OBJECTIVES Counter referral success rate is defined as number of patients received back at the original referring service with counter referral slips divided by the total number of patients referred and received at the referral hospital. Study objective was to determine the number of patients who returned counter referral slips to the original referral service for confirmation of arrival to the hospital. METHODS Quasi -experimental study was carried out in two sub- locations in Kenya where hundred community health workers were trained on community based referral and counter referral model and issued with referral tools. Each was assigned 25 households, instructed to regularly visit them in order to identify sick persons counsel and refer them to link hospitals. One hundred villages comprising 2209 households with a population of 11,000 people were covered where the counter referral model was implemented. RESULTS During the 12 months of implementation, a total of 322 patients were identified, counseled and referred to link hospitals of whom 93% (298/322) arrived the hospitals with referral and counter referral slips. The study showed that forty six percent (138/298) of counter referral slips had the name, signature and date of referring health worker, only 12 % (35/298) indicated CHW’s telephone contact. Forty one percent (121/298) had the name and signature of attending physician of which 96% (116/121) had hospital stamp. Further, forty seven percent (140/298) of the patients returned counter referral slips to the original referral service for confirmation of arrival at the referral hospital. Fifty one percent (117/228) were satisfied with referral and counter referral process. CONCLUSIONS It is concluded that referral and counter referral model is both feasible and acceptable. However, referral protocols and other resources are necessary for the process to be successful. Further, both ends should be willing and prepared to receive those being referred there.