What Is Primary Care?
Primary care is your first contact with the health system for most health problems. It’s the basic medical care you get for common illnesses, injuries, and preventive services.
Examples: Treating fever, managing diabetes, immunizations, antenatal care, minor injuries.
In Kenya, primary care happens at dispensaries, health centers, and hospitals. Knowing which one to use saves you time and money.
Quick Decision Guide
Go to Dispensary or Health Center For:
- Common fever, cough, flu
- Minor cuts and burns
- Immunizations
- Family planning
- Antenatal care (pregnancy check-ups)
- High blood pressure or diabetes check-ups
- STI testing and treatment
- Minor stomach issues
Go to Hospital For:
- Severe pain
- High fever that won’t go down
- Difficult breathing
- Deep cuts needing stitches
- Broken bones
- Serious accidents
- Chest pain
- Severe headache with other symptoms
- Pregnancy complications
- When dispensary/health center refers you
Go Straight to Emergency Room For:
- Unconsciousness
- Severe bleeding
- Suspected stroke (face drooping, arm weakness, speech difficulty)
- Suspected heart attack (chest pain, shortness of breath)
- Severe burns
- Poisoning
- Difficulty breathing
- Seizures
Dispensaries: Your First Stop
What Is a Dispensary?
A small health facility in your community, usually serving a few thousand people.
Who Works There?
- Nurses
- Clinical officers (sometimes)
- Lab technician (maybe)
- Pharmacist or pharmacy assistant
No doctors at most dispensaries.
Services Offered
1. Outpatient Care
- Treat common illnesses: malaria, flu, stomach issues, UTIs
- Basic wound care
- Health screenings (BP, temperature, weight)
2. Preventive Services
- Immunizations for children
- Tetanus shots
- Deworming
3. Maternal Services
- Antenatal care (pregnancy check-ups)
- Postnatal care (after delivery)
- Family planning
Note: Most dispensaries DON’T deliver babies. They refer to health centers or hospitals.
4. Chronic Disease Management
- Blood pressure checks
- Diabetes monitoring (if equipment available)
- Medication refills
- Health education
5. Basic Lab Tests
- Malaria test
- Pregnancy test
- HIV test
- Urinalysis
- (Limited tests—not all dispensaries have full lab)
What Dispensaries CAN’T Do
- Surgery
- X-rays
- Deliveries (most)
- Complex lab tests
- Admitting patients overnight
- Specialized care
When to Use a Dispensary
Perfect for:
- Common, non-urgent health issues
- Routine check-ups
- Preventive services
- Chronic disease follow-up
Advantages:
- Close to home
- Short wait times
- Very affordable (KES 50-200)
- Less crowded
Cost at Dispensaries
- Consultation: KES 50-100
- Basic medications: Often free or very cheap
- Lab tests: KES 50-200
- Immunizations: Free
Health Centers: More Services
What Is a Health Center?
Larger than a dispensary, serving a wider area (maybe 10,000-30,000 people).
Who Works There?
- Clinical officers
- Nurses (more than dispensaries)
- Lab technicians
- Pharmacy staff
- Sometimes a doctor (not always)
Services Offered
Everything dispensaries offer, PLUS:
1. Maternity Services
- Normal deliveries (no cesarean sections)
- 24-hour maternity ward
- Immediate newborn care
2. Inpatient Services
- Limited beds (usually 10-30)
- Short-term admission (1-3 days)
- Observation of patients
3. More Lab Tests
- Full blood count
- Stool analysis
- Sputum tests (TB)
- More comprehensive urinalysis
4. Minor Procedures
- Suturing (stitches) for deeper cuts
- Removal of foreign bodies
- Abscess drainage
- Minor surgeries (sometimes)
5. Expanded Chronic Care
- TB diagnosis and treatment
- HIV testing, counseling, and treatment
- Nutrition programs
What Health Centers CAN’T Do
- Cesarean sections
- Major surgery
- X-rays (most don’t have)
- CT scans or MRIs
- Highly specialized care
- Long-term inpatient care
When to Use a Health Center
Perfect for:
- Normal deliveries
- Slightly more serious illnesses
- When dispensary refers you
- If you need to stay overnight
- More comprehensive care than dispensary
Advantages:
- Still close to home
- More services than dispensary
- Still affordable
- Can handle deliveries and short admissions
Cost at Health Centers
- Consultation: KES 100-300
- Delivery: Free (Linda Mama program)
- Lab tests: KES 100-500
- X-ray (if available): KES 200-500
- Admission: KES 200-500 per day
Hospitals: Comprehensive Care
Types of Hospitals in Kenya
1. Sub-County Hospitals (Level 4)
- Serve several health centers
- Have doctors
- Basic specialist services
2. County Referral Hospitals (Level 5)
- Main hospital in the county
- Multiple specialists
- More advanced services
3. National Referral Hospitals (Level 6)
- Kenyatta, Moi Teaching and Referral, Coast General
- Most specialized care
- Teaching hospitals
Who Works There?
- Many doctors (general and specialists)
- Clinical officers
- Nurses
- Lab staff
- Radiographers (X-ray, CT, MRI)
- Pharmacists
- Specialists (surgeons, gynecologists, pediatricians, etc.)
Services Offered
Everything health centers offer, PLUS:
1. Emergency Services
- 24/7 emergency room
- Trauma care
- Resuscitation
2. Surgery
- Cesarean sections
- Appendectomy
- Hernia repair
- Orthopedic surgery (bones)
- Many other surgeries
3. Specialized Clinics
- Diabetes clinic
- Hypertension clinic
- Mental health
- TB and HIV
- Oncology (cancer)
- Cardiology (heart)
4. Advanced Diagnostics
- X-rays
- Ultrasound
- CT scans (county and national hospitals)
- MRI (mainly national hospitals)
- Endoscopy
- Comprehensive lab tests
5. Inpatient Wards
- Medical ward
- Surgical ward
- Maternity ward
- Pediatric (children) ward
- ICU (Intensive Care Unit) at larger hospitals
6. Specialized Care
- Newborn unit (NICU)
- High-risk pregnancy management
- Cancer treatment
- Heart disease management
- Kidney dialysis
- Mental health inpatient care
When to Use a Hospital
Use a hospital when:
- You have a serious or complicated condition
- You were referred from dispensary/health center
- You need surgery
- You need specialized care
- It’s an emergency
Don’t go to hospital for:
- Simple cough or cold (use dispensary)
- Minor injuries (use health center)
- Routine check-ups (use dispensary)
Why? Hospitals are crowded and expensive. Save them for when you really need them.
Cost at Hospitals
- Consultation: KES 200-500
- Emergency visit: KES 500-1,000
- Lab tests: KES 200-2,000
- X-rays: KES 500-1,500
- Ultrasound: KES 1,000-2,500
- Surgery: KES 5,000-50,000+ (varies widely)
- Admission per day: KES 500-2,000
SHA/SHIF covers most of these costs.
How to Navigate the System
Start at the Right Level
Most health issues: Start at dispensary or health center
Why?
- Faster service (less crowded)
- Cheaper
- Closer to home
- They handle 80% of health problems
If they can’t help, they’ll refer you to a hospital.
The Referral Chain
Dispensary → Health Center → Sub-County Hospital → County Hospital → National Referral Hospital
You should move up the chain only when necessary.
When to Skip Levels
Emergencies: Go straight to the nearest hospital with emergency services.
Specialized clinics: Some services (mental health, HIV, TB) available directly at county hospitals—no referral needed.
Maternal care: Pregnant women can choose health center or hospital for delivery (based on risk).
Making the Right Choice
Questions to Ask Yourself
1. How serious is the problem?
- Mild/common → Dispensary
- Moderate → Health Center
- Serious/complicated → Hospital
2. Do I need specialized care?
- Yes → Hospital
- No → Dispensary or health center
3. Is it an emergency?
- Yes → Hospital emergency room
- No → Start at dispensary/health center
4. Can it wait?
- Yes → Dispensary during normal hours
- No → Hospital emergency
Examples
Scenario 1: Fever and cough for 2 days → Dispensary. Common illness, not urgent.
Scenario 2: Deep cut from panga, bleeding a lot → Health Center or Hospital. Needs stitches and possibly tetanus shot.
Scenario 3: Chest pain and difficulty breathing → Hospital Emergency. Possible heart problem, needs immediate care.
Scenario 4: Pregnancy check-up → Dispensary or Health Center. Routine antenatal care.
Scenario 5: Child not breathing well, very fast breathing → Hospital Emergency. Possible pneumonia, needs urgent care.
Scenario 6: Diabetes medication refill → Dispensary or Health Center. Routine follow-up.
Scenario 7: Suspected broken bone → Hospital. Needs X-ray and possibly cast or surgery.
Scenario 8: Immunizations for baby → Dispensary. Routine preventive service.
Tips for Using Primary Care
For Any Facility
1. Go Early
- Arrive before 8am to avoid long queues
- Clinics often run out of numbers by mid-morning
2. Bring Your Essentials
- National ID
- Patient file/card (if you have one)
- SHA/SHIF card or number
- Previous medical records
- List of current medications
3. Be Prepared to Wait
- Bring water and snacks
- Have something to occupy yourself
- Emergency cases go first
4. Ask Questions
- What’s wrong with me?
- How do I take this medication?
- When should I come back?
- What danger signs should I watch for?
- Do I need to go to a hospital?
5. Follow Instructions
- Take medication as directed
- Return for follow-up
- Go to hospital if referred
Know Your Rights
As a patient, you have the right to:
- Respectful treatment
- Privacy during examination
- Clear explanation of your condition
- Know cost of services before receiving them
- Refuse treatment (except in life-threatening situations)
- Get a referral if facility can’t help
Using SHA/SHIF
Coverage at All Levels
SHA/SHIF covers services at dispensaries, health centers, and hospitals.
How to Use
- Bring your ID to the facility
- Tell them you’re under SHA/SHIF
- They verify your membership
- Most services are covered (some co-payments may apply)
See SHA/SHIF articles for complete details.
Common Mistakes to Avoid
Mistake 1: Going to Hospital for Everything
Problem: Long waits, high costs, overcrowding
Solution: Start at dispensary/health center unless it’s serious
Mistake 2: Ignoring Referrals
Problem: Condition worsens, complications develop
Solution: If referred to hospital, go as soon as possible
Mistake 3: Not Following Up
Problem: Condition doesn’t improve or returns
Solution: Return for follow-up visits as instructed
Mistake 4: Sharing Medication
Problem: Wrong treatment for other person, your condition doesn’t improve
Solution: Each person needs their own diagnosis and treatment
Mistake 5: Stopping Medication Early
Problem: Condition comes back, bacteria become resistant (antibiotics)
Solution: Complete the full course as prescribed
Take Action Today
Know Your Facilities
- Identify your nearest dispensary
- Know where the closest health center is
- Find out which hospital serves your area
- Save their contacts
Register
- Get a patient file at your nearest facility
- Register for SHA/SHIF if you haven’t
- Keep your patient card safe
Use Wisely
- Start at the right level
- Don’t wait until problems are serious
- Follow referrals when given
- Build a relationship with your local facility
Understanding where to go for healthcare helps you get faster, cheaper, and better care. Use dispensaries and health centers for most needs, and save hospitals for serious conditions and emergencies.