National Strategic Plan for the Prevention and Control of Non-Communicable Diseases

Objectives

Kenya’s National Strategic Plan for the Prevention and Control of Non-Communicable Diseases provides a five-year blueprint for national and county action to halt and reverse the rising burden of non-communicable diseases (NCDs). Its vision is a nation free from the preventable burden of NCDs, and its mission is to secure accessible, affordable, quality, equitable and sustainable care across the NCD continuum through multisectoral collaboration and partnerships.[1]The overall goal is to reduce premature mortality from NCDs by one third by 2025, contributing to Universal Health Coverage, the Sustainable Development Goals and Kenya Vision 2030.[1][2]

• Address a broad NCD scope comprising cardiovascular diseases, cancer, diabetes, chronic respiratory diseases, mental health conditions, violence and injuries, haemoglobinopathies, haemophilia and other bleeding disorders, autoimmune and chronic renal diseases, neurological disorders, chronic skin conditions, and oral diseases.[3]
• Reduce exposure to tobacco use, harmful alcohol use, unhealthy diets and toxins, physical inactivity, indoor and environmental air pollution, other pollutants and stress through a life-course approach spanning pregnancy, childhood, adolescence, adulthood and older age.[3][2]
• Strengthen leadership, sectoral and multisectoral coordination, and governance for harmonised NCD prevention and response at all levels.[2]
• Reduce modifiable risks through policy, legislation, fiscal measures, community interventions, school-based action, health promotion, vaccination and risk assessment.[4][5][6]
• Provide equitable, quality, accessible, affordable, responsive and sustainable NCD management across the life course, including prevention, screening, diagnosis, treatment, rehabilitation, palliative care and survivorship support.[4][7]
• Strengthen advocacy, communication and social mobilisation, while promoting research, surveillance, monitoring and evaluation to inform decision-making and health planning.[8][9]

The strategy is guided by equity, universal coverage, a rights-based and people-centred approach, primary health care, evidence-based action, integrity and accountability, gender responsiveness, innovation and technology.[1][3]It recognises that NCDs account for 39% of annual deaths in Kenya and gives priority to population-wide prevention alongside stronger health systems and a comprehensive continuum of care.[10][11]

Implementation

Implementation combines whole-of-government and health-in-all-policies action with integrated, people-centred service delivery from communities and primary care to secondary and tertiary facilities.[1]The plan relies on national and county institutions, civil society, communities, people living with NCDs, development partners, academia and the private sector, recognising that many NCD determinants lie beyond the remit of the Ministry of Health.[10][8]

• Coordinate delivery through the Ministry of Health, the Non-Communicable Disease Interagency Coordinating Committee, a proposed Cabinet-level National Steering Committee, national and county health management structures, and county coordination committees or technical working groups.[4][12][13]
• Maintain stakeholder databases, engage non-health sectors, revitalise intersectoral coordination, convene steering forums, build coordination capacity and develop a multisectoral information-management system.[2][14]
• Engage private-sector actors through an engagement framework covering coordinated resource mobilisation, conflict-of-interest safeguards, reporting arrangements and regular consultation.[4][15]
• Integrate NCD education, screening and follow-up into community health services and level 2 and 3 facilities, supported by an integrated primary-health-care model, technical assistance to counties and an essential NCD management package for universal health coverage.[7][16][17]
• Strengthen workforce capacity through training for community health assistants, community health volunteers, providers and managers; human-resource mapping; career pathways; specialist sharing; and improved deployment and retention.[18][17][19]
• Improve access to essential medicines, diagnostics and technologies through supply-chain strengthening, pooled procurement, local manufacturing where feasible, commodity quantification and costing, affordability negotiations and ring-fenced county commodity funds.[7][9]
• Develop quality-improvement systems, telehealth, clinical guidance, job aids, integrated screening and referral pathways; establish county wellness centres and five regional comprehensive NCD centres by 2025.[7][20][21]

Monitoring, evaluation, accountability and learning are organised through a Common Results and Accountability Framework that integrates information across relevant sectors and supports efficiency, transparency and accountability at national and county levels.[22]It includes fifteen high-impact indicators linked to national and global commitments, routine data, surveys, special research, annual data-quality audits, annual performance reviews, and mid-term and end-term implementation reviews.[22][23]Data are intended to be disaggregated by sex and age, and the NCD department is responsible for implementation tracking while counties receive support supervision.[22]

Operational reporting includes weekly surveillance reports, monthly facility reports and expenditure returns, quarterly health-data reviews, annual work plans and annual performance reviews.[24]The plan also provides for integrated electronic medical records, disease-specific registries, standardised surveillance and patient-management tools, Kenya Health Information System reporting, research prioritisation, population surveys and annual NCD burden estimates.[22][25]

Financing is to be supported by Activity-Based Costing and the One Health Model, with estimated plan-period resource requirements of Kenya Shillings 377 billion.[26]Resource mobilisation includes national and county budget advocacy, donor engagement, public-private partnerships, civil-society collaboration, community mobilisation, resource tracking and inclusion of NCD expenditure in National Health Accounts.[27][13]

Monitoring & Evaluation

The strategy establishes a monitoring, evaluation, accountability and learning framework to track implementation, effectiveness, efficiency, relevance and sustainability of non-communicable disease interventions, support evidence-based decisions, and identify required changes.[22]It uses a Common Results and Accountability Framework that integrates information from relevant sectors to improve efficiency, transparency and accountability at national and county levels.[22]

• Measure progress through fifteen high-impact indicators aligned with World Health Assembly 2025 targets, the World Health Organization Global Action Plan for Non-Communicable Diseases and Kenya’s health-sector strategic plan.[23]
• Track implementation through routine data, service statistics, expenditure returns, periodic performance reviews, surveys, special research and assessment of service coverage, outcomes, access and impact.[22][24]
• Apply weekly surveillance reports, monthly facility reports, quarterly health-data reviews, annual work plans and annual performance reviews, with surveys and assessments undertaken periodically as required.[24]
• Conduct annual data-quality audits and review strategy implementation annually, at mid-term and at end-term.[22]A mid-term review and end evaluation are intended to assess achievement of strategic-plan objectives.[24]
• Disaggregate collected, analysed and reported data by sex and age to assess gender differences in programme benefits and impacts.[22]
• Strengthen surveillance through integrated electronic medical-record modules, disease-specific registries, standardised surveillance and patient-management tools, Kenya Health Information System reporting, annual burden estimates and routine data-quality audits.[25]

The monitoring and evaluation plan specifies the indicators to be tracked, collection methods and timing, responsible parties, and the frequency of collective programme-performance reviews.[22]Reporting responsibilities are distributed across health-system levels, including divisions, facilities, facility in-charges and the non-communicable disease department.[24]The department is responsible for maintaining an implementation-tracking plan recording recommendations and feedback from reviews and evaluations, while county support supervision monitors delivery.[22]

Accountability mechanisms include joint periodic data and performance reviews, common reporting tools and processes, implementation-work-plan tracking, private-sector reporting mechanisms, national and county resource-tracking tools, and annual resource-tracking and accountability exercises.[2][4][22]The framework also seeks social accountability through performance reporting, transparency, public awareness and participation in health decision-making.[1][3]

Output indicators are supported by defined baselines, targets, data sources and reporting periodicities, including sources such as coordination-committee records, county reports, National Health Accounts, Kenya Health Information System data, registries, surveys and policy documents.[12][15][28]Baseline indicators include government allocation to non-communicable diseases, risk-factor prevalence and raised blood pressure, with 2025 targets.[23]Selected service and outcome targets include 80% availability of essential non-communicable disease medicines and technologies, 50% cervical-cancer screening among women aged 25 to 49 years, 90% human papillomavirus immunisation among 10-year-old girls, and 50% preventive drug therapy and counselling coverage for eligible people at risk of heart attacks and strokes.[29]

The previous 2015–2020 strategy’s end-term assessment monitored 109 activities: 19 were achieved, 75 partially achieved and 15 not achieved.[30]This informed the successor strategy and highlighted the need for clearer prioritisation, specific indicators, process targets and a mid-term review.[31][32]

Costing & Financing

The strategy uses costing to support resource mobilisation and realistic annual budgeting for non-communicable disease interventions.[33][34]It estimates total financing requirements of 377 billion Kenya shillings over the plan period, using Activity-Based Costing and a bottom-up approach that connects input quantities, frequencies and unit costs to activities, outputs, objectives and the overall budget.[26]Where comprehensive quantification reports are unavailable, the One Health Model is used with strategic targets, published unit-cost data and expert interviews.[26]

• Compare required and available resources to identify financing gaps, although the supplied extract does not include detailed available-resource or gap tables.[34]
• Prioritise non-communicable disease interventions within Ministry of Health planning and resource allocation, including county commodity funds.[7][9]
• Strengthen affordability through pooled procurement, local manufacturing where feasible, stakeholder negotiations on price reductions, and national quantification and costing of essential health products and technologies.[7][19]
• Track resources and expenditure at national and county levels through resource-tracking tools and the National Health Accounts process.[4][15]
• Mobilise resources through national and county budget advocacy, donor engagement, public-private partnerships, civil-society collaboration and community-based mobilisation.[27]

The financing context includes poor national and county allocations, non-ring-fenced county health budgets, limited financial protection for people living with non-communicable diseases, shortages and affordability barriers for health products and technologies, and limited financing transparency and accountability.[35]The plan proposes advocacy through National Treasury and legislative budget processes, including advocacy for allocation of sin-tax revenue to non-communicable diseases.[27]

Non-communicable diseases are associated with a 28.6% reduction in household income and catastrophic expenditure that can reinforce poverty.[36]Interventions to mitigate this impact are estimated to require 17% of total health expenditure, or 11.97 dollars per person annually, described as an almost three-fold increase on current non-communicable disease expenditure.[36]The stated spending scope includes inpatient and outpatient care, mental health, surgery, palliative and rehabilitation services, and community and population prevention.[36]

The Common Results and Accountability Framework includes government allocation to non-communicable diseases as an impact indicator, with a 2020 baseline of 48% and a 2025 target of 60%.[23]Detailed budget allocations by activity, confirmed funding sources, expenditure ceilings and quantified funding gaps are otherwise not specified in the supplied excerpts.[22][23]