Kenya National Strategy for the Prevention and Control of Non-Communicable Diseases

Objectives

Kenya’s National Non-Communicable Disease Strategic Plan 2015–2020 provides a five-year national and county framework to reduce preventable morbidity, mortality, disability, risk factors and related costs from non-communicable diseases, improve wellbeing across the life course, and contribute to sustainable socioeconomic development.[1][2][3]Its vision is a nation free of the avoidable burden of non-communicable diseases, aligned with Kenya’s health-reform agenda, Vision 2030 and a whole-of-government and whole-of-society approach.[2][4][3]

• Prioritise cardiovascular diseases, cancer, diabetes and chronic respiratory diseases, alongside their shared behavioural risk factors: tobacco use and exposure, harmful alcohol use, unhealthy diets and physical inactivity.[1][2]
• Address additional conditions and determinants, including haemoglobinopathies, mental disorders, rheumatic heart disease, oral and eye diseases, chronic diseases with infective origins, violence, injuries, environmental and occupational exposures, and biological and genetic risks.[1][5][6]
• Strengthen policy, legislation, regulation and multisectoral action so that non-communicable disease prevention and control are incorporated into national and county plans, budgets and relevant policies across sectors.[7][8]
• Promote healthy lifestyles and reduce exposure to modifiable risks through measures on food environments, physical activity, tobacco control, harmful alcohol use, violence and injury prevention, and environmental and occupational health.[9][10][11][12][13]
• Strengthen health systems to provide prevention, screening, early diagnosis, treatment, referral, rehabilitation, palliative care, essential medicines, basic technologies and chronic-care services, particularly through primary health care.[14][15][16][17]
• Advance monitoring, evaluation, research, surveillance, advocacy, communication, social mobilisation, networks and partnerships as core strategic functions.[18][19][20][21]

The plan seeks to domesticate global voluntary targets, including a 25% relative reduction in premature mortality from cardiovascular diseases, cancer, diabetes and chronic respiratory diseases by 2025.[2]The monitoring framework also includes a 2020 target of a 20% relative reduction in premature mortality from these conditions, together with targets for tobacco use, salt intake, harmful alcohol use, insufficient physical activity, diabetes and obesity.[22][23]Equity, human rights, community empowerment, action on social determinants, evidence-based delivery and protection from undue vested interests are identified as guiding principles.[3]

Implementation

Implementation combines integrated, people-centred and cost-effective interventions at individual, community and population levels, with action distributed across national, county, sub-county and community structures.[24][2][4]The delivery model integrates non-communicable disease prevention and control into existing primary health-care platforms and programmes, including community health, maternal and child health, school health, disease surveillance, HIV, tuberculosis and malaria services.[2][25][26]

• Coordinate national and county action through an NCD Inter-Agency Coordinating Committee, a national prevention and control Steering Committee, thematic technical working groups, focal units and focal persons at all levels.[27][28][25]
• Assign national government functions for policy formulation, review, resource mobilisation, national planning, monitoring and evaluation, while assigning county governments responsibility for local prioritisation, resource allocation, county planning and partnership development.[29][30]
• Engage health and non-health ministries, county health departments, development and implementing partners, civil society, communities, patient groups, academia, research institutions, private providers, regulatory agencies and the media.[31][28][32]
• Implement risk-factor measures through legislation, taxation and pricing where applicable, food and tobacco regulation, public awareness, school and workplace programmes, community initiatives, smoke-free environments, cessation support, alcohol rehabilitation and injury-prevention services.[10][11][12][33][34]
• Develop and disseminate clinical guidelines, treatment protocols, wellness policies, referral strategies and palliative-care arrangements; strengthen workforce numbers, skills, curricula, equipment, technologies, medicines and supply systems.[14][15][35][17]
• Strengthen legal, policy and protective programmes addressing environmental, occupational, biological and genetic risks in workplaces, public settings and homes, including vaccination, screening, early detection and treatment for infection-related risks.[6][18][36]

Monitoring and accountability are intended to use locally adapted targets and indicators, standardised tools, health-information-system reporting, disease and risk-factor surveys, situational analyses, periodic strategic-plan reviews, supportive supervision, review meetings and information-sharing platforms.[37][38][39]Surveillance and research should include epidemiological, behavioural, biomedical, clinical and health-system evidence, with data disaggregated by age, sex, socioeconomic status and geographical location to support equitable resource allocation.[19][40]Specified measures include mortality, cancer incidence, tobacco use, alcohol consumption, physical activity, blood glucose, body weight, dietary intake, cholesterol, service access, medicine availability and budget allocation indicators.[22][23][41]

Financing is to be supported through inclusion of non-communicable disease initiatives in national and county fiscal budgets, sustainable universal-health-coverage mechanisms, use of sin-tax revenue, public-private partnerships and collaboration with development partners.[29][15][27]The supplied material does not provide a total implementation budget, monetary allocations, quantified funding gap or detailed cost assumptions.[15][28]

Monitoring & Evaluation

The strategy establishes monitoring, evaluation, surveillance and research as core components of Kenya’s non-communicable disease response. It aims to track inputs, processes, outputs, outcomes, trends and impact, while using evidence to guide policy, implementation and equitable resource allocation.[18][37][19]

• Adapt the global non-communicable disease monitoring and evaluation framework to locally relevant targets and indicators, and integrate disease and risk-factor surveys into the national surveillance system.[37][38][39]
• Monitor progress against global voluntary targets, including a 20% relative reduction in premature mortality from cardiovascular diseases, cancer, diabetes and chronic respiratory diseases by 2020, as well as tobacco, salt, alcohol, physical-activity, diabetes and obesity targets.[22][23]
• Measure premature mortality using the probability of death between ages 30 and 70 from the four major non-communicable diseases, alongside cancer incidence per 100,000 population.[22]
• Use the Global Adult Tobacco Survey, Global Youth Tobacco Survey, STEPS survey, Kenya Demographic and Health Survey, national surveys and health records to monitor risk factors and outcomes.[22][23][41]
• Strengthen mortality information through improved vital registration, International Classification of Diseases, 10th Revision coding and certification, verbal autopsy where needed, and national cancer-registry rollout.[22]
• Improve reporting of non-communicable disease indicators in the District Health Information System and establish standardised monitoring tools, a central data repository and mechanisms to collect data not routinely captured by health-information systems.[42][6][37]
• Conduct baseline and periodic surveys, establish national and sub-national surveillance and research networks and reference centres, and disseminate findings for decision-making.[19][20][40]
• Disaggregate surveillance and research data by age, sex, socioeconomic status and geographical status to support equitable responses.[19]
• Review implementation through periodic strategic-plan reviews, integrated supportive-supervision visits, county and national review meetings, information-sharing platforms, committee reports and designated data-committee reporting.[37][39][40][25]
• Track governance and implementation through indicators such as county partnerships, inter-agency meeting records, policy reviews, dissemination outputs, fiscal-budget allocation measures, service availability, commodity stock-outs, workforce training and facility uptake of clinical guidelines.[28][43][32][35][17]
• Monitor risk-factor interventions through enforcement, periodic reports and activity indicators covering tobacco control, harmful alcohol use, healthy diets, physical activity, violence and injury prevention, environmental risks, advocacy and community mobilisation.[10][12][44][45][34][46][36][47]

Accountability is distributed across national and county governments, the Ministry of Health, coordinating committees, health departments, regulatory bodies, development partners and other stakeholders. National government holds responsibilities for policy review, monitoring and evaluation, evidence generation and dissemination, while county governments are expected to implement and resource local priorities.[29][30][28][48]

Costing & Financing

The strategy recognises that sustained, adequate and equitable financing, skilled personnel, medicines, diagnostic technologies, infrastructure, surveillance capacity and partnerships are necessary for non-communicable disease prevention and control.[24][42][15][19]

• Allocate non-communicable disease initiatives within national and county fiscal budgets and prioritise financing during the 2015–2020 implementation period.[29][28]
• Mobilise financial and technical resources through national and county governments, development partners, civil society, public-private partnerships and local and international collaboration.[24][29][27]
• Strengthen universal-health-coverage financing through innovative, sustainable and equitable mechanisms, including guidance for financing primary health-care delivery with non-communicable disease services.[15]
• Use sin-tax revenue mechanisms for non-communicable disease prevention and control, and apply tax, price, subsidy and other economic measures to discourage tobacco use and encourage healthier food and beverage choices.[10][15][45]
• Allocate resources for routine and periodic surveillance, research infrastructure, health-information systems, equipment, supplies and workforce capacity at county and national levels.[19][40]
• Address implementation constraints including inadequate resources for health promotion, limited workforce capacity, and poor availability and affordability of medicines and technologies.[42]
• Track financing through the proportion of the national health budget allocated to non-communicable diseases, the proportion of counties with a non-communicable disease budget, the proportion of budget allocated to surveillance and research, and the proportion of health budgets allocated to essential medicines and supplies.[28][17][40]

Support for development, printing, launch and dissemination came from the Kenya Red Cross, the International Association of National Public Health Institutes and the Ministry of Health/Centers for Disease Control and Prevention Cooperation Agreement.[31]The broader strategy acknowledgement also identifies the Ministry of Health and the World Health Organization among funding sources.[49]

No quantified implementation budget, programme costings, funding allocations, expenditure totals, funding gap or economic assumptions are provided in the supplied material.[15][19][28][40][41]