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Background: Cancer is the third-leading cause of mortality in Kenya, resulting in unique challenges to the country’s
health system. An increase in the number of cancer cases in Kenya over the past decade resulted in legislative
actions and policies to guide delivery of cancer services. Kenya’s new national cancer control strategy and past
policy efforts provide an opportunity to synergise information and enhance understanding to improve cancer
diagnosis and treatment in the country. The objectives of this study are to (1) document policy-modifiable factors
based on a review of policy documents and results of a key informant survey and (2) develop recommendations to
improve policies affecting cancer testing and treatment services in Kenya. This study builds upon our previous
study Improving Access to Cancer Testing and Treatment in Kenya (Makau Barasa et al. J Global Oncol 2(216), 2017).
Methods: The study applied an in-depth systematic review of Kenya’s cancer policies and guidelines, a qualitative
analysis of results from a section of a semi-structured key informant survey focused on the opinions of clinicians
delivering cancer services as well as cancer support groups and advocacy leaders, and a stakeholder analysis
identifying key policy-makers and implementers. Details of the complete key informant survey were published in
our previous study.
Results: Kenya’s cancer policies have guided progress made in providing the legal and implementation frameworks
for the development and delivery of cancer services at the national and county levels. Some policy implementation
gaps are noted. These include inadequate financing for cancer services, limited research and data to support policy
formulation, and the concentration of cancer services in urban areas. The key informant survey identified policy modifiable actions that can address some of the gaps and improve the delivery of and access to cancer testing and
treatment services in the country. Some of these include addressing the financial barriers affecting cancer testing
and treatment services; increasing stakeholder engagement in training health personnel to deliver cancer testing
and treatment services; decentralising cancer services and improving cancer surveillance and research; and
increasing education and awareness about cancer symptoms, screening procedures and treatment options. A set of
priority policy actions were selected from the study findings and used to develop recommendations for Kenya’s
policy-makers and stakeholders Conclusions: Revisions to Kenya’s cancer policies are seeking to address gaps noted in past policies and to
improve access to cancer testing and treatment in Kenya. However, based on study findings, additional actions can
be taken to strengthen policy implementation. Considering the policy formulation and implementation process and
costs, this study recommends focusing on three priority policy actions that can have significant impact on
improving access to cancer testing and treatment services. These include addressing financing, insurance and
human resources gaps; increasing stakeholder engagement; and decentralising health services for better
surveillance and data to inform policies. |
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