Comprehensive List of County Referral Hospitals in Kenya

Kenya has 47 counties. Each one has at least one designated county referral hospital. These facilities form the backbone of the public healthcare system, sitting between the national referral hospitals in Nairobi and Mombasa and the smaller sub-county and dispensary-level facilities spread across the country.

This article lists every county referral hospital in Kenya, explains how the referral system works, what services these hospitals offer, and what you need to know before visiting one.

County Referral Hospitals in Kenya: Full List by County

Understanding Kenya’s Public Hospital Referral System

Kenya’s public healthcare system is structured in levels. Understanding these levels helps you know where to go — and when you can expect to be referred.

Level 1 facilities are community health units. These are not hospitals. They are community volunteers and health promoters who provide basic health education, referrals, and first-contact care.

Level 2 facilities are dispensaries. These handle minor illnesses, maternal care, immunisation, and basic outpatient services. Most villages and small towns have one.

Level 3 facilities are health centres. They offer slightly more advanced outpatient care, basic laboratory services, and maternity services including normal deliveries.

Level 4 facilities are sub-county hospitals. These provide general inpatient care, surgery, blood transfusions, more advanced laboratory services, and 24-hour emergency services.

Level 5 facilities are the county referral hospitals listed in the table above. They offer specialist care, theatre services, intensive care units (ICU), advanced diagnostics including CT scans and MRI (in better-equipped counties), and a wider range of medical and surgical specialists.

Level 6 facilities are the national referral hospitals — Kenyatta National Hospital (KNH) in Nairobi and Moi Teaching and Referral Hospital (MTRH) in Eldoret. These handle the most complex cases and train medical professionals.

When a case is beyond what a lower-level facility can manage, the patient is given a referral letter and sent to the next level. County referral hospitals are therefore the last port of call within the county before a patient is referred out of their home county entirely.

What Services Do County Referral Hospitals Offer?

Services vary between counties depending on staffing, infrastructure, and available equipment. However, a fully functional county referral hospital in Kenya is expected to offer the following:

Outpatient services. General medical and surgical outpatient clinics, specialist clinics (depending on staffing), pharmacy, and laboratory services.

Inpatient services. General medical wards, surgical wards, maternity wards, paediatric wards, and in many hospitals a high-dependency unit (HDU) or intensive care unit (ICU).

Surgical services. General surgery, caesarean sections, orthopaedic procedures, and emergency surgery are available in most county referral hospitals. Specialist surgical procedures may require referral to a national hospital.

Maternity and reproductive health. Antenatal care, skilled delivery, postnatal care, family planning, and management of high-risk pregnancies.

Diagnostic services. Blood tests, urinalysis, microbiology, X-rays, and ultrasound are standard. Some hospitals have CT scan facilities. MRI availability remains limited to a handful of well-equipped county facilities.

Specialist clinics. Better-resourced county hospitals run dedicated clinics for HIV/AIDS, tuberculosis, diabetes, hypertension, cancer screening, mental health, renal disease, and eye care. The availability of these clinics depends on the county’s investment in health.

Blood transfusion services. Most county referral hospitals have blood banks. Critical patients can receive transfusions without being transferred.

Physiotherapy and rehabilitation. Offered in most county referral hospitals, particularly for stroke recovery, orthopaedic rehabilitation, and post-surgical patients.

Notable County Referral Hospitals Worth Knowing

Coast General Teaching & Referral Hospital — Mombasa

The oldest and largest public hospital on the Kenyan coast. It serves Mombasa County and receives referrals from the entire coastal region including Kwale, Kilifi, Taita Taveta, Lamu, and Tana River. It has a burns unit, an ICU, a neonatal unit, and a range of specialist services.

Jaramogi Oginga Odinga Teaching & Referral Hospital — Kisumu

The main referral facility for the Lake Region. It serves Kisumu County and takes referrals from Siaya, Homa Bay, Migori, Kisii, and Nyamira counties. It is a teaching hospital affiliated with Maseno University School of Medicine.

Meru Teaching & Referral Hospital — Meru

One of the busiest referral hospitals in the Mount Kenya region. It handles referrals from Meru, Tharaka-Nithi, Isiolo, and Marsabit counties and has been growing its specialist services steadily.

Kisii Teaching & Referral Hospital — Kisii

One of the most upgraded county referral hospitals in the Nyanza region. It handles complex medical and surgical cases from Kisii and Nyamira counties and has been recognised for its expanding oncology services.

Kakamega County Teaching & Referral Hospital — Kakamega

The main referral hub for the Western Kenya region. It serves Kakamega County and takes overflow from Vihiga, Bungoma, and Busia. It has a well-established paediatric unit and maternity services.

Nakuru Level 5 Hospital — Nakuru

One of the most modern and well-equipped county referral hospitals in the Rift Valley. Nakuru is a rapidly urbanising county, and its Level 5 hospital has benefited from significant infrastructure investment in recent years.

Nanyuki Teaching & Referral Hospital — Laikipia

A standout facility in central Kenya. Nanyuki Teaching & Referral Hospital has seen substantial investment and often draws patients from neighbouring Isiolo, Meru, and Samburu counties who prefer its services.

Challenges Facing County Referral Hospitals in Kenya

Despite their critical role, county referral hospitals face real and persistent challenges that affect the quality of care patients receive.

Staffing shortages. Many county hospitals are understaffed. The doctor-to-patient ratio in most counties falls far below the World Health Organization’s recommended minimum. Nurses, clinical officers, and specialists are unevenly distributed, with rural counties bearing the greatest burden.

Medical equipment gaps. Some hospitals listed above lack functional CT scanners, ventilators, or dialysis machines. Equipment is sometimes donated or purchased but sits unused due to a lack of trained operators or spare parts.

Supply chain inconsistencies. Drug and medical supply shortages are a recurring problem in the public health system. The Kenya Medical Supplies Authority (KEMSA) — now rebranded as the Kenya Healthcare Federation — has faced logistical and governance challenges that have affected availability of essential medicines.

Infrastructure. Several county referral hospitals are housed in ageing buildings. Renovation and expansion projects are underway in many counties but progress is uneven.

Funding. Under Kenya’s devolved system, county governments are responsible for managing Level 2 to Level 5 health facilities. Health budget allocations vary significantly between well-resourced and financially constrained counties.

What to Bring When Visiting a County Referral Hospital

If you are visiting a county referral hospital in Kenya — whether as a patient or accompanying someone — bring the following:

• Your National ID or passport for registration
• Your SHA (Social Health Authority) card or NHIF card if applicable — this covers costs at public facilities
• Any referral letter from the facility that sent you
• Previous medical records, prescriptions, or test results if available
• Cash or mobile money (M-Pesa) for any charges not covered by SHA

County referral hospitals are the most important healthcare institutions most Kenyans will ever use. They are not perfect — no public health system is — but they represent a remarkable network of care stretching from Mandera in the north to Kwale in the south. Knowing where your county referral hospital is, what it can offer, and how the referral system works is knowledge every Kenyan household should have.

If you need specialist care and your local health centre or sub-county hospital cannot help, a county referral hospital is your next step. And if your county hospital cannot resolve your condition, the national referral system — through KNH or MTRH — is there to receive you.

Always carry your SHA card and a referral letter when seeking care at a county referral hospital. It will save you time, paperwork, and money.