Reframing non-communicable diseases and Injuries for equity in the era of universal health coverage: findings and recommendations from the Kenya NCDI poverty commission
JavaScript is disabled for your browser. Some features of this site may not work without it.
Reframing non-communicable diseases and Injuries for equity in the era of universal health coverage: findings and recommendations from the Kenya NCDI poverty commission
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.