By Gatonye Gathura
The Ministry of Health may have set a world record becoming the first to adopt a major policy shift and then go out to search for supporting evidence.
Last year the ministry published the Kenya Health Policy 2014-2030 which for the first time in the country’s history shifts public health care emphasis to non-communicable diseases.
But experts quickly took issue with the policy arguing it was not based on any sound medical or scientific data. They have argued that all available evidence indicates communicable diseases are and will continue being the biggest health challenge in the country.
The Nairobi based African Institute for Development Policy (AFIDEP) in a detailed communication say if any, the policy was based on data of questionable quality.
This Dr Rose Oronje of AFIDEP says is particularly so for evidence arising from programme implementing organisations, which often implement small pilot programmes. Data from such pilots many not be nationally representative.
“Without these programmes going through rigorous evaluations, the evidence they generate remains questionable.”
Dr Oronje in her brief: Evidence-informed policy-making in Kenya’s health sector: The devil is in the quality of evidence, had in February promised to take up the issue with the government.
But in a masterstroke the Ministry last week disarmed Dr Oronje when it presented what it calls the first national survey of non-communicable diseases claiming in part they kill 100,000 people in the country annually.
However according to the ministry there are an estimated 420,000 deaths in Kenya annually, out of which 64 per cent, 26 per cent, and 10 per cent are due to communicable, non-communicable, and injury conditions, respectively.
Cancer which has the working and middle class in Kenya panicked accounts for only seven per cent of deaths but more than 90 per cent of health headlines.
The non communicable diseases survey was by among other funded by the British-Swedish multinational pharmaceutical and biologics company AstraZeneka. A major player in the study was the Nairobi based NGO the African Population and Health Research Center, (APHRC).
The NGO, affiliated to the APHRC Inc. of the US has in the past done some research on non communicable diseases in Kibera slums.
Dr Oronje says many health experts had observed how the policy shift had been influenced by global trends and especially because foreigners have a big sway in Kenya’s policy making process.
It is notable that the policy shift coincided with the introduction of the controversial multi billion shilling medical equipment leasing programme.
APHRC has also been significantly involved in the development of the Adolescent Sexual and Reproductive Health Policy of 2015 which has also raised credibility issues from AFIDEP.
APHRC is most likely remembered for its 2013 landmark study which claimed that 464,690 abortions were carried out in Kenya in 2012.
But curiously while all evidence indicates the study was done by three NGOs it was claimed to be a Ministry of Health research. Consequently was launched with huge fanfare by the government while printed on official letterheads
On 21st August 2015 a version of the study was published by the NGOs in the international journal BMC Pregnancy & Childbirth.
In both documents all the planning conceptualizing, planning, carrying out the study, analyzing, the write up as well as the revision of the paper was done by 11 people all from the three NGOs.
Six from the African Population and Health Research Center, two from Ipas and three from the Guttmacher Institute, the latter a US organization promoting sexual and reproductive health rights including abortion.
Soon after, the government launched the National Adolescent Sexual and Reproductive Health Policy which was largely seen as a major win for local and international pro-abortion groups.
The policy also created a much wider market for abortion and birth control biomedicals by giving 10-year-olds the right to confidentially access these products.
But it is not only policy experts who are questioning research processes in the country. Currently Kenya’s National Assembly committee on health is investigating how the Kenya Medical Research Institute is colluding with some NGOs to divert resources.