.
Level 6: the national referral hospitals
These are the end of the referral chain, the places a patient reaches when no county hospital can help. Veligraph has 6 on record:
| Facility | County | Ownership |
|---|---|---|
| Kenyatta National Hospital | Nairobi | Public (MoH) |
| Kenyatta University Teaching Refferal and Research Hospital | Nairobi | Parastatal |
| Mathari Hospital | Nairobi | Public (MoH) |
| Moi Teaching Refferal Hospital | Uasin Gishu | Public (MoH) |
| Mwai Kibaki Teaching and Referral Hospital | Nyeri | Public (MoH) |
| National Spinal Injury Hospital | Nairobi | Public (MoH) |
Level 5: the county referral hospitals
Level 5 is the specialist tier below national referral: the hospital a county sends its complicated cases to. Veligraph has 19 facilities graded Level 5:
| Facility | County | Ownership |
|---|---|---|
| Embu Provincial General Hospital | Embu | Public (MoH) |
| Garissa County Referral Hospital | Garissa | Public (MoH) |
| Kakamega County General Hospital | Kakamega | Public (MoH) |
| Kiambu County Referal Hospital | Kiambu | Public (MoH) |
| Kijabe (AIC) Hospital | Kiambu | Faith-based |
| Thika Level 5 Hospital | Kiambu | Public (MoH) |
| Kisii Teaching And Referral Hospital (Level 6) | Kisii | Public (MoH) |
| Tabaka Mission Hospital | Kisii | Faith-based |
| Jaramogi Oginga Odinga Teaching & Referral Hospital | Kisumu | Public (MoH) |
| Machakos County Referral Hospital | Machakos | Public (MoH) |
| Meru District hospital | Meru | Public (MoH) |
| Coast General Teaching and Referral Hospital | Mombasa | Public (MoH) |
| Aga Khan Hospital | Nairobi | Private |
| Nairobi Hospital | Nairobi | Private |
| The Mater Misericordiae Hospital | Nairobi | Faith-based |
| Nakuru Provincial General Hospital | Nakuru | Public (MoH) |
| The white cresent Hospital | Nandi | Private |
| Nyeri Provincial General Hospital (PGH) | Nyeri | Public (MoH) |
| Kitale County Hospital | Trans Nzoia | Public (MoH) |
A few names carry a level in the title that differs from the level in the register, and some large private hospitals are graded lower than their size suggests. We show the grade as recorded rather than correcting it, because the register is what determines referral and reimbursement in practice.
Why the level on the sign matters to a patient
Three reasons. First, capability: a Level 3 health centre cannot admit you for surgery, so arriving at one with a surgical emergency costs you a transfer. Second, referral: Kenya's system is designed to move patients up the ladder, and skipping tiers is what creates the queues at national hospitals. Third, who pays: reimbursement under the Social Health Authority, which replaced the NHIF in 2024, is tied to what a facility is contracted and graded to do. The level is not administrative trivia; it is the difference between being treated and being referred.
Who owns Kenya's facilities
Of the facilities with a recorded owner, 10,264 are public or state-linked, 5,244 are private for-profit, and 2,096 are run by faith-based organisations or NGOs. That faith-based tier is easy to overlook and hard to replace: mission hospitals carry a real share of inpatient care in rural counties, and several appear in the Level 5 table above.
Since devolution in 2013, health services have been a county responsibility, which is why the county column matters: your access to Level 4 and 5 care depends heavily on which of the 47 counties you live in.
What this data is, and is not
Read every count above as facilities on record in Veligraph, not as a national total. Our Kenyan records come from the country's master facility register and reflect a 2020 snapshot, so newer facilities and recent upgrades will be missing, and a facility that has since been reclassified may still show its older grade. Kenyan records in our set also have no coordinates attached, so we do not publish maps for Kenya. We would rather say that plainly than imply a completeness we do not have.
Browse the full register on the Kenya facility index, or see every hospital on record in Nairobi.
Sources
- Kenya Master Health Facility Registry, Ministry of Health, facility level, ownership and county as registered (2020 snapshot)
- Kenya Essential Package for Health (KEPH), Ministry of Health, the six-tier service framework
- WHO Global Health Observatory, health system context
Register figures are shown as recorded; anomalies are flagged, not edited. Method and limitations: how Veligraph is built.