Addressing NCDs to Fast-Track Achievement of Universal Health Coverage

The emerging prevalence of Non–Communicable Diseases (NCDs) and related risk factors may reverse Kenya’s recent gains in health, unless urgent and deliberate actions are taken.

It is estimated that non-communicable diseases account for 27% of all deaths suffered by Kenyans, equivalent to almost 100,000 people per year (WHO, 2016). Over 50% of all hospital admissions are as a result of NCDs.

The burden of disease brought about by non-communicable diseases is a major public health concern which has resulted in a significant socioeconomic drag for Kenya, a nation just emerging as a low middle-income country, and presented an additional burden for the health system that it can ill afford.

The rise of NCDs has been driven by primarily four major behavioural risk factors: tobacco use, physical inactivity, the harmful use of alcohol and unhealthy diets. Kenya’s National Strategy for the prevention and control of non-communicable disease (2015–2020) indicates that total tobacco smoking is estimated at 26% among Kenyan men and more than a quarter of youth (25%) are exposed to second hand tobacco smoke at home. Prevalence of insufficient physical activity for adults aged 18 and over was estimated to be 10% in men and 14% in women in 2010; around 30% of Kenyan adults are overweight, around 9% are obese, and the total estimated consumption of pure alcohol in Kenya is 4.3 litres per adult aged 15 years and above per year.

In addition the four major risk factors, air pollution, environmental degradation, climate change and psychological stress including chronic stress related to work or unemployment, may contribute to morbidity and mortality from cancer, cardiovascular disease and chronic respiratory diseases. Exposure to environmental and occupational compounds such as asbestos, petroleum exhaust gases, and ultraviolet radiation in the living and working environment also increase the risk of cancer.

Fortunately, NCDs are largely preventable though behavioural interventions. Up to 80 percent of premature deaths from heart disease, stroke and diabetes can be averted with evidence-based behavioural and pharmaceutical interventions. In developed countries, the population often benefits from Governments’ plans to reduce the exposure to risk factors for NCDs, while strengthening the capacity of individuals and populations to make healthier choices.

The country is grappling with low levels of awareness on strategies of prevention and control of NCDs among health policy makers, planners and health care providers at both national and county government levels. To stem the impact of NCDs, we need to raise awareness at the highest levels of government to ensure that all parts of government and society respond to the challenges of NCDs. This way, health gains can be achieved much more readily by influencing public policies in sectors beyond health, than by making changes in health policy alone.

In light of the above, the second Universal Health Coverage (UHC) Conference which will be held from September 12 to 13, 2018 in Nyeri County will focus on addressing NCDs. The conference which has been organised by Kenya Vision 2030 Delivery Secretariat in collaboration with the Ministry of Health, Amref Health Africa in Kenya, Nyeri County, Kenya Healthcare Federation, and Kenyatta University will be an interdisciplinary platform that brings together national and county governments and other key stakeholders to discuss, share and learn of innovative and transformative solutions to halt and reverse the raging non-communicable diseases epidemic.

Among the topics for discussion will be the need to regularly formulate and review existing legislation and policies that ensure the population is protected from exposure to the risk factors. We need to place stronger emphasis on protecting people from exposure to highly processed foods and beverages loaded with unhealthy fats, salt and sugar and raising awareness on the dangers of these foods among the population. There is also need to regulate the food and beverages industry, the alcohol and tobacco sectors and other activities associated with NCDs.

We need to ensure there is a favourable environment for a whole-of-government, whole-of-society and health-in-all policies approach across the key sectors to address NCDs. These sectors include health, agriculture, communication, customs, education, energy, environment, food, housing, industry, sports, trade, transport, urban planning and youth affairs among others.

We also need to strengthen the health systems to sustainably address NCDs. This includes addressing the inadequate capacity of the health workforce to deal with NCDs. Amref Health Africa for example has been working closely with the Ministry of Health to develop curricula and to train health care workers and community health volunteers. In addition, there is need to advocate for better access to essential medicines and technologies for early detection and management of NCDs. This includes ensuring the UHC Health Benefit Package under development adequately caters for NCDs and adequate resources are allocated to health and specifically NCDs both at national and county level.

Addressing NCDs will ensure that Kenya remains on course to achieve the UHC agenda

Dr Meshack Ndirangu

Dr. Ndirangu is the Country Director at Amref Health Africa in Kenya @Amref_Kenya, Twitter: @meshackn