New Referral System Aims to Reduce Patient Overcrowding

Kenya’s Ministry of Health is pushing forward a strengthened national referral system designed to ease overcrowding in referral hospitals and improve efficiency across the health sector. At a high-level meeting with referral hospital CEOs on 14 July 2025, Health Cabinet Secretary Aden Duale called for urgent reforms to reinforce coordination between primary, secondary, and tertiary health facilities.
A cornerstone of the reform is better resource allocation. The government has emphasized ensuring each hospital’s bed capacity is accurately recorded in regulatory systems so patients are not mistakenly sent to already overburdened referral hospitals. Duale also directed hospitals to procure additional beds to tackle the problem of patients sleeping on the floor or sharing beds.
Technology is playing a critical role. In Nakuru County, officials are rolling out a digital JOIN platform that supports e-referrals, telemedicine, and follow-ups. This system will allow referring facilities to track whether referred patients actually make it to the higher-level hospital, whether treatment is completed, and feedback from the receiving facility — all vital for improving referral outcomes.
In addition to digitisation, counties are also decentralizing services to reduce unnecessary referrals. For example, under the National Equipment Service Programme (NESP), 14 counties recently received CT scanners, which means fewer patients needing to be referred to national hospitals for scans. By bolstering capacity in county hospitals — through both infrastructure and human resources — the government hopes to strengthen level‑4 and level-5 facilities, ensuring that only cases requiring specialized, tertiary care are referred upward.