National Strategic Plan for the Prevention and Control of Non-Communicable Diseases 2021/22 - 2025/26

Objectives

Kenya’s National Non-Communicable Disease Strategic Plan 2021/22–2025/26 provides a five-year framework to halt and reverse the rising burden of non-communicable diseases through multisectoral collaboration, while ensuring accessible, affordable, equitable, quality and sustainable care across the continuum. Its vision is a nation free from the preventable burden of non-communicable diseases, and its goal is to reduce premature mortality from these diseases by one third by 2025.[1]

• Address cardiovascular diseases, cancer, diabetes, chronic respiratory diseases, mental health conditions, violence and injuries, blood disorders, neurological disorders, autoimmune and chronic renal diseases, chronic skin conditions, and oral diseases.[2]
• Reduce exposure to tobacco, harmful alcohol use, unhealthy diets and toxins, physical inactivity, indoor and environmental air pollution, other pollutants and stress through a life-course approach.[2]
• Apply five strategic pillars: sectoral and multisectoral coordination and governance; reduction of modifiable risk factors; health-system response; advocacy, communication and social mobilisation; and surveillance, monitoring, evaluation and research.[3]
• Strengthen coordination and governance, equitable management across the life course, advocacy and social mobilisation, and research, surveillance, monitoring and evaluation.[4]
• Align interventions with the constitutional right to health, the Health Act 2017, Universal Health Coverage, Kenya Health Policy 2014–2030, Sustainable Development Goals and Vision 2030.[5][6]
• Achieve specific 2025 outcomes including lower diabetes prevalence, overweight and obesity, raised cholesterol, suicide, serious injuries and road-traffic mortality, alongside improved cardiovascular prevention, cancer screening, vaccination, diabetes and hypertension control, and availability of essential products and technologies.[7][8]

Implementation

Implementation uses a whole-of-government, multisectoral and people-centred model spanning community, primary, secondary and tertiary care. The Ministry of Health leads the response with county governments, while communities, people living with non-communicable diseases, civil society, development partners, academia and private-sector actors participate in planning, delivery, monitoring and resource mobilisation.[1][9][10]

• Coordinate action through the National Non-Communicable Disease Steering Committee, the Non-Communicable Disease Intersectoral Coordination Committee, national and county health management structures, boards, committees and technical working groups.[10][3]
• Strengthen county coordination committees and technical working groups, maintain stakeholder databases, hold biannual steering forums, engage non-health sectors, operationalise work plans and establish a multisectoral information-management system.[3]
• Integrate prevention, screening, diagnosis, treatment, rehabilitation, palliative care and survivorship support into primary health care and Universal Health Coverage, supported by an essential non-communicable disease management package and an integrated primary health care model.[11][12]
• Build workforce capacity through training, deployment, retention measures, career pathways and optimised roles for nurses, allied professionals, community health assistants and community health volunteers, particularly in underserved areas.[13][11]
• Improve access to essential medicines, diagnostics, devices and assistive technologies through product-list reviews, quantification and costing, pooled procurement and price negotiations, pharmacovigilance, post-market surveillance and ring-fenced county commodity funds.[11][14][15]
• Deliver risk-factor action through legislation and fiscal measures on tobacco, alcohol, unhealthy foods, salt, trans-fats, sugar-sweetened beverages and environmental pollutants, alongside urban design, school, workplace, community and mass-media interventions.[16][17][18]
• Develop quality-improvement, telehealth, guideline and referral frameworks; establish county wellness centres of excellence and five additional regional comprehensive non-communicable disease centres by 2025.[11][19]
• Apply a Common Results and Accountability Framework with 15 high-impact indicators, baselines, targets and data sources; disaggregate reported data by sex and age; and undertake annual, mid-term and end-term reviews.[20][21]
• Strengthen surveillance through integrated electronic medical records, disease-specific registries, data tools, annual data-quality audits, population surveys and annual burden estimates.[22][23][24]
• Cost the strategy using Activity-Based Costing and the One Health Model, with a stated financing requirement of 377 billion Kenyan shillings over the plan period; quantify resource gaps by comparing required with available resources.[25][23]
• Mobilise resources through national and county budget processes, National Health Accounts, development-partner proposals, responsible private-sector engagement and advocacy for allocation of sin-tax revenue to non-communicable diseases.[26][27]

Monitoring & Evaluation

The Strategic Plan establishes surveillance, monitoring, evaluation and research as one of its five pillars, supported by a monitoring, evaluation and learning framework and a Common Results and Accountability Framework (CRAF) for tracking implementation, results and accountability.[9][4][21][20]

• Measure progress against 15 high-impact indicators in the CRAF, with specified baselines, targets, data sources, collection methods, responsibilities, frequencies and review timelines.[20][21]
• Track impact indicators and targets for 2025/26, including the overall goal of reducing premature mortality from non-communicable diseases by one third by 2025.[28][1][3]
• Monitor service coverage, outcomes, patient outcomes, investment outputs, access to services and impacts through routine facility reporting, surveillance reports, health-data reviews, expenditure returns and periodic surveys.[8]
• Submit weekly surveillance reports, monthly facility reports by the fifth day of each month, quarterly reports and health-data reviews, annual work plans by the end of June, and annual performance reports and reviews between July and November.[8]
• Conduct annual reviews, a mid-term review and an end-term evaluation, while using an implementation tracking plan to follow up recommendations and feedback.[21][22][23]
• Strengthen surveillance through integrated electronic medical records, disease-specific registries, surveillance and patient-management tools, annual facility data-quality audits, population surveys including the STEPwise approach to NCD risk-factor surveillance, and annual burden estimates.[21][22][29][24]
• Disaggregate collected, analysed and reported data by sex and age to support gender integration and identify gender-related effects of programming.[21][20]
• Apply accountability through transparent joint data and performance reviews, social accountability, performance reporting, public awareness, public participation, resource-tracking tools and annual resource-accountability assessments.[1][3][30][21]
• Use data from the Kenya Health Information System, the NCD Navigator tool, National Health Accounts, committee and county reports, policy documents, surveys, registries and named administrative sources.[31][32][33][34]

Key quantified targets include reducing diabetes prevalence from 1.9% to 1.7%, overweight and obesity from 27.9% to 25.8%, and serious injuries from 15% to 10% by 2025.[7]Other targets include increasing cardiovascular preventive drug therapy and counselling coverage from 6.2% to 50%, essential product and technology availability to 80%, cervical cancer screening to 50%, human papillomavirus immunisation among 10-year-old girls to 90%, and diabetes and hypertension control to 40% and 50%, respectively.[7][8]

The previous 2015–2020 strategy evaluation found that 19 of 109 activities were achieved, 75 partially achieved and 15 not achieved.[35]The Plan responds by strengthening specific, measurable, achievable, relevant and time-bound indicators, process indicators, dissemination and routine data collection and reporting.[36]

Costing & Financing

The Plan is costed to support resource mobilisation and adequate financing for non-communicable disease interventions, using Activity-Based Costing and the One Health Model where comprehensive quantification reports are unavailable.[37][6][25]The reported total financing requirement is 377 billion Kenyan Shillings over the plan period.[25]

• Estimate costs by strategic pillar, quantify total resource requirements, project financial resources by funding source and analyse financial gaps for both the Strategy and Strategic Plan.[28][38]
• Determine resource gaps by comparing required with available resources, although the supplied material does not quantify available resources or the resulting gap.[23]
• Increase the government allocation to non-communicable diseases from a 2020 baseline of 10.9% to a 2025 target of 20% under the CRAF.[20]
• Increase the health ministry budget allocation for non-communicable disease interventions from a 2015 baseline of 6.5% to planned allocations of 11.5% in 2021, 16.5% in 2022, 21.3% in 2023, 26.5% in 2024 and 31.5% in 2025.[39]
• Develop national and county resource-tracking and accountability tools, conduct annual resource tracking, and improve non-communicable disease representation in National Health Accounts.[30][33][27]
• Mobilise resources through national and county budget advocacy, medium-term expenditure framework and annual budget processes, development-partner proposals, private-sector partnerships, sin-tax revenue advocacy and county resource-mobilisation frameworks.[26][10]
• Reduce patient costs through pooled procurement, negotiations on product and technology prices, review of taxation and pricing policies, and ring-fenced county commodity funds.[11][14][15][40]
• Quantify and cost essential health products and technologies to inform supply planning and affordability measures.[14][15][40]

Non-communicable diseases are associated with a reported 28.6% reduction in household income and catastrophic expenditure that may contribute to poverty.[41][42]An intervention package to mitigate their impact was estimated to require 17% of total health expenditure, or United States Dollars 11.97 per capita annually.[42]

The supplied extracts identify financial transparency, inadequate national and county allocations, non-ring-fenced county budgets, limited financial protection and the lack of an essential chronic disease package as financing constraints.[31]They do not provide a complete currency-denominated budget breakdown, quantified available resources, donor contributions or a final monetary funding-gap value.[28][23]