The County Government of Nakuru plans to establish a primary healthcare service delivery unit at the Rift Valley Provincial General Hospital (Nakuru PGH) in a bid to expand outpatient capacity and improve access to essential, high-quality healthcare services in the region.
It also aims to tackle challenges arising from the implementation of the Social Health Authority (SHA) Act, which has brought significant changes to Kenya’s healthcare delivery system, necessitating enhanced capacity and streamlined access to services.
The SHA Act introduced significant reforms, including the Primary Health Care Act, which emphasizes outpatient care through community-level facilities such as Level 1 units, dispensaries (Level 2), and health centers (Level 3).
The restructuring seeks to ease congestion in higher-level hospitals (Levels 4, 5, and 6) by ensuring patients access initial care at lower-level facilities, with referrals to specialized institutions only when necessary.
However, Dr. Joy Mugambi, the Nakuru County Director of Health Administration and Planning, noted that this shift has created a gap in outpatient services for many walk-in patients traditionally served by the regional hospital.
“Many walk-in patients we have served for years now lack viable options under the current system, highlighting the urgent need for accessible alternatives,” Dr. Mugambi, who is also the Secretary-General of the Commonwealth Medical Association explained in an interview.
Previously, the facility served over 2,000 outpatients from Nakuru and neighboring counties on a daily basis. With SHA, it now handles about 500 non-referral patients, most paying for services due to urgent and complex needs and limited low-level facilities.
To address this, she revealed plans to relocate certain services to the new outpatient complex near the Margaret Kenyatta Mother-Baby Unit, freeing up space to establish and expand the dispensary’s operations.
The facility will offer timely outpatient and vaccination services to residents of Milimani, Kiamunyi, Olive Inn, London, and the Central Business District—areas that have traditionally depended on Nakuru PGH for primary healthcare services.
Recently, the community has had to rely on the Nakuru GK Prisons, Industrial Area, and Bondeni dispensaries for services. This has been inconvenient due to long distances and overcapacity, driven by the high population in the catchment areas.
Dr. Mugambi further noted that the County will soon register, staff, and equip the dispensary in compliance with Kenya’s legal requirements for establishing new healthcare institutions and in alignment with the objectives of the SHA Act.
To register a health facility in Kenya, applicants must apply through the Kenya Medical Practitioners and Dentists Council (KMPDC), undergo facility inspections, obtain County permits, meet environmental standards, and ensure compliance with professional and safety regulations.
“The establishment of the dispensary at Nakuru PGH is a breakthrough in the County’s ongoing efforts to enhance healthcare accessibility, improve the quality of services, and ensure efficient and equitable service delivery to residents at all levels,” Dr. Mugambi stated.
On Tuesday, November 26, SHA Acting Chief Executive Officer Robert Ingasira announced that patients nationwide can now access primary healthcare services at designated Level Four facilities, expanding availability and improving access to essential care across the country.
“We have authorized select Level Four facilities, as specified in the Act, to deliver primary healthcare services. This move has greatly eased the strain on lower-level facilities, improving service delivery and patient access,” Ingasira explained.
This development is a welcome relief, according to residents, as many lower-level hospitals operate from 8 am to 5 pm, close on weekends and public holidays, and are often under-resourced and poorly equipped to manage the complex outpatient cases typically handled by higher-level facilities.
Nakuru County prides itself on a well-developed healthcare infrastructure, including one Level 5 referral facility, 15 Level 4 hospitals, 38 health centers, 141 dispensaries, and 362 community health units, effectively catering to the healthcare needs of both urban and rural populations.
The Nakuru PGH serves as a critical regional referral center, providing specialized services to residents of eight neighboring counties: Baringo, Kericho, Bomet, Narok, Nyandarua, Laikipia, Samburu, and parts of Kiambu County.
Additionally, it functions as a teaching hospital for Egerton University, Kabarak University, the Kenya Medical Training College, and other local medical training institutions, contributing significantly to the training of healthcare professionals in the region.
