TACOMA, Washington — The “burden of disease” is the measure of loss in a human population from death before life expectancy or disability resulting from diseases, risk factors and injuries. The burden is much higher in developing nations and countries that lack quality healthcare infrastructure and technology. With high poverty rates and underdeveloped rural areas, many people lose their lives to diseases that could otherwise be treatable or preventable. Factors that affect the spread and severity of disease compound as well. Kenya is a nation that has a triple burden of disease.
The Terrible Three
Kenya is a lower-middle-income country facing a triple burden of disease from neonatal diseases, communicable diseases and noncommunicable diseases (NCDs). Neonatal diseases, together with communicable, maternal and nutritional diseases, account for 63% of deaths in the country, whereas NCDs account for 27% and injuries for 10%.
An epidemiological transition has shifted the burden of disease in Kenya from communicable to noncommunicable. The former still persists, but improved socioeconomic status has led to a demographic shift, increasing the life expectancy from 46.76 years in 1960 to 66.342 years in 2018.
- Neonatal diseases are a threat to infants under one-years-old and are usually vaccine-preventable. One such disease is pneumonia caused by the pneumococcal virus, the world’s deadliest disease for children under five years.
- Communicable diseases can spread through contact with infected agents or carriers. Unhealthy living conditions are risky. Kenya’s Kibera slum, for example, has 200 water points for approximately 200,000 residents. The unsanitary conditions, poor access to water and crowded housing are conducive for communicable diseases such as the highly infectious COVID-19.
- NCDs encompass lifestyle and environmental illnesses. Some contributing factors include tobacco use, obesity and stress, accounting for 27% of all deaths in Kenya. Deaths from NCDs typically come in the form of cancer and cardiovascular disease. A 2015 survey on NCDs in Kenya found that approximately 13% of those surveyed were tobacco users, 12.7% were heavy alcohol consumers, 94% ate less than the recommended daily servings of five fruits and vegetables and 6.5% had sub-par daily physical activity levels. Additionally, people with mental illness are at higher risk of developing chronic illnesses such as heart disease and diabetes.
Kenya’s Ministry of Health (MoH) is committed to curbing all vaccine-preventable diseases. The Kenyan Government partnered with Gavi, an organization dedicated to vaccinating children in the world’s developing countries, to introduce the pneumococcal conjugate vaccine, reducing the prevalence of the pneumococcal disease by two-thirds in 2016. Between 2011 and 2016, Gavi had supported Kenya with several vaccines, approximately $350 million in funds and a digitized health surveillance program to improve overall healthcare delivery.
Compared to 78% in 2000, 89% of children 18-23 months of age received a measles vaccine in 2018 and the country had a DTP3 immunization coverage of 81%. Kenya also entered a “preparatory transition” stage with Gavi’s support to become self-financing.
In 2019, the MoH and UNICEF provided 2.25 million Polio vaccine doses and 1.9 million doses of measles and rubella vaccines. Kenya also achieved its Maternal Neonatal Tetanus Elimination Goals in addition to providing free immunization services at over 9,000 health facilities countrywide. Between 2000 and 2019, Kenya had reduced the burden of disease from vaccine-preventable diseases by 70%.
In 2015, a task force released the Kenya National NCD Strategic Plan in line with WHO’s 2013-2020 plan to reduce the world’s NCD mortality rate by 25% by 2025. WHO targets involved the reduction of tobacco use, physical inactivity, salt consumption, blood pressure and obesity. As of 2017, nine out of every 10 Kenyans had access to essential medication and four out of six to essential health technologies to treat NCDs.
The MoH released the 2018-2023 National Physical Activity Action Plan to prevent NCDs in the country. The plan aims to create awareness of NCDs and increase physical activity in schools and local communities. Guidelines and policies have also been implemented to facilitate healthier practices.
The NCD Alliance of Kenya (NCDAK) is an independent organization lobbying for NCD control in Kenya. In 2018, NCDAK, together with the MoH and Safaricom, launched a digital public platform “Fafanuka” for NCD awareness.
Controlling Communicable Diseases
The Government has a mHealth application that circulates national health information. This has been crucial in infectious disease control and has facilitated better handling of over 40 infectious diseases in the country between 2015-2020. mHealth also has a “Jitenge System,” a quarantine module used to manage COVID-19.
Easing The Burden During The Pandemic
The Kenyan government continues to take steps to ease the triple burden of disease without compromising access to essential healthcare during the pandemic. To help with National Hospital Insurance Fund services during COVID-19 restrictions on movement, the Government launched a self-care portal accessible through mobile phones. The MoH has also hired more community health workers and availed more equipment and services. These include more PPE, medications, health-promotion guidelines and psychosocial support to altogether curb the pandemic and ease the triple burden of disease in Kenya.
– Beth Warūgūrū Hinga
Photo: Wikimedia Commons