Inside Kenya's six-tier maternal healthcare system: What every mother should know
Mothers at a healthcare centre for routine vaccination of their babies in this photo taken in 2022 at Bundung Maternal and Child Health Hospital in Gambia.Kenya's restructured healthcare system now offers maternity and child health services across six facility levels.
What you need to know:
- Kenya's healthcare system is structured into six levels, with maternity and child health services provided differently at each tier.
- The Primary Healthcare Fund covers services at lower levels (1-3 and select level 4 facilities), while the Social Health Insurance Fund covers services at higher levels (4-6).
Under the new healthcare system in Kenya, different levels of health facilities provide varying maternity, neonatal, and child health services.
According to guidelines from the Ministry of Health, Kenya’s health system is structured into six levels, ranging from the most accessible, offering basic services, to the highest level with advanced medical care.
Level 1 comprises community health services managed by community health promoters (formerly known as community health workers or volunteers). These promoters are linked to health facilities and are responsible for creating awareness on family health services, as well as referring households or individuals to appropriate health facilities for further care.
A recent legal notice issued by the Cabinet Secretary for Health prescribes not only tariffs but also the maternity, neonatal, and child health services covered under the Primary Healthcare Fund and the Social Health Insurance Fund.
Antenatal care and postnatal care services are covered under outpatient services at Level 2 facilities (dispensaries and clinics), Level 3 facilities (health centres, maternity homes, and nursing homes), and selected Level 4 facilities (sub-county hospitals and medium-sized private hospitals) designated as primary healthcare referral centres.
Further, management of complications for mothers and new-borns is covered under other benefit packages, depending on the need.
These outpatient services fall under the Primary Healthcare Fund, which purchases primary health care services from registered facilities. The fund comprises monies appropriated by the National Assembly, grants, gifts, donations, and fees or levies administered.
Primary health care is essential health care made accessible, acceptable, and affordable through the full participation of individuals, families, and communities.
At Levels 4 to 6, services are provided under the Social Health Insurance Fund. This fund is financed through contributions from registered Kenyans, allocations from the National Assembly for indigent and vulnerable populations, and support from grants, donations, and other innovative financing mechanisms.
Level 5 refers to county referral hospitals and large private hospitals, while Level 6 includes national teaching and referral hospitals.
Other maternity, neonatal, and child health services are available at Level 2 to Level 6 facilities, with set tariffs as follows: Sh10,000 for normal delivery and essential new-born care, Sh30,000 for caesarean section and essential new-born care, and Sh6,000 for anti-D serum.