Abstract:
In Kenya, non-communicable diseases (NCDs) are an increasingly important cause of mor-
bidity and mortality, requiring both better access to health care services and self-care sup-
port. Evidence suggests that treatment burdens can negatively affect adherence to
treatment and quality of life. In this study, we explored the treatment and self-management
burden among people with NCDs in in two counties in Western Kenya. We conducted a
cross-sectional survey of people newly diagnosed with diabetes and/or hypertension, using
the Patient Experience with Treatment and Self-Management (PETS) instrument. A total of
301 people with diabetes and/or hypertension completed the survey (63% female, mean
age = 57 years). They reported the highest treatment burdens in the domains of medical
and health care expenses, monitoring health, exhaustion related to self-management, diet
and exercise/physical therapy. Treatment burden scores differed by county, age, gender,
education, income and number of chronic conditions. Younger respondents (<60 years)
reported higher burden for medication side effects (p<0.05), diet (p<0.05), and medical
appointments (p = 0.075). Those with no formal education or low income also reported
higher burden for diet and for medical expenses. People with health insurance cover
reported lower (albeit still comparatively high) burden for medical expenses compared to
those without it. Our findings provide important insights for Kenya and similar settings where
governments are working to achieve universal health coverage by highlighting theimportance of financial protection not only to prevent the economic burden of seeking health
care for chronic conditions but also to reduce the associated treatment burden.