Most health centres can't treat cancer, says report

Most dispensaries and health centres in Kenya cannot diagnose or treat patients with cancer, the second most deadly non-communicable disease in Kenya.

This means most Kenyans with the disease are only diagnosed from level  4 and treated in faraway referral facilities.

Health advocates said this was a key reason for poor outcomes because the disease is only diagnosed when it has progressed.

Cancer is the second leading cause of NCD-related deaths in Kenya after cardiovascular diseases and accounts for eight per cent of overall national mortality, according to the ministry of health.

The assessment on access to services was done by the African Population and Health Research Center and published ahead of the Global Week of Action for NCDs, marked in Nairobi on Thursday

“Where NCDs health services are needed most by the populations (that is, at primary health care, public and rural facilities), they are not always readily available in these settings,” APHRC researchers said in their report published in the BMC Health Services Research journal.

APHRC researcher Dr Welcome Wami and his colleagues surveyed 258 facilities level 2 to Level 6 facilities countrywide, 67 per cent of them being public. Half of the facilities were located in urban areas.

Level 2 refers to dispensaries, Level 3 health centres while Level 4 and above refers to hospitals.

The researchers looked at the service availability and readiness for cardiovascular diseases (CVD), chronic respiratory diseases (CRD), Diabetes Mellitus and cervical cancer.

Of the surveyed facilities, 93.8 per cent offered CRD diagnosis and/or management services, 82.2 per cent diabetes mellitus, 65.1 per cent CVD, and only 24.4 per cent cervical cancer screening.

Modelling results revealed that private facilities were more likely to be “ready” to offer NCDs services than public facilities. Similarly, hospitals were more likely “ready” to provide NCDs services than primary health facilities, the authors said.

Their study is titled “Readiness of health facilities to deliver non-communicable diseases services in Kenya: a national cross-sectional survey.”

It was released ahead of Thursday’s Global Week of Action for NCDs, marked in Nairobi by the Ministry of Health and the NCD Alliance (Kenya).

NCDAK  chief executive Dr Catherine Karekezi asked the government to increase investment in NCDs saying treatment is expensive and leaves families poor.

“Even those who can afford are headed to catastrophic expenditure. Studies show if you have a person with NCD in your household, 28 per cent of house income is spent on NCDs,” she said.

“NCDs are mostly managed from Level 4 which have skilled health professionals but we don’t have diagnostic tools at the lower levels, so when one is diagnosed, the condition has already worsened.”

Karekezi called for the equipping of lower-level facilities with staff and equipment to diagnose and treat NCDs.

“Because of a lack of awareness at the community level people are being misdiagnosed with other conditions like TB, and malaria,” she said.

Head of NCD prevention and control unit at the Ministry of Health Dr Ephantus Maree called for partnerships to tackling the ever-rising burden.

“We are experiencing challenges when it comes to the issue of resources. It was just last year when we developed our next five-year strategic plan, the first-ever costed arrangement for NCDS in this country,” Maree said.

He said, however, there is a need to fully integrate NCDs into Primary Healthcare, and increased funding by all the stakeholders.