Health officials investigating why many patients still prefer India for cancer treatment, yet Kenya has made huge investments, have found surprising answers.
They say low cost of treatment is no longer the main reason many Kenyans choose India.
Mary Wangai from the Ministry of Health's Department of International Health Relations, and colleagues from Kenyatta National Hospital and the University of Nairobi, said most patients are after quality care.
Most patients treated in India are influenced by the perceived superior quality of care there, the country’s advanced medical facilities, referrals from Kenyan doctors, and the general reputation of the country.
These are the main reasons Kenyan patients gave last year after obtaining travel approval for cancer treatment abroad from the Ministry of Health.
Cost came fifth as a factor for these patients.
However, it still remains a major reason with many patients saying cancer treatment in India is cheaper than at local private hospitals.
“The Kenyan Ministry of Health reports also show that cancer is the third highest cause of mortality and the commonest health condition prevalent among medical tourists,” Wangai and her colleagues say in a recently published paper.
They interviewed 254 patients, where 174 (69.5 per cent) were treated for cancer in Kenya and 80 (31.5 per cent) in India.
Those going to India were recruited from the Ministry of Health’s records while the locally treated patients were chosen from KNH, and Texas Cancer Center, a private hospital in Nairobi.
Patients treated in Kenya said advice from doctors and cost were the main reasons they were stuck in the country.
All the patients sampled suffered various forms of cancers: reproductive tract cancers (126 cases), gastrointestinal tract cancers (46), blood cancers (30) and ear, nose and throat cancers 24.
Wangai and her colleagues said the choice to travel to India was significantly associated with higher monthly income with those flying out likely to earn more than Sh30,000 a month.
They also realised most patients travelling to India had probably tried treatment locally without satisfactory improvement.
The majority had known of their diagnosis for an average period of 26 months, while those treated in Kenya had an average duration of eight months.
“We found that traveling to India was associated with the male gender, urban dwelling, higher education background and government or NGO employment,” the researchers added.
They published their finding in the Plos One journal last September in a paper titled: “Understanding and comparing the medical tourism cancer patient with the locally managed patient.”
Dr Catherine Nyongesa, who heads KNH cancer treatment centre and is the proprietor of Texas Cancer Centre, took part in the study.
With regard to cancer categories, most patients going to India had blood cancers while most of those diagnosed with reproductive organ cancers were managed in Kenya.
The authors also found that private hospitals referred a higher proportion (73 per cent) of patients to India compared with government hospitals (eight per cent).
They also revealed the two main cancer treatment financers were the National Health Insurance Fund and out-of-pocket funds.
Private insurance companies funded only three per cent of the respondents while employers paid for one per cent of the patients.
“The NHIF funded 47(58.8 per cent) of respondents that sought treatment in India while 98 (56.6 per cent) respondents were funded to receive treatment in Kenya,” the authors said.
“This implies that NHIF equally finances treatment in and out of the country. Interestingly, the biggest group that were supported to receive treatment in India by NHIF were government employees (41.9 per cent) and the self-employed (30.4 per cent) respondents,” they said.
The medics advised that in a order to reverse the outward-bound medical tourism Kenya must increase early diagnosis and early initiation into comprehensive cancer care.
They also recommended increased training of health workers and upgrading to offer cutting-edge procedures such as bone-marrow transplants at a low cost.
“Third, develop a partnership with hospital chains in India to provide cancer treatment in Kenya in the short term,” they said.
They also advised the government to continually sensitize physicians in private and public health facilities, and the general public on the availability of comprehensive, specialized and cost-effective cancer care within Kenya.
“This will increase the confidence of health worker in the capacity of in-country health facilities to provide highly specialized cancer care,” the authors said.
According to the ministry, Kenyans spend about Sh10 billion every year in medical tourism, mostly to India.
