DISEASE BURDEN

March towards fewer cancer deaths

Treatment has been decentralised so detected cases are linked to care.

In Summary

• Kenya has prioritised prevention and control of NCDs as part of its progress towards Vision 2030.

• Government has set up strategies to increase manpower in oncology services, investment in equipment and automation of healthcare towards sharing of skills. 

FEWER CANCER DEATHS
FEWER CANCER DEATHS
Image: OZONE

Non-communicable Diseases (NCDs), including cancer, are chronic, caused by a combination of genetic, physiological, environmental and behavioural factors. The NCDs kill 40 million people annually, equivalent to 70 per cent of all deaths globally, according to the World Health Organization.

Currently, Kenya is experiencing an epidemiological transition in its disease burden from infectious to NCDs, resulting in a double burden. The largest burden comes from cardiovascular diseases, common infectious diseases and cancers, respectively. The top five common cancers in Kenya include Breast, Cervical, Oesophageal, Prostate and Colorectal.

The number of cancer cases has risen due to an ageing population resulting from improved life expectancy and increasing adoption of risky behaviours such as consumption of unhealthy diets, lack of physical exercise, harmful use of alcohol and tobacco use. Infections due to HIV, Human Papilloma Virus, Hepatitis B and C viruses have also contributed significantly to the cancer burden in Africa.

It is estimated that 47,887 new cases of cancer are detected annually, with about 3,200 new cases among children below 18 years. And 32,987 people die of cancer annually in Kenya. The increased reported cases of cancer are also attributed to increasing awareness among Kenyans and better diagnostic capacities.

Consequently, Kenya has prioritised prevention and control of NCDs as part of its progress towards Vision 2030 and launched the National Strategy for the Prevention and Control of Non-Communicable Diseases 2015-2020 and the National Cancer Control Strategy 2017-2022 as key policy documents.

Screening for breast cancer is now routinely done through manual palpation at all primary healthcare facilities and that of the cervix through visual inspection using a special dye. Mammography services are available in every county referral hospital following the implementation of the National Government’s Managed Equipment Service project while screening for colorectal cancer is available at Level 5 and 6 facilities.

The aim of the cancer strategy is to reduce cancer incidence, morbidity, mortality through prevention, screening and early detection, effective partnerships in diagnostics, treatment, palliation, financing, setting up cancer registries and research.

The government has set up other strategies to increase manpower in oncology services, investment in equipment and automation of healthcare towards sharing of human resource skills across the country leading to increased access to cancer services, and reduced the patient load at the national referral hospitals as well as waiting time.

Screening for breast cancer is now routinely done through manual palpation at all primary healthcare facilities and that of the cervix through visual inspection using a special dye. Mammography services are available in every county referral hospital following the implementation of the National Government’s Managed Equipment Service project while screening for colorectal cancer is available at Level 5 and 6 facilities.

Secondly, treatment services have been decentralised so that detected cases are linked to care. Kenyans are now able to access chemotherapy in seven county referral hospitals in Mombasa, Kisumu, Kakamega, Garissa, Nyeri, Nakuru and Meru. Similar services will soon be available in Embu, Bomet and Machakos hospitals.

The hospitals have been kitted with chemotherapy chairs, biosafety hoods, essential drugs and capacity building for health workers. The essential medicines for cancer are procured through Kemsa and availed to all county chemotherapy units as well as to Kenyatta and Moi teaching and referral hospitals.

In addition, there are ongoing interventions to further strengthen our capacity to manage cancer, which include operationalisation of the Kenyatta University Hospital within a month at an estimated cost of Sh1.5 billion and construction of radiotherapy centres in Mombasa, Garissa and Nakuru at a cost of Sh1.5 billion, which will be ready for use by December this year.

Other initiatives include the equipping of Moi Teaching and Referral Hospital with radiotherapy equipment by end of this year valued at Sh350 million and establishment of an Oncology Reference laboratory at the National Public Health Laboratory within a month to support county labs in cancer diagnosis. The project will leverage on the specimen referral networks already established under the HIV and TB programmes.

On financing and access, the NHIF’s oncology package, which covers consultation, radiotherapy and chemotherapy, has enabled Kenyans to access cancer treatment in public and private sectors.

To ensure provision of quality healthcare, Kenya has a progressive increase in the number of oncologists, which currently stands at 35 with an additional 20 in training institutions while short-term local training programmes have been established in collaboration with local teaching institutions.

Cabinet Secretary, Ministry of Health