CHRONIC DISEASES

NCD burden calls for new strategy

For every Sh104 invested in scaling up action there will be a return of at least Sh730

In Summary

• Insurance industry has introduced stand-alone critical illness cover.

• Public health approach of primary prevention is considered to be the most cost-effective, affordable and sustainable course of action.

A woman undergoes an examination at Railways Club during a function to mark World Heart Day, September 29, 2013.
A woman undergoes an examination at Railways Club during a function to mark World Heart Day, September 29, 2013.
Image: FILE

Non-Communicable Diseases (NCDs) account for more than 50 per cent of total hospital admissions and over 55 per cent of hospital deaths in Kenya.

Chronic illnesses—cancer, heart attack, stroke, renal/kidney failure and dementia, among others—require extensive medical care and treatment. Besides death and disability, chronic diseases pose a great burden to the economy, as they affect the working population. The cost of treatment can outstrip a family’s cash flows and/or medical insurance policy quickly.

As most households lack emergency funds for chronic illnesses, paying for medical bills in cash exposes them to catastrophic healthcare expenditure and extreme financial strain.

As a result, more people are finding themselves financially drained. This is most common in situations where one does not have medical insurance. In some cases, even with medical insurance, some may exhaust their annual limit or have a cover that excludes certain conditions.

The growing financial burden of these illnesses has prompted the insurance industry to introduce stand-alone critical illness cover, which ensures that one receives the financial assistance one needs to seek treatment in the event they are diagnosed with any of the mentioned diseases.

With the critical illness cover, the beneficiary is provided with a lump sum payment on the first diagnosis of any of the covered severe illnesses and life-threatening conditions.

Diet has been known to be a key risk factor for chronic diseases which if properly managed, is critical to preventing these diseases. Physical inactivity, now recognised as detrimental to health, is the result of a progressive shift of lifestyle towards more sedentary patterns in developing countries as much as in industrialised ones.

While the insurance industry intervention is helping to address the financial burden of NCDs, several factors continue to constrain progress in the prevention and care of these diseases.

These include underestimation of the effectiveness of interventions, the belief of there being a long delay in achieving any measurable impact, commercial pressures, institutional inertia and inadequate resources. Existing healthcare systems are also ill-equipped to manage this rising chronic disease burden.

There is need for action to strengthen control and prevention, and provide measures to better manage chronic diseases, especially in developing countries.

The public health approach of primary prevention is considered to be the most cost-effective, affordable and sustainable course of action to cope with chronic diseases.

 

While age, gender and genetics cannot be changed, many of the risks associated with age and gender vary. They include behavioural factors such as diet, physical inactivity, tobacco use, alcohol consumption; biological factors such hypertension, overweight, hyperinsulinemia; and finally, societal factors, which include a complex mixture of interacting socioeconomic, cultural and environmental parameters.

Diet has been known to be a key risk factor for chronic diseases which if properly managed, is critical to preventing these diseases. Physical inactivity, now recognised as detrimental to health, is the result of a progressive shift of lifestyle towards more sedentary patterns in developing countries as much as in industrialised ones.

There are many opportunities for national action, including strengthened interaction and partnerships; regulatory, legislative and fiscal approaches; and more stringent accountability mechanisms.

We need to develop policy frameworks that reflect the national burden of critical illnesses, funding constraints and the nature of the healthcare system while also taking cultural factors into account.

There is an opportunity to leverage primary care clinics established to deliver reproductive, maternal and child health to extend the provision of screening and treatment for cervical cancer and hypertension, as well as patient education programmes.

Investing in NCDs control generates major financial and health gains for the population. According to a WHO report, for every $1 (Sh104) invested in scaling up actions to address NCDs in low- and lower-middle-income countries, there will be a return to society of at least $7 (Sh730) in increased employment, productivity and longer life.

Deputy director, NIC Insurance Agents

[email protected]