Kenya: NCD joint programming mission, 29 September-3 October 2014

NCD Joint programming mission, 29 September - 3 October 2014 Kenya Key mission findings from 2014 1. A number of strategies and polices have been adopted to address NCDs including: a) the National Medium Term Plan (2014-2018) and the National Health Sector Strategic Plan (2014-2018); b) Kenya’s National Strategy for the Prevention and Control of NCDs (2015-2020); c) the Interagency Coordinating Committee for NCDs; and d) NCDs are included in the 2014-2018 UNDAF for Kenya. 2. Multi-sectoral activities undertaken by the National Tobacco Control Unit and the National Tobacco Control Board are considered to reflect best practice. A cross government working group addressing diabetes also exists and others have been developed to address hypertension, violence injury prevention, prevention of harmful use of alcohol and promotion of physical activity. 3. NGOs can be further mobilized to promote awareness of NCDs, but first need to build their capacity and be better coordinated. The private sector is also engaged effectively in support of the National NCD Strategy, particularly as over a third of Kenya’s health facilities are now operated by private sector companies. Probability of premature mortality from NCDs: 13% (2016) 13% of adult men and 16% of adult women are insufficiently physically active (2016) 4% of adult men and 4% of adult women have raised fasting blood glucose (2014) 19% of men and 1% of women (aged >= 15 years) smoke tobacco (2016) 15% of adult men and 31% of adult women are overweight (2016) 93% of adult men and 95% of women consume insufficient amounts of fruit and vegetables (2015) Pure alcohol per capita consumption: 3.4 litres per year (population 15+, 2016) 21% of adult men and 19% of adult women have raised blood pressure (2015) Key adult NCD mortality and risk factors*: “This Task Force mission has re-awoken us to the numerous avenues of support and collaboration within and outside the health sector in line with the multi-sectoral nature of NCDs.” James Macharia Kenya Cabinet Secretary for Health Updated: July 2018 Adding value: actions taken following the mission 1. The National NCD Strategy (2015-2020) has been finalized and an NCD coordination mechanism launched. 2. NCDs are now included in the National Health Insurance Fund, which has historically covered inpatient care. As of mid-2015, the fund also covers outpatient care (e.g. diabetes, hypertension and cancer). 3. The government has given higher priority to the prevention of cervical cancer, a major killer of women in Kenya, through purchasing and equipping most health facilities with cryotherapy machines and trained health workers to screen women for cervical cancer. Those found to be in the early stages are treated immediately. 4. A community health workers’ NCD training kit has been prepared and launched. 5. A National Physical Activity Action Plan is finalized and awaits printing and official launch while the National Cardiovascular Disease Management Guidelines are finalized, to be launched on World No-Tobacco Day 2018 (the theme this year is tobacco and heart diseases). 6. An increasing number of partnerships have been created between the private sector, civil society organizations and community-based groups. 7. The “Healthy Heart Africa” campaign on hypertension awareness, screening and treatment was launched in partnership with Astra Zeneca and six local implementing partners. 8. Private-Public Partnerships on NCDs are gaining momentum, with four currently planned. Examples include: Novo Nordisk’s Base of the Pyramid project, the Novartis Access project and Path’s ‘No Empty Shelves’ project. 9. Resource mobilization campaigns on NCDs have been launched, e.g. the NCD Alliance/ Ministry of Health gala dinner. Key recommendations from 2014 1. The government should place greater focus on premature deaths and on the most cost-effective, evidence-based and feasible interventions. 2. A cross-government costed NCD communications strategy should be developed. 3. An economic and investment case for the prevention and control of NCDs should be made to fast track government funding on NCDs. 4. Annual tax increases on tobacco products and alcohol should be introduced. Next steps 1. Complete the NCD investment case. 2. Identify financing to support: (a) effective implementation of the national integrated NCD prevention and control strategy; (b) finalization and dissemination of draft policy documents, strategic plans, action plans and guidelines; (c) dissemination of STEPS survey results at county level; and (d) sensitization and capacity building in Kenya’s 47 counties. 10. Tobacco control regulations, including graphic health warnings, have been introduced and are in force; however the tobacco industry continues to scuttle the process. 11. A tobacco tax was introduced but in 2017 the government went to a two tier system where it separated filtered and unfiltered cigarettes. Plans are underway to revert to the one tier system. The Government also plans to use revenue from tobacco taxes to achieve the Universal Health Coverage, one of the president’s four priority areas. 12. An investment case for priority best buy interventions is currently being developed between the Ministry of Health, RTI and the Institute for Health Metrics and Evaluation at the University of Washington. 13. Targeted NCD indicators have been integrated into Kenya’s existing health management information system platform. *All data are rounded WHO crude country comparable estimates taken from the WHO Global Health Observatory, who.int/gho/ncd/ en, accessed 18/6/2018, with the exception of rounded data for consumption of fruit and vegetables, which comes from Kenya STEPS survey, 2015, accessed 18/6/2018. Additional information on the status of NCDs in Kenya can be found on the WHO NCD DataFinder app. © World Health Organization 2018. All rights reserved. WHO/NMH/NMA/18/82