Kibachio Mwangi1,2,3, Gladwell Gathecha1, Mary Nyamongo4, Sylvester Kimaiyo5, Jemima Kamano5, Fredrick Bukachi6, Frank Odhiambo7, Hellen Meme7, Hussein Abubakar8, Nelson Mwangi8, Joyce Nato9, Samuel Oti10, Catherine Kyobutungi11, Marylene Wamukoya11, Shukri F Mohamed11, Emma Wanyonyi12, Zipporah Ali13, Loise Nyanjau1, Ann Nganga1, Dorcas Kiptui1, Alfred Karagu1, Mary Nyangasi1, Valerian Mwenda1, Martin Mwangi1,8, Aaron Mulaki14, Daniel Mwai15, Paul Waweru16, Mamka Anyona17, Peninah Masibo18,19, David Beran20, Idris Guessous2,21, Matt Coates17, Gene Bukhman17,22, Neil Gupta17,22. 1. Division of Non-Communicable Diseases, Ministry of Health, Nairobi, Kenya. 2. Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland. 3. World Health Organization (WHO) South Africa Country Office, South Africa. 4. African Institute of Health and Development, Nairobi, Kenya. 5. Academic Model Providing Access to Healthcare, Eldoret, Kenya. 6. Department of Clinical Medicine and Therapeutics, University of Nairobi, Nairobi, Kenya. 7. Kenya Medical Research Institute, Nairobi, Kenya. 8. Field Epidemiology and Laboratory Training Program, Nairobi, Kenya. 9. World Health Organization Country Office, Nairobi, Kenya. 10. International Development Research Center, Nairobi, Kenya. 11. African Population and Health Research Center, Nairobi, Kenya. 12. International Institute For Legislative Affairs, Nairobi, Kenya. 13. Kenya Hospices and Palliative Care Association, Nairobi, Kenya. 14. RTI International, Nairobi, Kenya. 15. School of Economics, University of Nairobi, Nairobi, Kenya. 16. Kenya National Bureau of Statistics, Nairobi, Kenya. 17. Program in Global Non-Communicable Diseases and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, USA. 18. Global Programs for Research and Training affiliate of The University of California San Francisco, USA. 19. Moi University School of Public health, Eldoret, Kenya. 20. Division of Primary Care Medicine, Geneva University Hospital and University of Geneva, Geneva, Switzerland. 21. Division of Tropical and Humanitarian Medicine, University of Geneva and Geneva University Hospitals, Geneva, Switzerland. 22. NCD Synergies, Partners In Health, Boston, USA.
Abstract
Background: Kenya has implemented a robust response to non-communicable diseases and injuries (NCDIs); however, key gaps in health services for NCDIs still exist in the attainment of Universal Health Coverage (UHC). The Kenya Non-Communicable Diseases and Injury (NCDI) Poverty Commission was established to estimate the burden of NCDIs, determine the availability and coverage of health services, prioritize an expanded set of NCDI conditions, and propose cost-effective and equity-promoting interventions to avert the health and economic consequences of NCDIs in Kenya. Methods: Burden of NCDIs in Kenya was determined using desk review of published literature, estimates from the Global Burden of Disease Study, and secondary analysis of local health surveillance data. Secondary analysis of nationally representative surveys was conducted to estimate current availability and coverage of services by socioeconomic status. The Commission then conducted a structured priority setting process to determine priority NCDI conditions and health sector interventions based on published evidence. Findings: There is a large and diverse burden of NCDIs in Kenya, with the majority of disability-adjusted life-years occurring before age of 40. The poorest wealth quintiles experience a substantially higher deaths rate from NCDIs, lower coverage of diagnosis and treatment for NCDIs, and lower availability of NCDI-related health services. The Commission prioritized 14 NCDIs and selected 34 accompanying interventions for recommendation to achieve UHC. These interventions were estimated to cost $11.76 USD per capita annually, which represents 15% of current total health expenditure. This investment could potentially avert 9,322 premature deaths per year by 2030. Conclusions and Recommendations: An expanded set of priority NCDI conditions and health sector interventions are required in Kenya to achieve UHC, particularly for disadvantaged socioeconomic groups. We provided recommendations for integration of services within existing health services platforms and financing mechanisms and coordination of whole-of-government approaches for the prevention and treatment of NCDIs. Copyright:
Background: Kenya has implemented a robust response to non-communicable diseases and injuries (NCDIs); however, key gaps in health services for NCDIs still exist in the attainment of Universal Health Coverage (UHC). The Kenya Non-Communicable Diseases and Injury (NCDI) Poverty Commission was established to estimate the burden of NCDIs, determine the availability and coverage of health services, prioritize an expanded set of NCDI conditions, and propose cost-effective and equity-promoting interventions to avert the health and economic consequences of NCDIs in Kenya. Methods: Burden of NCDIs in Kenya was determined using desk review of published literature, estimates from the Global Burden of Disease Study, and secondary analysis of local health surveillance data. Secondary analysis of nationally representative surveys was conducted to estimate current availability and coverage of services by socioeconomic status. The Commission then conducted a structured priority setting process to determine priority NCDI conditions and health sector interventions based on published evidence. Findings: There is a large and diverse burden of NCDIs in Kenya, with the majority of disability-adjusted life-years occurring before age of 40. The poorest wealth quintiles experience a substantially higher deaths rate from NCDIs, lower coverage of diagnosis and treatment for NCDIs, and lower availability of NCDI-related health services. The Commission prioritized 14 NCDIs and selected 34 accompanying interventions for recommendation to achieve UHC. These interventions were estimated to cost $11.76 USD per capita annually, which represents 15% of current total health expenditure. This investment could potentially avert 9,322 premature deaths per year by 2030. Conclusions and Recommendations: An expanded set of priority NCDI conditions and health sector interventions are required in Kenya to achieve UHC, particularly for disadvantaged socioeconomic groups. We provided recommendations for integration of services within existing health services platforms and financing mechanisms and coordination of whole-of-government approaches for the prevention and treatment of NCDIs. Copyright:
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