Establishing care for sickle cell disease in western Kenya: achievements and challenges

Abstract

Introduction

Sickle cell disease (SCD) is the most common hemoglobinopathy encountered in Kenya. In the western part of the country, about 4.5% of children are born with SCD, and 18% of children are born with sickle cell trait. SCD has contributed significantly to the mortality rate in children younger than age 5 years, primarily because of late diagnosis, educational gaps among service providers, and lack of access to appropriate treatment. Academic Model Providing Access to Healthcare (AMPATH) is part of a collaboration between Moi Teaching and Referral Hospital, Moi University, and Indiana University (including the Indiana Hemophilia and Thrombosis Center). Moi Teaching and Referral Hospital, which operates primarily in the western part of Kenya, has been at the forefront of solving the problem of SCD by partnering with local authorities to help improve comprehensive care for patients with SCD. Go to: Objectives

To improve diagnosis of SCD,

To train clinicians and other health care providers in managing patients with SCD,

To improve access to treatment for people living with SCD, and

To create partnerships with stakeholders involved in caring for people living with SCD.

Go to: Methods

Between 2012 and 2019, AMPATH helped start a comprehensive sickle cell care program that was gradually extended to eight other counties in the western part of the country. The five main pillars of the expansion were:

Training and mentoring clinicians in the satellite facilities (Figure 1),