Kenya’s public health sector misses key life-saving targets

By Gatonye Gathura

The public health sector has failed to meet crucial targets set out to improve the life of Kenyans in the last three years.

A mid-term review of the national five year health plan by the ministry and the World Health Organisation completed in August reveals deteriorating service delivery in the sector.

For example, the review of Kenya Health Sector Strategic Plan 2014–2018 shows a decline in child immunization and almost total failure in prevention and treatment of lifestyle diseases.

The national strategy among others promises to halt, treat and reverse the incidence of non-communicable disease (NCDs) and attendant risk factors.

But the review, also involving the United States Agency for International Development (USAID) tells of an unchecked epidemic of non-communicable diseases.

For the first time the Ministry of Health admits that the rate of obesity in the country especially among women has reached epidemic proportions.

“Kenya has observed a dramatic increase in obesity in a very short time. For instance, the per cent of women with obesity increased from seven per cent to 13 per cent between 2009 and 2015,” says the review.

The increase in overweight and obesity, the review says has been observed in all counties with one in seven women reported to be obese.

However this varied by more than five folds between counties, ranging from less than 15 per cent in northern Kenya to over 45 per cent in cities and the central region.

Two-thirds of all obese women the review shows lived in 10 counties with the top three Nairobi having 216,745, Kiambu 101,365 and Mombasa 71,728 individuals. Nearly one million women aged 15-49 are obese.

The review says latest data from all over the country showed alarming rates of outpatient cases with raised high blood pressure.

Although it estimates almost a quarter of adult Kenyans to have raised high blood pressure only four per cent are receiving treatment.

“Counties in central region and, to a lesser extent, eastern had much higher prevalence of raised blood pressure than elsewhere in Kenya.”

Another major health problem facing Kenyans the report says is diabetes with an estimated prevalence of 1.6 per cent however only about half of these had been diagnosed and the disease controlled in only four per cent by last year.

Equally the number of women screened for cervical cancer, remained low at less than 17 per cent ranging from zero per cent in Wajir to 54 per cent in Mombasa.

According to the review there is no system to monitor the per cent of cancer patients admitted in hospitals in the country.

The ministry says NCDs such as cancers, heart diseases and diabetes represent almost up to 70 per cent of all hospital admissions and up to half of all inpatient mortality. “There is no evidence of reductions in these trends,” says the review.

The report presents evidence showing more children missed lifesaving vaccines last year compared to 2014.

“Even though immunization coverage in infants is still about 80 per cent, there has been a decline in more than two thirds of counties and nationally,” says the review.

Data by county shows that in 34 of the 47 counties full immunization coverage levels in 2015/16 were lower than in the previous financial year.

A total of 290,000 children were not fully immunized last year with Nairobi, Narok, and Bungoma the three worst performing counties.

While the review claims major success in antiretroviral coverage of HIV patients, this is dampened by what it says are increasing cases of new infections estimated at about 100,000 annually.

The ministry is upbeat over its achievement against malaria despite missing 2016 targets to reduce inpatient deaths from the current 11 per cent to eight per cent.

The review, Cabinet Secretary for Health Dr Cleopa Mailu say highlights areas where significant progress has been made and others where greater efforts are required to improve on health care delivery.

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